Innovative Approaches Boost HIV Testing Rates


Malawi has a population of 18 million, with an adult HIV prevalence of 10.6%. The country has made remarkable progress toward achieving the UNAIDS 90-90-90 goals, achieving the first goal remains a challenge. The Malawi HIV program estimated Malawi’s progress on achieving the 90-90-90 goals at 88-78-86 by June 2017. The huge disparities seen in HIV prevalence by age, sex, and geographic distribution make the provision of one-size-fits-all interventions inadequate. Instead, Malawi needs targeted methodologies that are proven to be effective in achieving epidemic control. Success is not possible if some groups, such as youth or men, are left behind.

In 2015, the National AIDS Commission led Malawi in refocusing the National Strategic Plan for HIV and AIDS around the 90-90-90 targets. Based on evidence from other countries and taking into account the limitations of Malawi’s over-stretched health system, the District Health System Strengthening and Quality Improvement for Service Delivery (DHSS) Project introduced several initiatives to improve HIV testing coverage and maximize the yield of new HIV-positive diagnoses to accelerate progress toward the first 90. This technical brief describes the interventions implemented by DHSS to maximize HIV case identification.