Impact Of Hiv And Aids In Africa – HIV/AIDS in Lesotho is a very serious threat to Basotho and the economic development of Lesotho. Since it was first discovered in 1986, HIV/AIDS has spread at alarming rates in Lesotho.

According to the Joint United Nations Program on HIV/AIDS (UNAIDS) in 2016, Lesotho’s adult prevalence rate of 25% is the second highest in the world, after Eswatini.

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Estimated HIV infection rates in Africa (% of population aged 15-49) show the highest prevalence in Eswatini, Lesotho, South Africa and Botswana in 2011. (World Bank)

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The lack of developed sex education programs in schools puts the young demographic at increased risk of HIV infection.

Over the past thirty years, the Government of Lesotho, in collaboration with global organizations such as The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), the World Health Organization (WHO), and the President’s Emergency Relief Plan from AIDS (PEPFAR). , HIV testing and treatment coverage have greatly improved through the implementation of comprehensive programs.

However, high levels of poverty, inequality and HIV stigma remain major barriers to HIV prevention in Lesotho.

As such, Lesotho seeks financial help and guidance in program reform from its neighbor South Africa, which despite having the highest number of people living with HIV in the world.

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Lesotho’s adult prevalence rate of 25% has remained relatively constant since 2005. In 2016, an estimated 330,000 people were living with HIV compared to 240,000 people in 2005, and 270,000 people in 2010. overall, the incidence of HIV is decreasing, from 30,000 new infections in 2005 to approximately 21,000 new HIV infections in 2016.

According to the Lesotho Demographic and Health Survey (LDHS) 2014, female prevalence has increased from 26% in 2004 to 30% in 2014, while male HIV prevalence is approximately 19% over the same period.

In 2014, the Lesotho Ministry of Health and Social Welfare (MOHSW) determined that the prevalence rate among young women was 10.2%, but among young men it was 5.9%.

According to the 2003 Stinel HIV Survey Report, the 25-29 age group was the most affected by HIV, with a prevalence of 39.1%. For the 15-19 and 20-24 age groups, the median prevalence was 14.4% and 30.1%, respectively.

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In 2014, LDHS found that 13% of young women and 6% of young people 15-24 were infected with HIV.

In 2003, the Ministry of Health estimated that there were approximately 100,000 children under the age of 15 in 10 districts of Lesotho who had lost one or both parts to AIDS.

HIV disproportionately affects sex workers and factory workers, with prevalence rates of 79.1% and 42.7% in 2015, respectively.

The government of Lesotho has taken concrete steps to address the epidemic since King Letsie III declared HIV/AIDS a national emergency. The establishment of the National AIDS Prevention and Control Program and the Lesotho AIDS Program Coordinating Authority (LAPCA) under the Prime Minister’s Office accelerated the national and international response to the epidemic.

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However, funding and infrastructure limitations prompted the United Nations to intervene in 1992 and help release stinel surveys to monitor the spread of HIV. Therefore, data collection was inconsistent until 2000.

It was not until 2004 that LDHS included HIV testing data to estimate the extent and patterns of HIV infection.

LAPCA was established in 2001 to coordinate the multisectoral response to HIV/AIDS, but several factors prevented it from fulfilling its strategic role.

In October 2003, the government used Turning a Crisis into an Opportunity, a document put together by a United Nations interagency group based in Lesotho, as an official working model to address the epidemic.

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In 2005, the government passed a bill establishing the semi-autonomous National AIDS Commission (NAC) and the National AIDS Secretariat (NAS) to coordinate and support strategies for the period 2005 to 2008.

Lesotho has committed itself to the World Health Organization (WHO) goal of having 28,000 people on antiretroviral therapy (ART) by 2005.

The Global Fund for AIDS, Tuberculosis and Malaria (Global Fund), private international organizations, local and international non-governmental organizations (NGOs), and community-based organizations (CBOs) provided the backbone of the HIV/AIDS response, especially in those countries . area of ​​community mobilization.

Most of these operations were small and localized to specific geographical areas in urban cities. The biggest challenge was to establish national networks and civil society organizations on HIV/AIDS, especially among people living with HIV/AIDS and within the NGO network.

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In 2005, the clothing and textile industry, Lesotho’s largest private employer, established an innovative sector-wide HIV workplace program through a public private partnership with the Lesotho government, buyers, employers and other donors.

