Abstract: Objective To explore the early diagnosis actuality of HIV exposed infant in Guangdong province, in order to provide reference to improve the work in Guangdong.Methods HIV exposed children who born in July 2014 to September 2017 in all levels of delivery institutions in Guangdong were follow-up and monitored. Dried blood spots (DBS) were collected and determined by Abbott real-time qualitative detection of HIV-1 amplification test when the babies were 6 weeks old, and collected the second DBS immediately or 3 months old when the results were positive or negative. SAS and SPSS were employed for difference examination of test situation by years and test results.Results During the study period, there was a total of 1242 tests, and the proportion (42.11%, 523/1242) of test samples in 2016 was the largest. The pairwise compare of nonparametric tests showed that it took the longest time for samples received to tested in 2014 (12.5 days), and followed by 2017 (5 days). It took the longest time for samples test to result feedback in 2014 (0.5 days). Of the 680 children who underwent the first early diagnosis, 562 underwent the second early diagnosis (82.65%, 562/680). The positive rate of the first early diagnosis was 3.38% (23/680), and the positive rate of the second early diagnosis was 4.09% (23/562). The first early diagnosis was started at age of 44 days, and the second was 95 days. The second diagnosis age of children tested positive for first diagnosis was 84 days. The paired chi-square analysis showed there was no difference between the first and second early diagnosis. The consistent rate of the two early diagnosis test results was 99. 64%.Conclusions The early diagnosis strategy is conductive to early detection of HIV infected children, and the twice tests are conductive to further detect of missed diagnosis or newly infected children from those with negative results in first test. As the program deepening and perfection in Guangdong, the normative early diagnosis service could provide to HIV exposed children and could ensure the safe and timely circulation of specimens and information. However, the second test time was hysteretic while the first test results were positive, which remains it is necessary to strengthen the standardization.