At a glance: HIV in Malawi

In 2020:

• 990,000 people with HIV 
• 8.1% adult HIV prevalence 
• 21,000 new HIV infections 
• 12,000 AIDS-related deaths 
• 86% people with HIV 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.

Did you know? 

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

Preventing HIV in Malawi focuses on: 

• condom provision 
• PrEP 
• voluntary medical male circumcision 
• prevention of mother-to-child transmission of HIV 
• supporting vulnerable children 
• addressing gender inequality 
• providing specific services for adolescent girls and young women 
• workplace HIV programmes. 

Did you know?

More than 98% of pregnant women with HIV received treatment to prevent mother-to-child transmission of HIV in 2020. 

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 cadres 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 
• 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, showing that a key focus should be on improved adherence support. 

Around a third 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 and 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.