Not Too Late: Overcoming Barriers to Access HIV/TB Prevention and Care Services for Young People by Reducing Late Diagnoses

In Malawi, AIDS and tuberculosis (TB) remain among the leading causes of death, according to the World Health Organization (WHO, 2023). Data from UNAIDS and the Malawi Ministry of Health indicate that in 2023 there were approximately 992,000 people living with HIV, with a prevalence rate of 4.7%, rising to 5.7% among women, and an incidence of 0.7 per 1,000 people. Adolescent girls and young women (AGYW) are particularly affected, accounting for 29% of new infections in 2023, while sex workers represent 7%.

Social, cultural and religious barriers limit women’s access to prevention and care services, exacerbating gender inequalities. In addition, the fragility of the health system—especially in rural areas—hinders timely access to care, leading to late diagnoses and reducing the effectiveness of treatment. This increases the risk of co-infections and mortality.

The Not Too Late project aims to overcome barriers to access HIV and TB prevention and care services among young people, reduce late diagnoses and contribute to the elimination of HIV and TB in Malawi. The initiative focuses on promoting equity in healthcare services, improving gender equality and strengthening human rights in the districts of Balaka and Blantyre.

Activities and Expected Results

• Improved access to services for women, AGYW and key vulnerable populations (KVPs);

• Engagement of community and district authorities to bring services closer to the population;

• Organisation of youth-dedicated days at health facilities to improve treatment adherence;

• Strengthened identification of late diagnoses in the target districts;

• Epidemiological research to identify the most vulnerable groups and optimise testing and prevention strategies;

• Training of healthcare workers and Peer Counsellors to enhance skills for delivering integrated and differentiated services using a youth-friendly and gender-sensitive approach.

Through these actions, the project aims to ensure a more equitable and effective health response, reduce inequalities and improve the quality of life of people affected by HIV and TB in Malawi.