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OBJECTIVE: To assess the validity of oral mucosal transudate (OMT) specimens for HIV testing in children using enzyme-linked immunosorbent assay (ELISA). METHODS: A cross-sectional descriptive study was conducted asThe overall sensitivity of OMT specimens for HIV part of a community-based behavioural and HIV sero-status survey testing in children using ELISA was low. Stratifying the analysis of adults and children in the Chimanimani district of Zimbabwe. by sector showed that OMT samples are good specimens for HIV Dried blood spot (DBS) and OMT samples were collected from testing. It is important to note that factors such as the low HIV children aged between 2 and 14 years, inclusive. Both samples were prevalence in our study population, quality of the OMT, diet and tested for HIV using the Vironostika Uniform II plus O kits. The oral hygiene could have influenced the results. main study outcomes were the sensitivity and specificity of OMT samples, with DBS as the gold-standard specimen. RESULTS: Paired DBS and OMT specimens were available from 1 274 (94.4%) of the 1 350 children enrolled. Using the DBS, HIV prevalence was 3.2%. Overall sensitivity of OMT was 48.8% (95% confidence interval (CI) 33.3 - 64.5), and specificity was 98.5% (95% CI 97.7 - 99.1). CONCLUSION: The overall sensitivity of OMT specimens for HIV testing in children using ELISA was low. Stratifying the analysis by sector showed that OMT samples are good specimens for HIV testing. It is important to note that factors such as the low HIV prevalence in our study population, quality of the OMT, diet and oral hygiene could have influenced the results.