Malawi Integrated HIV Program Report 2022 Q1

Program performance highlights by the end of March 2022 include:

• Scale-up of integrated HIV services had reached the following number of sites:
  • 754 static and 227 outreach HIV testing sites.
  • 787 (static) ART sites; 626 of these started at least one pregnant or breastfeeding woman.
  • 716 sites with HIV-exposed children in follow-up.
• 717,316 persons were tested for HIV by a trained provider and received their results; 149,358 (21%) accessed HIV testing for the first time; 567,958 (79%) were repeat testers and 22,045 (4%) of these received confirmatory testing (after having tested positive in the past). 19,944 (3.0%) clients received a positive result for the first time.
• A total of 122,135 people received 202,946 self-test kits; 98,800 (49%) of these were for use by the recipient and 103,796 (49%) for onward distribution to sex partners or other people.
• 23,038 (92%) of 25,140 blood units collected were screened for (at least) HIV, hepatitis B and syphilis.
• A cumulative total of 21,550 clients were referred for PrEP eligibility screening and 19,687 (91%) were found eligible. 17,086 (87%) were enrolled in PrEP and 10,784 (63%) clients were retained on PrEP at the end of the December 2021.
• 167,127 (97%) of 173,413 women at ANC had their HIV status ascertained; 8,595 (6%) of these were HIV positive. 139,409 (95%) of 147,830 at maternity had their HIV status ascertained 8,361 (6%) of these were HIV positive.
• 19,687 patients started ART this quarter; 87% were classified as asymptomatic / in WHO stage 1 and started under the “Test & Treat” policy.
• 909,284 patients were alive and on ART by end of March 2022.2 This means that 92% of the estimated 985,346 HIV positive population was on ART. ART coverage was 78% (42,909/ 53,225) for children4 and 92% (866,375 / 932,121) for adults.
• 54,998 (93%) of viral load results from routine monitoring were <1000 copies/ml. Viral suppression rates for routine samples among children (0-14 years) and adults (15+ years) were 80% and 93%, respectively.
• 80% of adults and 81% of children were retained alive on ART at 12 months after initiation.5
• Out of 906,149 patients on first line adult ART 865,861 (97%) had transitioned to TDF/3TC/DTG and only 1,157 (99%) of an estimated 9,363. HIV infected pregnant women in Malawi were on ART this quarter. 8,573 (76%) of these were already on ART when getting pregnant and 2,753 (24%) started ART during pregnancy/delivery.
• An additional 684 breastfeeding women (re-)started ART in WHO stage 1 or 2.
• 86% and 82% of women started while pregnant or breastfeeding were retained on ART at 6 and 12 months after initiation, respectively.
• 7,871 (7%) of infants discharged alive from maternity were known to be HIV exposed, 7,554 (96%) of these received ARV prophylaxis (nevirapine).
• A total of 12,455 HIV exposed children were newly enrolled for follow-up this quarter; 10,250 (82%) of these were enrolled before age 2 months.
• Out of the total 985,346 estimated PLHIV by end March 2022: