HIV/STI testing in the 2004 Malawi Diffusion and Ideational Change Project: what did we learn?

Philip A. Anglewicz, University of Pennsylvania
Li-Wei Chao, University of Pennsylvania
Agnes M. Chimbiri, University of Malawi
David Chilongozi
Irving Hoffman, University of North Carolina at Chapel Hill
Hans-Peter Kohler, University of Pennsylvania
Francis Martinson, University of North Carolina at Chapel Hill
Georges Reniers, University of Pennsylvania
Kirsten Smith, University of Pennsylvania

This paper reports on practical issues that arose during the collection of biomarkers for HIV and other sexually transmitted infections as part of a field study with a population-based sample of approximately 4000 respondents carried out in rural Malawi in 2004. We consider several practical issues: 1) integrating demographic and biomarker data collection; 2) ensuring that the collection of specimens is done ethically (e.g. privacy and confidentiality of respondents); 3) gaining the support of community leaders; 4) quality control of the specimens, which were sent to an urban laboratory (e.g. maintaining a cold chain where electricity may be erratic); reducing turnaround time for receiving results; shortages of supplies for testing. This paper is expected to be of interest to those planning field biomarker collection and to stimulate wider discussion of practical issues related to biomarker collection in developing countries.