The HIVAIDS Epidemic in Swaziland- Fact Sheet by kvz49145

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									                                                                                                     The HIV/AIDS Epidemic in Swaziland                                                                                                  October 2005

Swaziland has the highest HIV/AIDS prevalence rate (the percent of people living with the disease) in the world, a much higher rate
                                                                           1
than the sub-Saharan African region overall (38.8% compared to 7.5%). Moreover, a recent survey suggests that HIV prevalence
                                         2,3,4
rates in Swaziland continue to increase.       As of the end of 2003, there were an estimated 220,000 people living with HIV/AIDS in
Swaziland, or almost 4 in 10 adults.1 The epidemic has already had a profound effect in Swaziland, posing significant development
challenges to this middle-income country.2,5,6,7 The Government of Swaziland created the Swaziland National AIDS Programme in 1987
                                                                                 8,9
to respond to the epidemic and declared HIV/AIDS a national disaster in 1999.        In 2001, the National Emergency Response Council
                                                2,8
on HIV and AIDS (NERCHA) was established, and the National AIDS Strategic Plan for HIV/AIDS 2006 - 2008 is currently under
development.6
         Figure 1: Percent of Adults Estimated to be Living                                                                            Figure 2: Number of People Estimated to be Living
                        with HIV/AIDS, 2003                                                                                                          with HIV/AIDS, 2003
                            Swaziland                                                                               38.8%                              South Africa                                                                          5,300,000
                            Botswana                                                                              37.3%                                         Nigeria                                                                 3,600,000
                               Lesotho                                                             28.9%                                                   Zimbabwe                                         1,800,000
                            Zimbabwe                                                       24.6%                                                             Tanzania                                    1,600,000
                         South Africa                                                 21.5%                                                            Mozambique                                   1,300,000
                               Namibia                                               21.3%                                                                       Kenya                            1,200,000
                                Zambia                                       16.5%                                                    Dem. Republic of Congo                                     1,100,000
                                 Malawi                                  14.2%                                                                                  Zambia                        920,000
                        Mozambique                                   12.2%                                                                                     Malawi                         900,000
                             Tanzania                          8.8%                                                                                           Uganda                    530,000
                                  Kenya                     6.7%                                                                                           Botswana                  350,000
                                Nigeria                  5.4%                                                                                                   Ghana                350,000
      Dem. Republic of Congo                           4.2%                                                                                                   Lesotho                320,000
                               Uganda                  4.1%                                                                                                     Angola             240,000
                                 Angola                3.9%                                                                                               Swaziland                220,000
                                 Ghana               3.1%                                                                                                     Namibia              210,000
                        Madagascar                 1.7%                                                                                                 Madagascar                140,000
                         Seychelles*            0.2%                                                                                                        Mauritius*          700
                           Mauritius**          0.1%                                                                                                   Seychelles**             <200
  Sources: UNAIDS, 2004 Report on the Global AIDS Epidemic, and 2002 Report on the Global AIDS Epidemic. *As of 2002. **As of 2001.   Sources: UNAIDS, 2004 Report on the Global AIDS Epidemic, and 2002 Report on the Global AIDS Epidemic. *As of 2002. **As of 2001.




Overview
•   The first case of HIV in Swaziland was reported in 1986.10
•  Swaziland has more than two hundred thousand people estimated to be living with HIV/AIDS (220,000 as of the end of 2003). 1
•  The HIV/AIDS prevalence rate11 in Swaziland is the highest of any country in the world (38.8%), and significantly higher than that of
   the sub-Saharan African region overall (7.5%) and globally (1.1%). 1
•  In 2003, an estimated 17,000 Swazis died of HIV/AIDS, and life expectancy at birth in Swaziland has fallen below 40 years in large
                           1,12
   part due to HIV/AIDS.        Most deaths due to HIV/AIDS in Swaziland occur among young people.8
•  HIV is spread primarily through heterosexual sex in Swaziland. 8

Populations and Regions Affected
•  Women account for over half (55%) of adults estimated to be living with HIV/AIDS in Swaziland.1
•  Recent studies suggest that youth in Swaziland are at significant risk for HIV infection, with young women hardest hit.8,10
   Among young people ages 15-24, the estimated number of young women living with HIV/AIDS was more than twice that of young
        13
   men. Although recent studies suggest that HIV prevalence may be declining among young people ages 15-19, prevalence rates
   continue to increase among those ages 20-29. 8
                           14
•  In 2003, 16,000 children in Swaziland were estimated to be living with HIV/AIDS and there were an estimated 65,000 AIDS
            1,15
   orphans.
•  HIV prevalence remains high among pregnant women across the country, with the highest rates in Manzini and the lowest
               10,16
   in Hhohho.

