Despite gains made to decrease HIV viral load and recent advances in preventative options, reservoirs of infection remain. In Africa, rapidly expanding populations of vulnerable youth and young adults combined with threats of decreased donor funding creates further risks and urgency. The potential impact of emerging novel prevention products to significantly decrease acquisition of HIV infection is threatened by systems unable to support delivery and uptake, nor sustain effective use, of these products. These weak prevention delivery systems present a grave risk to the ability to address persistent pockets of infection and control HIV epidemics over the long-term.
The Blantyre Prevention Strategy (BPS) was co-developed with Malawi's government and a consortium of partners to support development of the optimal system for the sustained prevention of HIV infection that is fully embedded in local structures. The Ministry of Health chose District of Blantyre as the initial geography because it has the highest HIV incidence rate in country. Over five years (May 2020-April 2025), BPS will support strengthening and institutionalizing an innovative and data-driven HIV prevention delivery system at the district level that is equipped to detect and target risk, generate demand, effectively deliver prevention products and interventions, enable effective and sustained use of prevention products by the end user, and monitor performance and impact. Improved functioning of the HIV prevention cascade will result in an accelerated decline in HIV infections and long-term epidemic control.
Local insights and pathways for community-driven approaches are essential for developing an optimized system. BPS includes development of a data pipeline, is designed to provide a continuous process for generating local solutions to unique community challenges, networks and leverages private sectors, and applies human centered design and quality improvement to HIV prevention.