Addressing the Blind Spot in Achieving Epidemic Control in Malawi: Implementing “Male-Friendly” HIV Services to Increase Access and Uptake

Description/Activities:  A differentiated service delivery model was designed and implemented in referral hospitals in rural settings. Male-friendly clinics provide integrated HIV, reproductive health, and NCD services during times that are more suitable for men; in this case, on Saturdays from 7:30 am-2:00 pm.  EGPAF supported health workers offer provider-initiated testing and counseling (PITC) in addition to routine screening for STIs, hypertension, and diabetes.  The services are exclusively for men and are run by male providers. To increase awareness of the services offered, health education advice is provided during routine outpatient service delivery. EGPAF conducted sensitization and mobilization through local radio stations and community announcements so that men in the community were aware of the male-friendly clinics.

What Makes the Intervention Unique/Different: EGPAF designed “male-friendly” services with input from MLHIV with male clinicians providing the services. To minimize stigma, men reported that integrating services for NCDs (specifically hypertension and diabetes screening) was important. The Malawi MoH already provide these services, so this represented a change in service flow rather than the introduction of new services. 

Impact Data:  EGPAF reported from May-December 2017, 1,827 men attended the male-friendly clinics at the three pilot sites, representing a mean of 228 male clients per month. Of the 1,827 male clients attending (May to December 2017):

  • 1,294 were eligible for testing
  • 94 percent (1216/1294) of clients received HIV testing 
  • 61 new positives were identified, representing an HIV positivity rate of 5 percent 

95% of the newly-identified HIV-positive clients were initiated on ART, with 56% starting on ART on the same day. While the national average HIV positivity rate is 3.1% (MOH, 2017), the mean HIV positivity rate at male-friendly clinics was 5%.