The Population-based HIV Impact Assessment is a multicountry project funded by the United States (US) President’s Emergency Plan for AIDS Relief (PEPFAR) to conduct national HIV-focused surveys that describe the status of the HIV epidemic. The surveys measure important national and subnational area HIV-related parameters, including progress toward the achievement of the Joint United Nations Programme on HIV and AIDS (UNAIDS) 95-95-95 targets for 2025, and will guide policy and funding priorities.

MPHIA 2020-2021 was led by the Government of Malawi through the Ministry of Health (MOH) and the National AIDS Commission (NAC). The survey was conducted with funding from PEPFAR and technical assistance through the US Centers for Disease Control and Prevention (CDC). ICAP at Columbia University implemented the survey in collaboration with Government of Malawi at national and subnational levels. The Government of Malawi, local civil society organizations, and international development partners participated in steering committees and technical working groups to provide input on survey planning and implementation.

MPHIA 2020-2021 was a household-based national survey among adults (defined as those 15 years and older) that measured the status of Malawi’s national HIV response. Conducted from January 2020 through April 2021 (with a pause from April 2020 until March 2021 due to the COVID-19 pandemic), MPHIA 2020-2021 offered HIV home-based testing and counseling (HBTC) with return of results and collected information about households and individuals' backgrounds, and the uptake of HIV care and treatment services. This was the second MPHIA to estimate HIV incidence and prevalence among a nationally representative sample of adults and national and subnational-level viral load suppression (VLS), defined as HIV RNA <1,000 copies per milliliter (mL), among adults living with HIV. The first MPHIA was conducted from November 2015 through August 2016.

With its focus on measuring key biological endpoints in a nationally representative sample of the population, MPHIA 2020-2021 provides direct estimates of HIV-infection risk and burden, the effectiveness and population-level impact of HIV-related prevention, care, and treatment interventions implemented in the country, and Malawi’s progress toward the achievement of the UNAIDS 95-95-95 targets.