Factors affecting viral load testing turnaround time in Malawi

Viral Load Testing (VLT) remains key in monitoring of HIV treatment. Despite being the gold standard test in disease monitoring, the tests face lengthy turnaround times in Malawi. With more people on ART, the demand for VLT has exponentially increased. Malawi faces a plethora of factors that enhance or hinder viral load testing. Some of the enlisted determinants and challenges include lack of molecular testing facilities, underutilization of GeneXpert machines for use in viral load testing, inconsistent specimen transport networks, procurement and supply chain management, and instrument downtime and functionality. These challenges have opened avenues for introduction of modifications to minimize turnaround times as would be desirable and eventually to reduce turnaround times and improve timely clinical management. This paper examines the status quo of viral loading testing in Malawi, highlights key areas affected by lengthy turnaround time in HIV management and presents recommendations on improving VLT turnaround time.