Article

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

ABSTRACT 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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    • "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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    ABSTRACT: How do people envision social reproduction when regular modes of generational succession and continuity are disrupted in the context of HIV/AIDS? How and where can scholars identify local ideas for restoring intergenerational practices of obligation and dependency that produce mutuality rather than conflict across age groups? Expanding from studies of HIV/AIDS and religion in Africa, this article pushes for an analytic engagement with ritual as a space and mode of action to both situate local concerns about and practices for restoring dynamics of social reproduction. It describes how the enduring HIV/AIDS epidemic in Swaziland contoured age patterns of mortality where persons identified socially and chronologically as youth have predeceased their elders. Based on discourse analyses of ethnography at church worship services and life cycle rites between 2008 and 2011, the findings show how both elders and youth understood this crisis of 'generational inversions' as a non-alignment of age groups and articulated projects to restore succession and continuity in vernacular idioms of 'work' as moralised social and ritual action.
    African Journal of AIDS Research 12/2014; 13(4):351-359. DOI:10.2989/16085906.2014.961942 · 0.61 Impact Factor
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    • "The 2006/7 Demographic and Health Survey (DHS) measured HIV prevalence among adults 15 to 49 to be 26% (CSO & Macro International Inc., 2008). The subsequent 2011 Swaziland HIV Incidence Measurement Survey (SHIMS) found that prevalence had remained essentially unchanged (32% among adults 18 to 49), although HIV incidence had declined somewhat in younger age cohorts (Bicego et al., 2013). According to the SHIMS, annual HIV incidence peaks at 3.1% among men ages 30 to 34, and at 4.2% and 4.1% for women ages 20 to 24 and 35 to 39, respectively. "
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    • "Swaziland is a small nation in southern Africa with the world’s highest HIV prevalence — 32% of adults between the ages of 18 and 49 are currently living with the virus [1]. At national antenatal clinic sentinel surveillance sites, this number peaks at 53.8% of women aged 30–34 [2]. "
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