Use of male champions to improve male involvement in HIV testing: the experience of the Malawi EMPOWER activity

BACKGROUND: Men living with HIV in Malawi have poor health-seeking behaviors, tend to present at clinics with advanced HIV, and have low viral load suppression rates. Research on men's barriers to HIV services and beneficiary engagement conducted through the USAID-funded Malawi EMPOWER activity, has demonstrated men's preference for male providers and for flexible and confidential service delivery models. EMPOWER's strategy to reach men provides education on HIV prevention behaviors, creates demand for HIV testing services (HTS), ensures that men know their HIV status, and encourages linkage to treatment and care for HIV-positive men. This abstract highlights how EMPOWER contributed to reaching more men with these services.
METHODS: EMPOWER reaches priority populations such as estate workers, fisherfolk, and male partners of adolescent girls and young women using targeted one-on-one and small group sessions on risk reduction. To encourage male participation and provide them with services, EMPOWER used trained male champions who are members of these populations. In addition, EMPOWER's community-based testing approach brings HTS closer to men, at times and locations that are convenient for them. To understand the contribution of this approach, EMPOWER analyzed program data for HTS from April to September 2020
RESULTS: During the period under review (April'September 2020), the total number of men tested increased from 41 in Q3 FY20 to 1,034 in Q4 FY20. In Q4, men accounted for 47% of the quarterly target. In addition, the number of men newly tested HIV-positive increased from 22 in Q3 FY20 to 84 in Q4 FY20, demonstrating an improvement in the targeting of men at high risk of HIV.
CONCLUSIONS: Use of male champions and bringing HTS to men is a promising strategy for increasing male participation in HIV prevention and testing services.