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ObjectivesTo describe the epidemiological situation of the HIV/AIDS epidemic and to identify the main drivers for vulnerability in Madagascar.DesignLiterature review, qualitative research and situational analysis.Data sourcesSearch of electronic bibliographic databases, national repositories of documentation from 1998 to 2018. Search keywords included Madagascar, HIV, sexually transmitted infections, men who have sex with men (MSM), sex workers (SWs), transactional sex (TS), injecting drug users (IDUs), vulnerability and sexual behaviour. Qualitative sources were interviews and focus group discussions.Review methodsStudies focused on HIV and/or vulnerability of HIV in Madagascar in general, and key populations (KPs) and HIV/AIDS response were taken into account. National reports from key HIV response actors were included.ResultsMadagascar is characterised by a low HIV/AIDS epidemic profile in the general population (GP) (0.3%) combined with a high prevalence of HIV among KPs (SWs, MSM and IDUs).An increase in HIV prevalence among KP has been observed during recent years. Hospital-based data suggest an increase in HIV prevalence among the GP. The vulnerability traits are inconsistent use of condoms, multipartner relationships and other contextual factors like widespread TS and gender inequality. A high prevalence/incidence of sexually transmitted infections could indicate a high vulnerability to HIV/AIDS. However, there are no reports of HIV prevalence of >1% in antenatal consultation.ConclusionThere is not enough evidence to make a conclusion about the HIV epidemiological situation in Madagascar due to the scarcity of the epidemiological data. However, Madagascar may be closer to a turning point towards a high-prevalence epidemic with severe consequences, particularly when taking into account its socioeconomical fragility and underlying vulnerabilities. More precise epidemiological data and improved HIV/AIDS diagnosis and case management should be a public health priority.

Although the importance of regulating and provisioning services provided by mangroves is widely recognised, our understanding of their role in the maintenance of terrestrial biodiversity is patchy globally and largely lacking for many regions, including conservation priorities such as Madagascar. We carried out the first multi-site bird inventory of mangroves in Madagascar and complemented our data with assessments of local knowledge, in order to broaden our knowledge of which species use this habitat. We directly observed 73 species across three sites in Ambanja and Ambaro Bays, while local respondents indicated the presence of 18 additional species: four observed species are globally threatened, while 37 are endemic to Madagascar or the Malagasy region. Over half the species observed are typically terrestrial, of which 22 have not previously been recorded in mangrove habitats in Madagascar. Local knowledge provided a useful complement to our observed data but we are likely to have underestimated total richness; nevertheless, our findings greatly increased our knowledge of mangrove use by Madagascar’s birds. However, further research is required to investigate the functional role of mangroves in the ecology of the observed species and provide insights into the factors influencing mangrove use.