MBABANE, 23 February 2009: HIV prevalence in Swaziland shows signs of stabilizing. Results of The 11 th HIV sentinel survey of pregnant women released by Minister of Health Hon. Benedict Xaba at a meetingattended by over 50 people from development partners, government officers, PLHIV associations, civil society, FBOs and implementing partners involved in HIV on the 20 th February 2009, shows that 42% of pregnant women tested positive to the HIV virus, leading health authorities to conclude that while HIV prevalence in Swaziland remains high, it appears to be stabilizing.
The current findings and trends show that HIV prevalence is homogeneously distributed in the country. Prevalence trends in young women also suggest that new infections are not decreasing as much as it may be expected, hence the epidemic levels not decreasing. Care and support interventions may be leading to improved survival among infected as indicated by high and increasing HIV prevalence among older women in the 2008 survey.
HIV is one of UNDP key focus areas, and the country office will continue to play its role in providing support in creating an enabling environment for the response through increased support for human rights promotion and capacity building of the sectors to ensure that the country has the capacity to manage the HIV response.
The first case of HIV infection was reported in 1986 and it appears the HIV epidemic in Swaziland rapidly increased in the late 1990s. There were an estimated 185,005 people living with HIV/AIDS in 2007 and the Swaziland Demographic and Health Survey in 2006 estimated the prevalence in the population 2 years and above at 19% and among the 15-49 age group at 26%.
The national response has been multisectoral guided by the national HIV AIDS policy and strategic plan which have been reviewed periodically. The response included strengthening of leadership and coordination, promoting prevention effort and providing effective treatment, care and support for people living with HIV and impact mitigation..
The sentinel surveillance system was established in 1992 and surveys have been conducted biennially to monitor trends in HIV infection. A behavioural survey and a population-based serological survey have been conducted in 2002 and 2006 respectively.
Objective of the HIV Sentinel Surveillance
The main objective of this surveillance is to establish the point prevalence and trends of the epidemic.
In 2008, the 11
th sentinel survey was done among pregnant women attending antenatal care services for the first time of that pregnancy. The survey was done in 17 sites that have been used since 2002. Personal particulars and HIV data were collected. .Testing for HIV and syphilis were done at the Mbabane National Laboratory. Data entry and analysis was done at the SNAP, using Epi info. The sentinel sites routinely offer Prevention of Mother to Child Transmission (PMTCT) services and therefore, all women participating in the survey were offered HIV testing and counselling .
Main findings (Results)
A total of 1,876 were included in the survey and 58.7% were in the 15-24 age group, 96.7% were Swazi, 64.3% had gravidity of 2 or less and 83.3% had had at most two live births prior to the survey. While 45% of the women were attended in rural facilities, 84.1% of the women lived in rural areas.
The level of HIV infection
The national prevalence of HIV infection among the pregnant women tested was 42.0% - 787/1876 (CI: 39.7; 44.2). Prevalence ranged from 38.5% in Shiselweni to 45.4% in Lubombo; 26.3% among the 15-19 year olds to 49.1% among those aged 30-34; Those who presented with first pregnancy had a significantly lower HIV prevalence. There were no significant differences in prevalence by marital status, level of education and residence.
A trend analysis using data from previous surveys indicates that the prevalence among pregnant women is showing some stabilization after rapidly increasing through the 1990s and slowing down after 2004. Although an increase was observed from 2006 to 2008, the increase was not significant.
Trend in the level of HIV infection among antenatal clients in Swaziland since 1992