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Objectives Children who are HIV exposed but uninfected (CHEU) are at risk for poor neurodevelopmental outcomes. No study has examined autism in CHEU in Africa where most of these children live. Study objectives were to: 1) examine autism outcomes in CHEU and children who are HIV unexposed and uninfected (CHUU), and 2) to explore agreement among standard autism diagnostic measures.Methods To date, 104 children (54 CHEU, 50 CHUU) ages 24-48 months (mean: 2.73 years; n=54 females), were recruited from a longitudinal study of >850 children. Children and their caregivers participated in an evaluation conducted by research-reliable personnel in which Swahili-translated Autism Diagnostic Observation Schedule (ADOS-2), Toddler Autism Symptom Inventory (TASI), and Social Responsiveness Scale (SRS-2) were administered. Autism diagnostic outcomes were confirmed by expert clinicians based on clinical judgment.Results Eight of 104 children (8%; n=3 CHEU; n=5 CHUU) had an autism outcome. No group (CHEU/CHUU) differences were found among ADOS-2 Total or Social Affect domain, TASI, or SRS-2 Total scores (all p >.05). There was a trend toward higher ADOS-2 Repetitive Behavior domain scores (p=.05) in CHEU. Across groups, total scores on all measures were significantly correlated (p <.01). There was fair categorical autism agreement (κ=.30) between ADOS-2 and TASI and poor agreement (κ=.10) between TASI and SRS-2 scores.Conclusions Preliminary results demonstrate: 1) elevated autism prevalence CHEU and CHUU, and 2) agreement between observational and caregiver-report measures may be limited. Investigation into how LMIC context and perinatal exposures influence autism phenotype is ongoing in this study.