Background:Malaria remains a major public health problem in the world with high burden of therndisease in sub-Sahara Africa, mostly affecting children. Malaria accounts for high proportion ofrnmorbidity and mortality in Ethiopia and in East Shewa Zone of Oromia Region. To reduce this burden,rnearly presentation and management is one of the priorityarea. Malaria diagnosis based onrnparasitological confirmation using microscopy/rapid diagnostic testing (RDT), which have similarityrnwith human immune deficiency virus (HIV) test, is therefore increasingly advocated. However, concernrnof being tested for HIV can discourage community members from seeking biomedical solutions.rnObjectives:to assess concernsabout HIV testingin delaying early presentation and treatment seekingrnofchildren with malaria.rnMethods: A facility-based cross-sectional design comprising mixed quantitative and qualitativernresearch methods were conductedfrom October - November 2012 in five purposively selected healthrncenters of East Shewa Zone. The source population were children under the age of 16 years withrnmalaria symptoms in the districts and study population were < 16 years of age children who werernsuspected to have malaria and requested for malaria blood film test in the health center accompanied byrncaretakers. A total sample size of 836 (418 concerned and 418 unconcerned) mothers/caretakers andrntheir childenwere included in the study. A pre-tested structured questionnairewas used and all clientsrnwere interviewed until the intended sample size was achieved. Data were entered using Epi-info versionrn3.5.3 and analysis was carried out using SPSS-16 statistical packages.Associations between dependentrnand independent variables were assessed and presented using odds ratios and 95% confidence intervals.rnQualitative data were summarized manually and the result was triangulated across the groups.rnResults: Of 830(412 concerned and 418 unconcerned with HIV testing) interviewedrnmothers/caretakers, about90% had knowledge on malaria and HIV diagnosis/testing and preventionrnwhile misconception on the two tests was also high. Nearly all(98%) of the concerned group thoughtrnthat health workers would do HIV testing for people who give their blood sample for malaria testing inrnthe health facilitycompared with only 4% of those unconcerned about HIV testing.About half(48%) ofrnthe concerned respondents believed that fear of HIV testing was the reason for people to stay awayrnfrom seeking early diagnosis and treatment while only 11%of unconcerned caretakers agreed with idea.rnAbout 48% of children presented to health centers after 2 days of illness.Laboratory confirmed prevalencernof malariaamong study children was 20.5% with P.vivax constituting 57% and P.falciparumrn41%.rnixrnMothers/caretakers concern about HIV testing was independent predictor of malaria treatmentdelayrnamong sick children [Adjusted odds ratio (AOR) = 1.84; 95% CI= 1.40-2.44].rnConclusions:Concern about HIV testing among the mothers/caretakers was associated with delay inrnpresentation and treatment of children at health centers,and nearly half of the children were broughtrnafter two days of illnesses onset. High knowledge of malaria and HIV testing observed,yetrnmisconceptions was also high.Moderate malaria prevalence with P.vivaxwas observed in healthrnfacilities. Therefore, removing fear of HIV testing in the community and improving early treatmentrnseeking behaviorfor malaria through delivery of appropriate and tailoredinformation, designing a betterrnstrategy and implementation by responsible bodies is recommended.