Linkages Project

LINKAGES is a 5-year USAID funded key population project being implemented in Malawi. Pakachere IHDC is implementing the project in Blantyre and Mangochi Districts in Malawi. The project is implementing a set of interventions to reduce HIV transmission among Female Sex Workers (FSW) and improve the quality of life of FSW with HIV. The project is using activities that demonstrate marked improvements in access to and uptake of HIV testing, care, support and treatment services.

HIV Cascade Model

LINKAGES is using the HIV services cascade model that illustrates how individual should ideally move through the continuum of HIV prevention care and treatment services to reduce HIV transmission as well as ensure high quality of life. The project emphasizes interventions stages of reach, test and treatment services as key steps to ensure long-term ART adherence that results in viral load suppression.

Project Activities

Linkages adThe project is being implemented through a comprehensive package that includes Peer education, HIV testing services, Gender Based Violence (GBV) services and referrals, Condom and lubricants distribution and promotion of use, STI screening and management, Cervical cancer screening and referrals, Family planning services and TB screening. The package is delivered through 5 Drop in Centres, Moonlight and Daylight outreach Clinics and Hybrid clinics.

Our Drop-In Centers

The project is using drop-in centers which are clinics that are providing clinical and psycho-social services for FSW. Peer Educators link FSW to the drop in centers where they access HIV prevention service. Those that are HIV positive are initiated on treatment and followed up to ensure adherence.


The project is using DHIS2 Platform version 2.25 for monitoring project performance. DIC Managers have computers and smartphone which they use to enter data both clinical and community. This ensures that with or without power outages, Pakachere has up to date information on the project. The next phase is to give Outreach Workers smartphone so that community data should also be captured by them.


Over a period of 12 months in the 2015/16 implementation year, Pakachere through LINKAGES achieved the following:

  • 2,391 sex workers were reached with behavior change messages, condoms and lubricants
  • 1,816 sex workers were tested for HIV, out of which 734 were HIV positive
  • 465 sex workers were linked to care and 324 were initiated on treatment
  • 811,528 Male Condoms, 37,400 female condoms and 78,897 lubricants were distributed among sex workers in the 2 districts
  • 1,697 sex workers were screened for STIs; 836 were diagnosed and treated at our drop in centres
  • 30 GBV cases were reported and responded to by the project

Read the success story: Commitment to Improve the Quality of Life for HIV Positive Sex Workers: Meet Tionge