HIV Southern Africa - Status of the Epidemic

Status of the Epidemic in Malawi

Malawi has one of the highest prevalence rates in Southern Africa but there is wide regional variation – prevalence is 2-3 times higher in the Southern region (17.6%) than in the Central region (6.5%).
Malawi HIV Data at A Glance*

	Male	Female
PLHIV (2007)	350 000	490 000
New infections (2007)		86 905
Prevalence in young people (15-24 years) (2007)	24%	8.4%

*Epidemiological Fact Sheet on HIV and AIDS Core data on epidemiology and response Malawi 2008 Update, UNAIDS Regional Support Team Eastern and Southern Africa Tracking Universal Access www.unaidsrstesa.org/progress-universal-access#prevention

HIV Epidemic Trends
Adult HIV prevalence has been relatively stable in the last few years, going from 16.2% in 1999 to 14.4% in 2003 and 12% in 2007. Although prevalence may be stabilizing it is still at a high level and many new infections will continue. As in other countries there is feminization of the epidemic. HIV prevalence among sexually active adults is higher among females (13%) than males (10%) and young women are about 4 times more likely to be infected than young men.

HIV Prevalence Malawi 1990 to 2007 (Epidemiological Fact Sheet on HIV and AIDS Core data on epidemiology and response Malawi 2008 Update UNAIDS)

There are important socioeconomic trends in adult prevalence – levels are 1.7 times higher in urban than rural areas. Prevalence also increases with increased wealth and is highest (16.4%) in the highest wealth category.

HIV prevalence (%) by socio-economic characteristics in Malawi (age 15-49)*

	Women	Men	Total
Residence
Urban	18	16.3	17.1
Rural	12.5	8.8	10.8
Wealth
Lowest	10.9	4.4	8.3
Second	10.3	4.6	7.6
Middle	12.7	12.1	12.4
Fourth	14.6	11.7	13.2
Highest	18	14.9	16.4

*Malawi DHS, 2004 in Republic of Malawi National HIV Prevention Strategy 2009-2013 June 2009

Using prevalence in young people (15-24) as a proxy for incidence, Malawi has seen more than 25% decrease in prevalence in this group between 2000 and 2005 indicating prevention is having an impact on new infections. The majority (88%) of new infections are through unprotected heterosexual sex, but a significant portion (10%) are through vertical transmission and 2% are still through blood transfusions. Partners of clients of sex workers are most likely to be infected, along with men who have sex with men and partners of those who have high risk heterosexual sex. This information will feed into future targeted prevention strategies.