The HIV epidemic in Malawi has affected every sector of the society to such an extent that it has been declared the single greatest challenge facing the nation today. Despite the country’s success in raising awareness in almost every corner of society, the number of new infections remain unacceptably high.

To address this challenge, The Malawi National Strategic Plan for HIV and AIDS (2015– 2020) has endorsed the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90- 90 Treatment Targets by 2020: for epidemic control by 2030, Malawi will by 2020 ensure that 90% of all people living with HIV know their status, 90% of all people with diagnosed HIV infection receive sustained antiretroviral therapy (ART), and 90% of all people receiving ART will have viral suppression.

HIV testing services (HTS) are the gateway to HIV care and treatment and are therefore the cornerstone to attaining the 90-90-90 targets. As Malawi strives to achieve universal access to ART, especially with the implementation of test and start, HIV testing services (HTS) represent an even greater opportunity for ART scale-up. Because of this, the newly revised HTS guidelines emphasize both increasing access and improving quality of HTS, ensuring all those tested receive the correct result.

These guidelines replace the previous HIV Testing and Counseling Guidelines (3rd edition, 2009); they describe and define basic minimum requirements for establishing, providing, and monitoring HIV testing services in Malawi. They are intended to assist health managers, clinical service providers, and HTS providers in developing and expanding HTS for people at risk of HIV infection as well as those requiring treatment, care and support.

HIV testing services remains integral in supporting efforts to reduce stigma and discrimination and promote openness in discussing issues of HIV and AIDS. As a coordinating institution for biomedical response to HIV, the Ministry of Health will continue to undertake its stewardship role through provision of guidelines to support service delivery.