HIV surveillance is conducted in selected antenatal clinics in Malawi on a regular basis. Initially the surveillance was conducted once every year but from 2001 the surveillance is conducted once every two years. The main objective of the survey is to provide data for monitoring HIV and Syphilis trends in Malawi. The surveillance targets pregnant women that come for their first ante-natal care visit. These are tested for Syphilis and residual blood from syphilis testing is dried on a filter paper and sent to Community Health Sciences Unit reference laboratory for HIV testing. In 2010 sample collection started on 13th September and ended in mid-December.

Data entry and cleaning were done using Microsoft Access for windows. Analysis of the data was done using STATA to calculate HIV prevalence rates and other important demographic factors. Spectrum was used to project and estimate the national HIV prevalence in the general population and to estimate ART needs.

The overall median HIV prevalence was 10.8% which is lower than the 2007 prevalence (12.6 %). The prevalence ranged from 1.3 % in Kamboni health centre in Kasungu to 25.2 % in Thyolo District hospital. In 2007 the prevalence ranged between 2% in Nthalire health centre in Chitipa and 25 % in Thyolo district hospital. Thyolo district has maintained the highest prevalence for the last two sentinel surveillance surveys. The Southern region has maintained the highest prevalence rate at 15.0% followed by the Central and northern region showed a similar HIV prevalence of about 9.0

However the overall prevalence has declined in all the regions. Prevalence according to health zones has indicated that the South West Zone has the highest prevalence (15.6%) with the lowest being the Central East Zone (6.7%). The urban sites have a higher prevalence (13.4%) than the rural sites (8.7%).

Number of marriages, locality of residence, and region of residence were some of factors that were associated with HIV prevalence.

Syphilis prevalence was 1.2% which is the same as the 2007 prevalence (1.1%). The prevalence ranged from 0% to 7.6 % in 2010 while in 2007 it ranged from 0% to 12.7%.

Using Spectrum and taking into account DHS data, gender differences, and ART and PMTCT program coverage we estimated that in 2010 national HIV prevalence was 10.5% (C.I 9.0-11.0) among those aged between 15 and 49 years. The number of people living with HIV was estimated at 923058 in 2010 of whom 180,972 are aged less than 15 years. A projection of these figures showed that in 2011 the number of people living with HIV was 917,407 of which 176,033 were aged less 15 years. It was also estimated that 287, 918 HIV positive adults and 106,490 were in need of ART in 2010 while for 2011 ART needs were estimated at 389,968 and 100,464 for adults and children respectively.