In May 2009, the Lesotho Apparel Alliance to Combat AIDS (ALAFA) provided prevention services to nearly 90% of its 42,000 employees, and up to 80% with treatment services.

Lesotho has made greater use of community mobilization and education, as well as offering HIV testing and counseling (HTC) on individual request.

The onus is placed on local communities to determine how and who receives treatment and counseling services. Communities are responsible for ensuring confidentiality and providing access to post-test services.

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In 2004, only 2.7% of Basotho adults participated in HTC. HTC’s participation increased to 35% by 2011, however.

In 2014, the Ministry of Health started a new program of provider-initiated testing and counseling, where providers traveled to homes providing HTC services rather than through individual requests. However, lack of staff and lack of HIV testing equipment seriously affected the effectiveness of the program.

A research study by Labhardt et al. (2014) examined the relative merits of home-based HTC services compared to mobile clinics, finding that mobile clinics were more effective at detecting new HIV infections, but that home clinics were more effective at testing those receiving test for the first time.

In 2014, 63% of Basotho m and 84% of Basotho women were tested for HIV at least once in their lives, according to LDHS.

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Other HIV prevention efforts led by the Lesotho Ministry of Health include prevention of mother-to-child transmission (PMTCT) programs, voluntary medical male circumcision (VMMC), and condom distribution.

A Mosotho woman kisses her son, who was born HIV-free in 2008 thanks to successful PMTCT treatment at Molikaliko health clinic, Lesotho.

In 2011, the Ministry of Health launched the VMMC program successfully. By 2012, 10,400 m had gone under VMMC; by 2014, about 36, 200 m had undergone treatment.

Expansion of the VMMC program is most hindered in rural areas, where traditional initiation rites promote the circumcision of young boys.

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PMTCT efforts include ART for women infected during pregnancy, and HIV medications for babies 4-6 weeks after birth. In some cases, mothers will be given caesarean deliveries to further prevent MTCT.

In 2010, the WHO recommended providing ART to all pregnant women regardless of CD4 count or viral load, prompting the Ministry of Health to revise its PMTCT program accordingly.

As a direct result, the number of infected pregnant women receiving ART increased significantly from 58% in 2009 to 89% in 2012. However, staffing and funding challenges affected the effectiveness of this program.

The Ministry of Health has proposed an HIV prevention strategy which aims to eliminate MTCT and reduce sexual transmission of HIV by 50% by 2015. MTCT is considered to have ended when the transmission rate falls below 5%, according to UNAIDS .

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In 2015, the National Aids Commission (NAC) in Lesotho reported the distribution of 31 condoms per adult male, exceeding the United Nations Population Fund average of 30.

Furthermore, in 2016, UNAIDS reported that 76% of adults aged 15-49 with more than one sexual partner in the past year used condoms.

In June 2016, the Ministry of Health launched the “Test and Treat” initiative, where ART is offered to everyone who has tested HIV-positive, regardless of CD4 count. Lesotho is the first country in sub-Saharan Africa to implement this program.

LDHS data from 2009 show that bonyatsi practices, the culturally sanctioned practice of maintaining multiple sexual partners, continue after marriage, as 9% of women and 24.4% of people 30-39 had two or more sexual partners in the past year.

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Differences in PCP self-reporting are strongly influenced by social norms: m gaining social status by having multiple partners, although women are driven by economic need.

However, correct research (Tanser et al., 2011; Thorton, 2008) found that MCP did not worsen the spread of HIV.

Lesotho’s highly patriarchal society greatly affects women’s experiences of gder-based violence, especially in schools. Basotho communities show dominant perceptions of heterosexual relationships, but the social structure of male superiority puts females at risk of harmful experiences through these heterosexual relationships.

Many women and girls are put at risk of HIV infection through gder-based violence, which commonly comes in the form of marital rape, rape or domestic abuse. Especially in rural areas, females are subject to this violence because they often lack social and economic power in sexual decision-making.

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The prevalence of customary law in Lesotho, despite constitutional amendments in 1993 granting civil rights to all individuals, acts as a barrier to women’s inheritance, ownership and equality in marriage and other sexual relationships.

Common law sees women as legal minors in the care of their fathers, brothers or husbands. As a result, Lesotho practices high rates of violence, intimate sex, and gender pay, which increase a person’s risk of HIV infection.

Through marriage, a Mosotho man becomes sexually entitled to his wife’s body by paying the bride price, leaving the woman

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