The Government of Malawi has emphasized as priorities the identification of undiagnosed cases of HIV in the population, the expansion of access to HIV care and treatment, and the maintenance of high levels of adherence to antiretroviral treatment. One Community (One C) is the U. S. Agency for International Development’s flagship community-based response to Malawi’s HIV epidemic. Its primary objective is to support the government’s efforts to reduce new infections and to mitigate the impact of HIV, ultimately improving the quality of life for Malawians.
Project SOAR is conducting a rigorous evaluation of One C using a cluster stepped-wedge randomized design. In this design, clusters are randomized to when they initiate the intervention, rather than being randomized to the program or no program (controls). Repeated cross-sectional surveys are being conducted at different points of One C scale-up. The study is designed to measure the change in key outcomes for each targeted population overtime, which may be attributable to One C. Qualitative research is also being conducted to provide a more nuanced understanding of the impact of One C on targeted populations.
The results from this evaluation will be used to inform Malawi’s support strategies for at-risk populations, improve U. S. President’s Emergency Plan for AIDS Relief (PEPFAR) Malawi programming, and inform the national Malawian and global PEPFAR policy agendas for HIV prevention, care, and treatment. These findings will be particularly relevant given that Malawi has a generalized HIV epidemic and that One C targets high risk populations and areas.