At a glance: HIV in Malawi

• 1 million people with HIV
• 7.1% adult HIV prevalence
• 16,000 new HIV infections
• 12,000 AIDS-related deaths
• 930,000 people on antiretroviral treatment

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

In 2022 in Malawi:

Did you know? 

Although AIDS-related deaths have declined significantly in recent years, it remains the leading cause of death in Malawi (2019 data).

Preventing HIV in Malawi focuses on: 

• condom provision 
• PrEP (oral PrEP is available for high-risk groups; vaginal rings and injections are approved for use and injections began to be rolled out in two states in 2024) 
• voluntary medical male circumcision
• prevention of mother-to-child transmission (PMTCT) of HIV
• supporting vulnerable children
• addressing gender inequality
• providing specific services for adolescent girls and young women
• workplace HIV programmes.

Did you know?

Between 2010 and 2022 new HIV infections have fallen by around 66% in Malawi, suggesting the country is on track to end the AIDS epidemic by 2030. In comparison, the global average for reducing HIV infections since 2010 is 38%.

Testing for HIV is:

• possible via self-testing
• initiated by providers at antenatal clinics
• heightened via index testing, where partners of people with HIV are encouraged to test
• higher among women than men, and adults than children.

Did you know?

Malawi is scaling up active index testing and assisted HIV self-testing, using community-based health workers to help identify more people with HIV who don’t know their status.

Treatment for HIV is:

• free
• initiated as soon as someone tests positive (test and treat)
• a dolutegravir-based regimen, in line with the latest World Health Organization guidelines
• monitored by viral load testing (although waiting times to receive viral load test results are an issue)
• lower among children, young people and men.

Did you know?

It is estimated that around 85% of AIDS-related deaths are among people already on treatment. To address this, Malawi is focusing on increasing access to viral load monitoring, reducing the time it takes to get viral load test results and enhancing adherence support.

Around a quarter of HIV infections in adults are among young women aged 15-24. Women are almost twice as likely to have HIV as men. Around 50% of the population of Malawi is under 18 years old. Large age gaps in sexual relationships is one of the main drivers of HIV transmission between older men and younger women.

Malawi’s most recent HIV law no longer criminalises HIV transmission. But homosexuality is illegal. Although sex work is legal, other laws are used to harass and arrest sex workers. Abortion is legal but only to save a woman’s life.

Although PMTCT access is high, mother-to-child transmission of HIV still occurs. This is due to pregnant women presenting to antenatal services late, new mothers not being retested for HIV after birth, and more children getting HIV during breastfeeding rather than during pregnancy.

Although HIV-related stigma is an issue, attitudes in Malawi are less discriminatory than in other countries in the region. A recent study found around 18% of people in Malawi had discriminatory views about people with HIV, compared to 33% in Uganda.

Malawi recognises linkage to treatment and adhering to treatment as important parts of the country’s prevention strategy because effective treatment means the virus cannot be passed on.