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Background: Understanding HIV risk perception is important for designing appropriate strategies for HIV/AIDS prevention, because these interventions often rely on behaviour modification. A key component of HIV risk perception is the individual’s own assessment of HIV status, and the extent to which this assessment is correct. However, this issue has received limited attention.

Objectives: To examine the validity of self-reported likelihood of current HIV infection among the general population in rural Malawi.

Methods: As part of a panel household survey, data on behaviour and biomarkers were collected for a population-based sample of approximately 3000 respondents in rural Malawi aged ⩾15 years. Information on self-assessed likelihood of currently having HIV was collected by survey interview. Saliva was obtained from all consenting respondents to assess actual HIV status.

Results: Of 2299 …