Malaria Home >

Malaria and HIV/AIDS

The Link Between Malaria and HIV/AIDS

The Geographic Link

Malaria and HIV/AIDS overlap geographically---primarily in sub-Saharan Africa, Southeast Asia, and South America. Globally, malaria is responsible for more than a million deaths per year, with 90% of these deaths in sub-Saharan Africa. In 2003, HIV/AIDS caused the deaths of an estimated 2.9 million people worldwide, of whom 2.4 million lived in Africa.

Source: WHO/UNAIDS

The Health Link for People Who Live in Malaria Risk Areas

While infection with either malaria or HIV can cause illness and death, infection with one can make infection with the other worse and/or more difficult to treat. The two diseases affect people who live in malaria risk areas in the following ways:

Pregnant Women

The consequences are especially serious for a pregnant woman with both malaria and HIV.

• HIV can increase the adverse effects of malaria, including anemia and placental malaria infection. As a result, a pregnant woman is more likely to give birth to a low-birth-weight baby, and a low-birth-weight baby is more likely to die during infancy.

Adult Men and Nonpregnant Women

For an adult man or a nonpregnant woman who lives in a malaria risk area,

• Infection with HIV can increase the risk of becoming ill with malaria, and of developing severe malarial illness.
• Antimalarial drugs taken by an HIV-positive adult with a low CD4 count (CD4 counts measure the strength of the immune system) are less likely to be effective.
• Malaria can also worsen a person’s HIV disease: Infection with malaria may lead temporarily to a higher level of HIV in the blood (“viral load”). It is not known whether this temporary increase in viral load changes the progression of HIV disease.

	A clinician at the HIV clinic of the Provincial General Hospital in Kisumu, Kenya, examines a child hospitalized with fever possibly caused by malaria. (Courtesy Kenya Ministry of Health.)

Children

For a child living in a malaria risk area,

• Infection with HIV can increase the chances of becoming ill with malaria and becoming severely anemic.
• Malaria can cause severe anemia; an HIV-negative child who develops severe anemia may receive a blood transfusion as a consequence and contract HIV from unsafe blood.
• Antimalarial drugs taken by an HIV-positive child with a low CD4 count (CD4 counts measure the strength of the immune system) are less likely to be effective.

Malaria Recommendations for HIV-Positive People Living in Malaria Risk Areas

HIV-positive people are at higher risk for malaria because of their weakened immune systems. They should be sure to follow the standard recommendations for all people living in malaria risk areas:

• Sleep under an insecticide-treated bed net (ITN), which repels and kills mosquitoes that might transmit malaria.
• Be treated with a highly effective antimalarial drug if ill with malaria.

Ali Khamis Abbas, on behalf of the Zanzibar Malaria Control Program, presents a long-lasting insecticide-treated net to Consolata John, Chairperson of the Zanzibar Association of People with HIV/ AIDS Living Positively.  (Courtesy Patrick Kachur)

The standard recommendation for pregnant women is to take at least 2 doses of IPT with SP. IPT helps lessen the harmful effects of malaria in pregnancy by reducing malarial infection of the placenta and decreasing anemia.

Malaria Recommendations for HIV-Positive People Traveling to Malaria Risk Areas

HIV-positive people are at higher risk for malaria because of their weakened immune systems and should be sure to follow the standard mosquito precautions recommended for all travelers to malaria risk areas:

• Use insect repellents
• Wear long-sleeved clothing and pants when outdoors
• Sleep in well-screened areas or under an insecticide-treated bed net.

Malaria chemoprophylaxis for HIV-positive travelers follows the same guidelines as those for HIV-negative travelers, although potential drug interactions between antimalarials and antiretroviral drugs should be considered.

If travelers, regardless of their HIV status, should experience symptoms of malaria, they should seek help right away and, if diagnosed with malaria, be treated with a highly effective antimalarial drug.

For information about recommendations when traveling to malaria risk areas, visit CDC’s Travelers’ Health.

For specific advice about prevention of malaria in HIV-positive travelers, contact the CDC Malaria Hotline at 770-488-7788 (8:00 am – 4:30 pm EST).

For more information on the link between malaria and HIV/AIDS, visit the World Health Organization ‘s Web site.