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Groundbreaking HIV Study Underway in Malawi

  • Lameck Masina

As in Malawi, Zimbabweans too can seek HIV testing at public clinics such as this one in Harare, June, 22, 2012.
BLANTYRE, MALAWI — European and Malawian researchers are conducting groundbreaking studies on the effectiveness of HIV self-testing as part of efforts to fight the virus that causes AIDS.

The five-year community-based research, which is the first of its kind to be conducted anywhere in the world, is focused on three densely populated areas of Malawi’s commercial capital Blantyre: Ndirande, Chilomoni and Likhubula.

Jointly backed by the London School of Hygiene and Tropical Medicine, the Malawi-Liverpool-Wellcome Trust Clinical Research Program and the Malawi College of Medicine, researchers say they want to see if self-testing for HIV will help combat the spread of AIDS by leading to earlier detection and treatment.

But critics say that self-testing, though well-intentioned, could pose hidden risks. In communities where HIV/AIDS retains strong associations with stigma and shame, critics say those who test positive without immediate access to counseling will face a potentially increased risk of self-destructive behavior or even suicide.

Malawi currently uses several strategies to encourage people to test for HIV, including door-to-door voluntary counseling, public testing facilities and prenatal clinics.

Statistics show that although between one and two million Malawians are tested each year, men remain reluctant to be screened for the virus.

"When women go to antenatal clinics, when they are expectant, they are usually tested, [but when] they go back to their houses and ask the men to come and test, they usually don’t come," said Augustine Choko, data manager at Malawi-Liverpool-Wellcome Trust. "So self-testing brings with it convenience, because a person can test at their convenient time because they've got the kit, but also it offers confidentiality."

Study participants are offered an oral self-testing kit and are given advice and instructions on where to go to get confirmatory testing and HIV care.

Regarding concerns about the potential dangers associated with self-testing, Choko says the statistics speak for themselves.

"So far we have no evidence suggesting that self-testing will increase the rate of suicide," he said. "We have at the moment done about 5,238 tests and we have recorded no suicides."

Concerns about suicide or other risks associated with self-testing have been mitigated by a community advisory board that alerts researchers to rumors and misperceptions about the study.

Choko says researchers have yet to decide if there will be a need to extend the study to other parts of the country or Africa after its completion in 2015.