Exploring HIV services needs of people at Lilongwe Central Market, Malawi

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Kamuzu University of Health Sciences
Reaching all people with HIV services, including those in the informal economy, is critical to meeting the UNAIDS goals of 95-95-95. However, people who sell in the market, prioritise their business over attendance at health facilities, inevitably limiting the services they can access if these services are not in their place of business. An exploratory qualitative study design was used to explore market traders' preferences for the type and delivery methods of HIV services at Lilongwe Central Market, Malawi. We conducted four Key informant interviews (KIIs), three with officers responsible for planning HIV services at both the District and Council levels, and one with a market chairman. Sixteen In-depth interviews (IDIs) were conducted with traders in different businesses at Lilongwe Central market. All interviews were face-to-face and were audio-recorded and later transcribed. Data were analysed thematically and was guided by the Differentiated Services Delivery framework. HIV services preferred by market traders include HIV testing, Antiretroviral Therapy, HIV awareness campaigns, and Condom’s dispensation. These services could be offered when the market is less crowded via a temporary shelter or mobile vans. Service providers can be both trained peers and health professionals depending on the service. To mitigate the stigma associated with HIV-specific services these HIV services should be offered in an integrated care setting. Therefore, to accelerate the achievement of UNAIDS 95-95-95 goals by 2030, HIV services should be available to all those who require them at times and locations that are convenient for them, through providers they have chosen and provided in an integrated manner to mitigate stigma. This necessitates the development of new approaches to closing gaps and the inclusion of under-served groups, such as traders, in markets.