Recent Patterns in Population-Based HIV Prevalence in Swaziland

Centers for Disease Control and Prevention (CDC), Mbabane, Swaziland.
PLoS ONE (Impact Factor: 3.23). 10/2013; 8(10):e77101. DOI: 10.1371/journal.pone.0077101
Source: PubMed


The 2011 Swaziland HIV Incidence Measurement Survey (SHIMS) was conducted as part of a national study to evaluate the scale up of key HIV prevention programs.
From a randomly selected sample of all Swazi households, all women and men aged 18-49 were considered eligible, and all consenting adults were enrolled and received HIV testing and counseling. In this analysis, population-based measures of HIV prevalence were produced and compared against similarly measured HIV prevalence estimates from the 2006-7 Swaziland Demographic and Health. Also, measures of HIV service utilization in both HIV infected and uninfected populations were documented and discussed.
HIV prevalence among adults aged 18-49 has remained unchanged between 2006-2011 at 31-32%, with substantial differences in current prevalence between women (39%) and men (24%). In both men and women, between since 2006-7 and 2011, prevalence has fallen in the young age groups and risen in the older age groups. Over a third (38%) of the HIV-infected population was unaware of their infection status, and this differed markedly between men (50%) and women (31%). Of those aware of their HIV-positive status, a higher percentage of men (63%) than women (49%) reported ART use.
While overall HIV prevalence remains roughly constant, age-specific changes strongly suggest both improved survival of the HIV-infected and a reduction in new HIV infections. Awareness of HIV status and entry into ART services has improved in recent years but remains too low. This study identifies opportunities to improve both HIV preventive and care services in Swaziland.

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Available from: Deborah J Donnell, May 12, 2014
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    • "Before the significant push to promote and provide VMMC, only 8% of Swazi men age 15–49 were circumcised (MoEPD, 2008). Despite the evidence suggesting that MC is protective against HIV and contrasting MC practices, both countries have high HIV burdens – Swaziland is currently recognized as having the highest prevalence of adult HIV (31%) in the world (Bicego et al., 2013), with Lesotho falling not far behind (22.9%) (UNAIDS, 2013). National data from both countries suggest that MC is not protective against HIV infection, with HIV prevalence higher in circumcised men (Lesotho: 21% compared to 16%, MoHSW, 2009; Swaziland: 22% compared to 20%, MoEPD, 2008). "

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    • "Adulthood is otherwise predicated on being a respectable provider for one's own children and older relatives, usually by undertaking work as domestic or wage labour to earn forms of wealth. Swaziland is notable for a pernicious HIV epidemic, registering the world's highest prevalence in 2007 and holding the morbid ranking into recent years (Bicego et al. 2013). Nearly one out of three Swazi people is seropositive . "
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