Results from Integrating Gender-Based Violence Services into HIV Care – a Case Study of Lighthouse Trust ART Clinic in Malawi

Introduction Gender-based violence (GBV) not only poses significant public health and human rights challenges but is also closely associated with HIV. GBV acts as a barrier to HIV prevention, testing, and treatment adherence, and fear of GBV inhibits disclosure of HIV status to sexual partners. In Malawi, where both GBV and HIV prevalence is high, integrating GBV services into HIV care is crucial. We describe the integration of GBV services into Lighthouse Trust’s ART clinics in Malawi, including screening, documentation, program implementation, and outcomes. Methods We conducted a retrospective analysis from January 2020 to September 2023. Data on cases identified, post-GBV services, and perpetrator demographics were collected from the GBV register. We used descriptive statistics to describe the program outcomes. Results We documented 7148 reported GBV cases from January 2020 to September 2023. Young women, particularly those aged 10-19, constituted a significant proportion of survivors. Psycho-social services were the most common type of service that was offered to GBV survivors (25%), followed by HIV testing (19%) and STI screening(18%). Perpetrators were mostly known to survivors or intimate partners of the survivor. Conclusion We successfully integrated GBV services into the Lighthouse Trust ART clinic, in close collaboration with the one-stop centers. Training healthcare providers enhanced support for GBV survivors, with a focus on increasing awareness, especially for minors. Recommended actions include improving access to services, confidentiality, and multi-sectoral collaboration to ensure comprehensive care aimed to create a safer, more dignified healthcare environment for all, particularly GBV survivors. Key Findings Teaser Key Message Key Messages and Implications to policy, program managers, donors etc ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The research was approved by the Malawi National Health Services Research Committee. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.