HIV infection rate stabilising in SD

MBABANE - Results presented at the XIX International AIDS Conference in Washington DC in the United States of America suggest that the number of people with HIV in Swaziland is stabilising.

In 2009, the rate of new infections was at 2.66 per cent for people aged between 15-49 but new results from the Swaziland HIV Incidence Measurement Survey (SHIMS) show the rate to be currently 2.38 per cent.

What seems to have made the difference is the widespread use of Anti-Retroviral Therapy (ART). "The country continues to have very high HIV incidence rates," said Rejoice Nkambule, Deputy Director of Public Health Services at the Ministry of Health, adding; "Since HIV services in Swaziland are more widely available now and we understand that ART treatment prevents the spread of new infections, the Ministry of Health will use these new results to plan HIV prevention, care and treatment programmes in Swaziland."

These plans require a good baseline knowledge of the number of people infected in Swaziland. The SHIMS study is one of the most comprehensive. The first phase used the results from 13 000 households in Swaziland and determined that the HIV infection rate was about 31 per cent of adults infected, the highest rate of infection in any country.

HIV-negative people who tested in the first round were voluntarily retested after six months and the number of new infections calculated. Ninety-four per cent of the participants showed up for the second test.

"This is the gold standard method for measuring HIV incidence and it hasn’t been attempted before at a national level," said Jessica Justman, ICAP Senior Technical Director and Associate Professor of Clinical Epidemiology at Columbia University’s Mailman School of Public Health.

While the rate of new infections has dipped from 2.66 per cent to 2.38, some sectors of society are more infected than others. Women between the ages of 20-24 have a 4.2 per cent incidence rate and women between 35-39 years old at 4.1 per cent. Among men, HIV incidence peaks between the ages of 30-34 at 3 per cent.

One conclusion drawn from the conference was that not knowing the status of the current partner predicts new HIV infection for both men and women and suggests prevention and treatment programmes need to target this specific problem. Studies like SHIMS can help.

"SHIMS provides a remarkable epidemiological look into the most severe national HIV pandemic in the world. Clearly the strategic scale-up of effective HIV interventions in combination is warranted," noted Dr Jason Reed of the Centre for Disease Control in the USA.

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