Malawi (2009): HIV/AIDS TRaC Survey among Evidence-based Targeted HIV Prevention (EBT Prev) Target Populations in Malawi. Round One.

Abstract

BACKGROUND & RESEARCH OBJECTIVES. More than 20 years into the HIV/AIDS epidemic, Malawi faces numerous prevention challenges similar to those in other East and Southern African nations. A high HIV prevalence of 12% points to very high incidence among most at-risk groups and, increasingly, to substantial levels of transmission in the general population. In March 2009, PSI/Malawi initiated a five-year Evidence Based Targeted HIV Prevention (EBT Prev) project designed to reduce the incidence of HIV in Malawi, by targeting prevention efforts at populations and settings with high risk behaviors. The purpose of the TRaC survey among these target populations is the identification and monitoring of key behavioral determinants in the target populations that are related to condom use and partner reduction including concurrency. DESCRIPTION OF INTERVENTION. The program will target the following high risk groups fishermen/women, plantation/estate workers and vendors. The program will deliver integrated, behavior change communications activities which includes interpersonal communications, peer education, targeted outreach communications, and mass media activities to promote condoms and partner reduction among the target groups. METHODOLOGY. Study sites were identified through the PLACE methodology, in partnership with key stakeholders, notably the Ministry of Health, HIV/AIDS Unit, and approved by USAID. The following sites were chosen: Lilongwe (Urban), Zomba rural (markets), Mwanza border, Thyolo and Mulanje (plantation area) and Mangochi district (lakeshore). Each site is presumed to be representative of local HIV/AIDS related attitudes and practices for the associated target group on a national scale. In mid-2010, PSI/Malawi conducted a cross-sectional, venue-based baseline survey designed to monitor trends in condom use and concurrent partnerships. Randomly selected vendors, plantation workers, and fisher men and women were sampled from the venues within the areas mentioned above. The participants were sexually active, aged 20-49 years, and provided consent. A total of 3,075 people were interviewed including: 1,034 vendors, 1,023 plantation workers, and 1,018 fishermen and women. Logistic regression was used to assess association between health behaviors and determinants. Socio-demographic characteristics were controlled for in the analyses