HIV/AIDS in Eswatini
HIV/AIDS in Swaziland has reached epidemic proportions.
Prevalence
HIV/AIDS remains one of the major challenges to Swaziland’s socioeconomic development. The epidemic has spread relentlessly in all the parts of the country since the first reported case in 1986.[1]
Periodic surveillance of antenatal clinics in the country has shown a consistent rise in HIV prevalence among pregnant women attending the clinics. The most recent surveillance in antenatal women reported an overall prevalence of 42.6% in 2004. Prevalence of 28% was found among young women aged 15–19. In women ages 25–29, prevalence was at an alarming 56%.[2]
The Human Development Index of the UN Development Programme reports that as a consequence of HIV/AIDS, life expectancy in Swaziland has fallen from 61 years in 2000, to 32 years in 2009.[3]
From another perspective, the last available World Health Organization data (2002) shows that 61% of all deaths in the country were caused by HIV/AIDS.[4] With a record crude death rate of 30 per 1000, this means that about 2% of the Swazi population dies from HIV every year. Chronic illnesses that are the most prolific causes of death in the developed world only account for a minute fraction of deaths in Swaziland; for example, heart disease, strokes, and cancer cause a total of less than 5% of deaths in Swaziland, compared to 55% of all deaths yearly in the US.[5]
The United Nations Development Program has written that if the spread of the epidemic in the country continues unabated, the "longer term existence of Swaziland as a country will be seriously threatened".[6]
Cultural background
Traditional Swazi culture discourages safe sexual practices, like condom use and monogamous relationships. There is a cultural belief in procreation to increase the population size, and Swazis believe a woman should have a minimum of five children and that a man's role is to impregnate multiple partners. Polygamy is common and men may never get married but still have many children from multiple partners.[3] Sexual aggression is common, with 18% of sexually active high school students saying they were coerced into their first sexual encounter.[1]
Many thousands of children have been orphaned by AIDS, and only 22% grow up in two-parent families.[7]
National response
In 2003, the National Emergency Response Committee on HIV/AIDS (NERCHA) was established to coordinate and facilitate the national multisectoral response to HIV/AIDS, while the Ministry of Health and Social Welfare (MOHSW) was to implement activities. The previous national HIV/AIDS strategic plan covered the period 2000–2005; a new national HIV/AIDS strategic plan and a national HIV/AIDS action plan for the 2006–2008 period are currently being developed by a broad group of national stakeholders. To date, the six key areas of the plan are prevention, care and support, impact mitigation, communications, monitoring and evaluation, and management/coordination.[2]
Despite the widespread nature of the epidemic in Swaziland, HIV/AIDS is still heavily stigmatized. Few people living with HIV/AIDS, particularly prominent people such as religious and traditional leaders and media/sports personalities, have come out publicly and revealed their status. Stigma hinders the flow of information to communities, hampers prevention efforts, and reduces utilization of services.[2]
On June 4, 2009, the USA and Swaziland signed the Swaziland Partnership Framework on HIV and AIDS for 2009-2013. The President's Emergency Plan for AIDS Relief will contribute to the implementation of Swaziland's multi-sectoral National Strategic Framework on HIV/AIDS.[8]
HIV-TB Co-Infection
Tuberculosis is also a significant problem, with an 18 percent mortality rate. Many patients have a multi-drug resistant strain, and 83 percent are co-infected with HIV.[9] There are roughly 14,000 new TB cases diagnosed each year. [10]
References
- ^ a b "Swaziland HIV/AIDS health profile" (PDF). USAID. September 2008. Retrieved 2009-10-21.
- ^ a b c "Health Profile: Swaziland". United States Agency for International Development (June 2005).
This article incorporates text from this source, which is in the public domain.
- ^ a b "Swaziland: A culture that encourages HIV/AIDS". Integrated Regional Information Networks (IRIN). 15 April 2009. Retrieved 2009-10-21.
- ^ Swaziland, Mortality Country Fact Sheet 2006. WHO. http://www.who.int/whosis/mort/profiles/mort_afro_swz_swaziland.pdf. Accessed November 22, 2009
- ^ Causes of death in US, 2006. CDC. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. Accessed November 22, 2009.
- ^ Country programme outline for Swaziland, 2006-2010. United Nations Development Program. http://www.undp.org.sz/index.php?option=com_docman&task=doc_download&gid=19&Itemid=67. Accessed November 22, 2009
- ^ "GOVERNMENT'S PROGRAMME OF ACTION 2008-2013". The Government of the Kingdom of Swaziland. 27 March 2009. pp. 4–5. Retrieved 2009-10-21. [dead link]
- ^ "Partnership to Fight HIV/AIDS in Swaziland". Office of U.S. Global AIDS Coordinator and the Bureau of Public Affairs, U.S. State Department. Retrieved 2009-10-21.
- ^ "Swaziland: An MSF Doctors Explains HIV-TB Co-Infection". USA: Doctors Without Borders/Médecins Sans Frontières. October 28, 2009. Retrieved 2009-10-31.
- ^ "HIV-TB in Swaziland: A Deadly Co-Infection Epidemic". USA: Doctors Without Borders/Médecins Sans Frontières. October 28, 2009. Retrieved 2009-10-31.
