Malawi Integrated HIV Program Report 2021 Q4

Program performance highlights by the end of September 2021 include:

• Scale-up of integrated HIV services had reached the following number of sites:
  • 727 static and 158 outreach HIV testing sites.
  • 783 (static) ART sites; 623 of these started at least one pregnant or breastfeeding woman.
  • 701 sites with HIV-exposed children in follow-up.
• 684,267 persons were tested for HIV by a trained provider and received their results; 125,567 (18%) accessed HIV testing for the first time; 535,955 (82%) were repeat testers and 22,260 (4%) of these received confirmatory testing (after having tested positive in the past). 19,453 (3.0%) clients received a positive result for the first time.
• A total of 130,070 people received 211,801 self-test kits; 107,165 (51%) of these were for use by the recipient and 104,633 (49%) for onward distribution to sex partners or other people.
• 18,888 (97%) of 19,548 blood units collected were screened for (at least) HIV, hepatitis B and syphilis.
• A cumulative total of 13,835 clients were referred for PrEP eligibility screening and 12,890 (93%) were found eligible. 11,221 (87%) were enrolled in PrEP and 7,631 (68%) clients were retained on PrEP at the end of the December 2021.
• 157,139 (95%) of 164,803 women at ANC had their HIV status ascertained; 8,367 (5%) of these were HIV positive. 135,464 (98%) of 144,231 at maternity had their HIV status ascertained 8,290 (6%) of these were HIV positive.
• 19,463 patients started ART this quarter; 88% were classified as asymptomatic / in WHO stage 1 and started under the “Test & Treat” policy.
• 898,132 patients were alive and on ART by end of December 2021.2 This means that 91% of the estimated 986,240 HIV positive population was on ART. ART coverage was 78% (42,771/ 54,742) for children and 92% (855,361 / 931,449) for adults.
• 87,938 (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 76% and 94%, respectively.
• 80% of adults and 81% of children were retained alive on ART at 12 months after initiation.
• Out of 893,136 patients on first line adult ART 853,785 (97%) had transitioned to TDF/3TC/DTG and only 1,571 (<1%) were on TDF/3TC/EFV.
• 9,001 6 (92%) of an estimated 9,798 HIV infected pregnant women in Malawi were on ART this quarter. 6,314 (70%) of these were already on ART when getting pregnant and 2,687 (30%) started ART during pregnancy/delivery.
• An additional 883 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.
• 7,747 (7%) of infants discharged alive from maternity were known to be HIV exposed, 7,465 (96%) of these received ARV prophylaxis (nevirapine).
• A total of 11,247 HIV exposed children were newly enrolled for follow-up this quarter; 11,186 (80%) of these were enrolled before age 2 months.
• Out of the total 986,240 estimated PLHIV by end December 2021: