HIV testing is free in Malawi, but users may still incur costs that can deter or delay them accessing these services. We sought to identify and quantify these costs among HIV testing service clients in Malawi. We asked residents of communities participating in a cluster randomised trial investigating the impact of HIV self-testing about their past HIV testing experiences and the direct non-medical and indirect costs incurred to access HIV testing. We recruited 749 participants whose most recent HIV test was within the past 12 months.
Over the last three decades, a range of biomedical and behavioral approaches have dramatically reduced HIV incidence throughout the world and improved the quality and availability of life-saving treatment for those living with HIV. Yet HIV remains a major public health issue and the leading cause of adult death in sub-Saharan Africa.