Geospatial Transmission Hotspots of Recent HIV Infection — Malawi, October 2019–March 2020
Carson Telford, Zaena Tessema, Malango Msukwa, Melissa Arons, Joe Theu, Fred Fredrick Bangara, Alexandra Ernst, Susie Welty, Gabrielle O’Malley, Trudy Dobbs, Vedapuri Shanmugam, Alinune N. Kabaghe, Helen Dale, Nellie Wadonda-Kabondo, Salem Gugsa, Andrea Kim, George Bello, Jeffrey W. Eaton, Andreas Jahn, Rose Nyirenda, Bharat Parekh, Ray W. Shiraishi, Andrea A. Kim, James L. Tobias, Kathryn Curran, Danielle Payne, Andrew F. Auld
Abstract
and HIV viral load testing (3,4). Among 9,168 persons aged ≥15 years with a new HIV diagnosis who received testing across 103 facilities during October 2019-March 2020, a total of 304 (3.3%) were classified as having a recent infection. Higher proportions of recent infections were detected among females, persons aged <30 years, and clients at maternal and child health and youth clinics. Using a software application that analyzes clustering in spatially referenced data, transmission hotspots were identified with rates of recent infection that were significantly higher than expected. These near real-time HIV surveillance data highlighted locations across Malawi, allowing HIV program stakeholders to assess program gaps and improve access to HIV testing, prevention, and treatment services. Hotspot investigation information could be used to tailor HIV testing, prevention, and treatment to ultimately interrupt transmission.