With more than 30 years into the HIV/AIDS epidemic, Malawi faces numerous prevention challenges similar to those in other Sub-Saharan countries. An HIV prevalence of 8.9% points to very high incidence among most at-risk groups and, increasingly, to substantial levels of transmission in the general population. Nearly one million Malawians aged 15 years and older are living with HIV. FHS plays an important role in HIV prevention and treatment through various interventions including condom distribution, voluntary medical male circumcision and provision of antiretroviral therapy (ART) treatment.

Condom Social marketing

FHS’s role is twofold within the total condom market in Malawi: 1) facilitating the government’s free condom and lubricants distribution supply chain management, as well as 2) distributing socially marketed male and female condoms. FHS promotes Chishango (male condom) brand targeting sexually active young males, and Care (female condoms) offering an alternative, female-initiated option in condom use. Since its introduction, over 250 million Chishango condoms have been sold and the brand continues to enjoy national wide coverage with 74% share of the paid market and 25% share of the total condom market in Malawi.

VMMC

Since 2012, FHS provides voluntary medical male circumcision (VMMC) services using both mobile service delivery and static sites. To date, the VMMC program has done xxxxx male circumcisions with support from USAID PEPFAR. FHS’s VMMC interventions are built on local capacity to deliver VMMC services and serve as a model to inform VMMC scale up in Malawi.

Decentralized ART Distribution in Private clinics.

Malawi has made impressive gains in the fight against HIV, with the UNAIDS Spectrum estimating the country at 91-87-94 on 95-95-95 UNAIDS goals. However, as the absolute number of people living with HIV (PLHIV) on ART grows, the Malawi program will increasingly be challenged to retain the PLHIV’ s on treatment. To help address the ART adherence challenges in Malawi, FHS in collaboration with FHI360 and through the EpiC project is utilizing the private health sector to provide ART. The Epic DDD utilize the hub and spoke model that maps private clinics to public facilities, where stable ART clients at hub public health facilities are encouraged to access drug refills at an accredited DDD private clinic. DDD private clinics provide convenient access to ART refills and PrEP. The ultimate objective of the DDD model is to help decongest the hub public facilities and present convenient platforms to get ART drug refills and PrEP.

Flip the Script Project - # Nditha Campaign.

Awareness of HIV treatment’s benefits, especially its ability to prevent onward transmission of the virus is low in sub-Saharan Africa. Rather than being seen as the solution to HIV infection, ART is seen as a sign that one has HIV and is thus associated with HIV-related stigma. As a result, many PLHIV lack a strong motivation to start or stay on ART and adherence across the region is uneven. FHS, together with its key stakeholders, rolled out a treatment literacy campaign branded # ICAN and in local language # Nditha! The campaign aim to increase uptake and ongoing use of anti-retroviral treatment (ART) by focusing on the benefits of treatment from the patient’s perspective.