Global HIV/AIDS

Swaziland

HIV/AIDS in Swaziland

27.4% Estimated HIV Prevalence
(Age 15–49) (2013)
4,500 Estimated AIDS Deaths (2013)
73,000 Estimated Orphans due to AIDS (2013)
80,103 Reported Number of Adults Receiving Antiretroviral Therapy (ART)
87% Estimated ART Coverage per WHO 2010 Guidelines (2012)

SOURCE:
UNAIDS Gap Report, 2014; UNAIDS Global Report, 2013

Strategic Focus

CDC began supporting Swaziland in 2004 and opened its HIV/AIDS office there in 2007. CDC works closely with the Ministry of Health (MOH), the World Health Organization, and other partners in building local health systems for a sustained response to the epidemic.

Strengthening Health Systems
CDC supports the MOH and implementing partners in building the capacity to improve the coverage and quality of HIV and tuberculosis care and treatment services. This includes the provision of clinical and community-based services, mentoring, laboratory support, provider- and client-initiated HIV testing and counseling services, prevention of mother-to-child transmission (PMTCT), and blood safety programming. In FY15, support to clinical services will be provided in an integrated manner at a regional level, with an increased focus on quality management. The goal is to combine these efforts with the United States Agency for International Development-sponsored voluntary medical male circumcision (VMMC) activities to create an effective and focused combination prevention program.

Strengthening Surveillance and Health Information Systems
CDC supports the MOH in the development of innovative systems to improve the collection and utilization of data to guide strategic decision-making. This includes technical support to establish an Electronic Health Record System and a unique health identifier in Swaziland and implementation of the Health Research Training Program. Planning is under way for a second HIV incidence measurement survey in 2016.

Key Activities and Accomplishments

Linkage to and Retention in HIV Services
CDC assists the MOH in planning and implementing high quality, decentralized HIV testing and treatment services. CDC support enables 25% of the population to be tested and, if positive, linked to care each year. Swaziland’s treatment coverage (at CD4<350) is more than 90% and 12-month retention is greater than 85%.

Health System Strengthening
CDC provides technical assistance for the establishment of an Electronic Health Record System, laboratory information system, and unique health identifier. By helping the MOH to establish standards for the health system and by measuring achievement transparently, CDC expects to improve both access to and quality of health care in Swaziland.

Combination Prevention
CDC is working with the MOH and development partners to develop a single roadmap of ongoing interventions in HIV testing and counseling, VMMC, PMTCT, and antiretroviral therapy at the community and health system level. CDC continues to support the MOH to develop specific targets for each of these interventions with a goal of achieving a measurable decrease in incidence of HIV in Swaziland between the first national survey in 2011 and the expected repeat survey in 2016.