In July this year, Malawi conducted what has become an annual event - a Voluntary Counselling and Testing (VCT) Week. Over the course of the week, 185,000 people tested at VCT centres throughout the country, almost double the number who tested in 2006.

But according to Marjorie Ngaunje, Malawi's minister of health and population, while the turn out for the VCT week was high, the number of young people who tested was disappointingly low.

Malawi's national HIV infection rate for adults is estimated at 14.4 percent, with prevalence much higher in urban areas than in rural. According to Malawi's National AIDS Commission (NAC), a body mandated by the government to coordinate and mitigate the impact of the epidemic, more than half of new HIV infections occur in young people aged between 15 and 24, with young women far more likely to become infected than young men.

“The youth are a window of hope for the future and that future starts now with them as active participants in VCT," said Ngaunje. "We need a generation that knows their HIV status to inspire others and the nation as a whole.”

What the youth say

From random interviews conducted in and around Blantyre, young people cited HIV/AIDS-related stigma and fear of the unknown as their main reasons for not wanting to test.

Charles Gama, a high school student, said he would rather live without knowing his HIV status than be subjected to stigma and discrimination if it was discovered he was HIV positive. “I know of a case where a woman was found with the virus in our village and nobody wanted to be associated with her. Parents told their children not to eat anything from her house,” Gama told IRIN/PlusNews.

Another young man, who works at a clothing factory in Blantyre and did not want give his name, said he had had a number of sexual relationships and was unsure of his status. One of the girls he had been involved with died of tuberculosis two years ago. He suspected it was AIDS-related.

Edith Phiri, 18, from the populous township of Ndirande in Blantyre said she had thought about going for VCT but could not overcome her fear of being declared HIV positive. “It would ruin my world,” she said.

Memory Njakale, 21, is one of the brave ones. In May this year she went to a VCT clinic and walked out of the testing room smiling broadly. She had been diagnosed HIV negative. “I was so happy I tested negative," she said. "I can now plan better for my future.”

Living in a country where the social, cultural and economic status of women and girls makes them especially vulnerable to HIV/AIDS, Njakale had every reason to smile, but she said fear of the unknown caused many young people to live dangerously while telling themselves, “after all I won’t be the first one to catch the virus”.

Youth ‘unfriendly’ services

McBain Mkandawire, executive director of YouthNet and Counselling (YONECO), an organisation aimed at addressing the social injustices and reproductive health issues affecting women and children, said stigma and a lack of support services for people living with HIV had negatively impacted VCT uptake.

“There are a number of calls for testing and yet there is limited advocacy to stop the stigmatising of those with HIV and AIDS,” Mkandawire observed.

Through recent research, YONECO discovered that a significant number of HIV positive youth who experienced stigma and discrimination suffered from mental illness. Young people also expressed concern about inadequate post-test counselling and support and the difficulty of accessing treatment.

Testing services often failed to take into consideration the special needs of young people, Mkandawire said. “There is need for a strategy that could attract young people to go for VCT.”

Maxwell Matewere, executive director of Eye of the Child, another NGO which deals with issues affecting the youth, agreed there was an urgent need to find approaches for "wooing" young people to test. “Entertain the youth with live bands and music for instance, and the numbers will increase,” he suggested.

Arnold Kabisala, communications manager for Active Youth in Development Organisation (AYIDO), which works to raise HIV/AIDS awareness among the youth, said there had been a lot of rhetoric calling on young Malawians to get tested, but little action. He urged government to take the lead in creating a conducive environment for halting the spread of HIV among the youth.

“Programmes must take into account the fact that the majority of people infected and affected are women and young people. Therefore empowering them and recognising their rights must be a central feature of government’s programmes,” Kabisala said.