Other Key Data
•   Knowledge of HIV/AIDS: Studies have found that general awareness of HIV/AIDS in Swaziland is relatively high. For example,
                                                                                                        1
    among young women ages 15-24, 81% knew that a healthy looking person could be infected with HIV.
•   Access to Antiretroviral Therapy (ART): Access to ART is limited in Swaziland. As of March 2005, an estimated 8,373 people were
    receiving ART (23% of those estimated to be in need as of December 2004). 8
   The Henry J. Kaiser Family Foundation: 2400 Sand Hill Road, Menlo Park, CA 94025 Phone: (650) 854-9400 Facsimile: (650) 854-4800 Website: www.kff.org
   Washington, DC Office: 1330 G Street, NW, Washington, DC 20005 Phone: (202) 347-5270 Facsimile: (202) 347-5274
International Support/Major Donors
•    Several donor governments provide funding and other support to address Swaziland’s HIV/AIDS epidemic, including the United
     States, the United Kingdom, Italy, and the European Union.5 The U.S. Government provides bilateral assistance to Swaziland for
     its HIV/AIDS activities, although Swaziland is not one of the 15 focus countries of the United States’ President’s Emergency Plan
     for AIDS Relief (PEPFAR).17 The U.S. also provides support for HIV/AIDS efforts around the world through its contributions to the
     Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund).
•    The Global Fund has approved two HIV/AIDS grants in Swaziland.18
•    UNAIDS and the UN Family support a variety of HIV/AIDS activities in Swaziland.2,5,8


       Table 1: HIV/AIDS in Swaziland1,8,13,19
         Indicator                                                                                 Swaziland                     Sub-Saharan Africa                       Global

         Estimated number of people living with HIV/AIDS, 2003                                     220,000                       25 million                               37.8 million

         Percent of adult population estimated to be living with
                                                                                                   38.8%                         7.5%                                     1.1%
         HIV/AIDS, 2003

         Estimated number of deaths due to HIV/AIDS, 2003                                          17,000                        2.2 million                              2.9 million

         Women as percent of adults estimated to be living with
                                                                                                   55%                           57%                                      48%
         HIV/AIDS, 2003

         Percent of young women, ages 15-24, estimated to be
                                                                                                   31.6 – 47.4%                  8.9%                                     1.4%
         living with HIV/AIDS, 2001

         Percent of young men, ages 15-24, estimated to be living
                                                                                                   12.2 – 18.3%                  4.4%                                     0.8%
         with HIV/AIDS, 2001

         Estimated number of AIDS orphans, 2003                                                    65,000                        12.1 million                             15 million

         Number of people estimated to be receiving antiretroviral                                 8,373 (March                  500,000                                  970,000 (June
         therapy (ART), 2005                                                                       2005 est.)                    (June 2005 est.)                         2005 est.)

         Number of people estimated to be in need of ART,
                                                                                                   36,500                        4.0 million                              5.8 million
         December 2004


   Key Sources/Websites
   •   Government of Swaziland, Ministry of Health and Welfare: www.gov.sz/home.asp?pid=61
   •   Swaziland National Emergency Response Council on HIV and AIDS (NERCHA): www.nercha.org.sz/
   •   UNAIDS Swaziland Country Page: www.unaids.org/en/geographical+area/by+country/swaziland.asp
   •   UNDP Swaziland: www.undp.org.sz/
   •   World Health Organization Swaziland Country Page: www.who.int/countries/swz/en/
   •   The AIDS Information and Support Centre (TASC): www.tasc.org.sz/
   •   Family Life Association of Swaziland (FLAS): www.flas.org.sz/
   •   Swaziland Network of AIDS Service Organisations (SwaNASO): www.sanaso.org.zw/country-networks.htm#swaziland

   References
   1
     UNAIDS, 2004 Report on the Global AIDS Epidemic, July 2004.
   2
     UNAIDS Swaziland Country Page: www.unaids.org/en/geographical+area/by+country/Swaziland.asp.
   3
     Reuters, “Swaziland: More than Half of Young Adult Swazis have HIV: Survey”, April 6, 2005. http://www.aegis.com/news/ads/2005/AD050656.html.
   4
     UN Integrated Regional Information Networks (IRIN), “Swaziland: HIV Prevalence Rate among Pregnant Women Rises”, April 5, 2005. http://www.aegis.com/news/irin/2005/IR050419.html.
   5
     UNAIDS, UNAIDS at Country Level: Progress Report, 2004.
   6
     USAID, “Health Profile: Swaziland HIV/AIDS”, April 2005.
   7
     World Bank, “Country Classification: Country Groups”: http://www.worldbank.org/data/countryclass/classgroups.htm.
   8
     WHO, “Summary Country Profile for HIV/AIDS Treatment Scale-Up: Swaziland”, June 2005.
   9
     National Emergency Response Council on HIV and AIDS (NERCHA), Annual Report for the Year Ended 31st March 2004”, http://www.nercha.org.sz/AR2004.pdf.
   10
      Kingdom of Swaziland, Ministry of Health & Social Welfare, 8thHIV Sentinel Serosurveillance Report, December 2002.
   11
      Among adults ages 15-49.
   12
      UNAIDS, “Africa Fact Sheet”, March 2005.
   13
      UNAIDS, Youth and HIV/AIDS: Opportunity in Crisis, 2002.
   14
      Under age 15.
   15
      Ages 0-17, living in 2003.
   16
      UNAIDS/WHO, “Swaziland: Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Infections – 2004 Update”: http://www.unaids.org/html/pub/publications/fact-
   sheets01/swaziland_en_pdf.pdf.
   17
      U.S. Department of State, Office of the Global AIDS Coordinator: www.state.gov/s/gac.
   18
      The Global Fund: www.theglobalfund.org.
   19
      WHO, “3 by 5” Progress Report, December 2004.




          Prepared by Jennifer Kates and Alyssa Wilson Leggoe of the Kaiser Family Foundation (KFF). Additional copies of this publication (#7366) are available on the Kaiser Family
          Foundation’s website at www.kff.org.
          The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the
          health care community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

								
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