Confidence Banda

Evaluation of the 3 Test HIV Algorithm And Scan Form Technology: Joint Qualitative Study.

Malawi uses a 2 – test HIV testing algorithm; once a client tests positive, they are instructed to return for positive confirmatory testing to confirm their HIV status; only two consecutive reactive tests can provide an HIV positive diagnosis. Due to the decline in the total number of undiagnosed people living with HIV, the rates at which clients are falsely diagnosed as HIV positive are increasing as the percentage of undiagnosed people living with HIV decreases. In 2019, the WHO released updated guidelines on HIV testing services which included updated guidance on HTS algorithms.

The guidelines state, “In response to changes in the HIV epidemic, WHO encourages countries to move toward using three consecutive reactive tests to provide an HIV positive diagnosis as their treatment-adjusted HIV prevalence and national HTS positivity fall below 5%.” With Malawi’s population of undiagnosed people living with HIV at 1.3%, well under the WHO recommended 5%, it is encouraged that Malawi switches to a 3 – test algorithm to improve quality of care.