Hiv recent infection and past hiv testing history among newly hiv-diagnosed 15-24-year-olds in malawi: an analysis of 2019-2022 hiv recent infection surveillance data

Awareness of HIV status in Malawi is 88.3% and lowest among 15- 24- year-olds (76.2%). There is a need to understand HIV testing history and transmission in this age group. We analyzed pooled HIV surveillance data to describe testing history and HIV recent infection among 8,389 HIV- positive 15-24-year-olds from 251 sites in Malawi between 2019 and 2022. Most HIV- positive 15-24-year-olds were female; aged 23- 24 years; rural residents; and diagnosed at voluntary counseling and testing. No prior HIV testing was reported in 43.5% and 32.9% of 15- 19- year-olds and males, respectively. Overall, 4.9% of HIV-positive diagnoses were classified as recent HIV infections, with the highest proportions among breastfeeding women (8.2%); persons tested at sexually transmitted infection clinics (9.0%); persons with a prior negative test within 6 months (13.0%); and 17-18-year-olds (7.3%). Tailored and innovative HIV prevention and testing strategies for young adolescents, young males, and pregnant and breastfeeding women are needed for HIV epidemic control.