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Malawi: Social contacts critical for identifying new HIV diagnoses

Monday, 6 January, 2014

People recently diagnosed with HIV were three times more likely to refer someone who will test positive for HIV, compared to the general population in Malawi, according to a recent study published in Journal of Acquired Immune Deficiency Syndromes. The research shows that social contacts of people living with HIV (PLHIV) are key to identifying those who are HIV positive and unaware of their status in Malawi.

Malawi is greatly affected by the HIV epidemic – an estimated 910,000 people are living with HIV, and AIDS is still the leading cause of death for adults (UNAIDS (2012) ‘Global Report 2012: AIDSinfo’). The government has done well to increase access to HIV services in recent years, however according to the researchers, around 11 percent of Malawian adults are living with HIV, with nearly a third remaining undiagnosed.

Three groups of people were recruited for the study. One group comprised of people newly infected with HIV, a second group comprised of people infected with an STI, and the control arm – a group of people uninfected with HIV or an STI. Each group were asked to recruit five people from their general network of family, friends, neighbours or sexual partners. Of the contacts referred by PLHIV, 31 percent were HIV positive, compared to only 11 percent among the control group. This means that for every new HIV diagnosis, eight contacts from one PLHIV were needed, 10 contacts from an STI patient, and 18 contacts from the general population.

The findings show that people who engage in risky behaviours are more likely to be in the same social groups. The researchers stated: “we demonstrated that asking STI patients to recruit their social contacts was a feasible, effective and efficient way of identifying this group”, and they hope that the findings could be translated into a strategy for reaching undiagnosed and hard-to-reach cases of HIV in the country.

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