Kate Rucinski, Johns Hopkins Bloomberg School of Public Health
Louis Masankha Banda, FHI 360

This blog post was originally featured on Infectious Diseases Society of America’s (IDSA) Science Speaks blog. To read the full blog post, click here.


Given the hard work of communities, government, academics and implementing partners, there have been significant decreases in HIV incidence over the last decade in countries across sub-Saharan Africa including Malawi. Targeted scale-up of HIV testing and antiretroviral-based prevention and treatment programs has increased the coverage of lifesaving services across the country. However, new infections haven’t slowed as much as had been expected based on projections from mathematical models. And this disconnect may be due to essential HIV services still being largely out of reach for populations that have historically been marginalized from the HIV response.

For key populations — including female sex workers, gay men and other men who have sex with men, and transgender women — a lack of friendly services combined with structural barriers such as stigma, discrimination and punitive legal policies have contributed to a high and sustained incidence of HIV, even in 2022. Our new study, published in Open Forum Infectious Diseases, examined one project’s attempts to help address some of these issues.

Read the full blog post here.