MTC transmission of HIV is a major public health challenge in Ethiopia; however there were a shortage of evidence on HIV sero status of exposed infants in Sidama zone, Southern Ethiopia. Therefore, this study aimed to assess, the HIV sero status and associated factors among HIV-exposed infants in selected public health facilities. A cross-sectional study was conducted in 14 public health facilities at Sidama zone SNNPR state, Ethiopia from May 1-30/2019Gc. Medical record cards of HIV-exposed

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... ants and their mothers enrolled from January 2014 to January 2018 was extracted using data extraction checklist. Magnitude and associated factors of HIV sero status of exposed infants was computed using SPSS version 21.0 software. A total of 203 HIV-exposed infants who had HIV DNA/PCR test results were included in the study. The overall prevalence of HIV among HIV exposed infants were nearly 9% (95% CI: 4.4, 12.8) Infants born from mothers' with baseline CD4+ counts of mother less than 350, (AOR=5.629; 95% CI: 1.454, 21.79), Mothers who had WHO clinical stage I and II, (AOR=4.975; 95% CI: 1.342, 18.446), and Poor ART adherence (AOR=4.302; 95% CI: 1.100, 16.823) had an increased odds of HIV infection comparing to their counterparts. Conclusion and recommendation: The prevalence of HIV infection among infants born to HIV infected mothers was high in the study area. Baseline CD4+ counts, WHO clinical staging, and ART adherences of mothers are associated with their infants HIV status. Therefore, stakeholders including health care workers working at PMTCT centers should make create awareness on the effects of poor ART adherence and undertaking further rigorous longitudinal studies are recommended.