HIV situation in the country
Madam,
In a country where the female population is abjectly impacted by the ripples of HIV infection, one is prompted to ponder on the efficacy of the new measures of curbing the tide of the epidemic. To shed some clarity on that prospect, may I proffer some statistical evidence to substantiate my submission.
Eswatini has had the highest HIV prevalence in the world over the years. According to data procured from the Swaziland HIV Incidence Measurement Survey (SHIMS 2), the prevalence of HIV among adults aged 15 and 49 in Eswatini is over 27 per cent, with 32.5 per cent females and 24 per cent of males infected. This equates to approximately 197 000 people living with HIV (PLHIV) aged 15 and upwards in a population of about 1.2 million people. In Eswatini, the annual incidence of HIV among adults aged 15 and older was 1.13 per cent, with 1.41 per cent among females and 0.85 per cent among males, resulting in approximately 6 000 new cases of HIV each year.
This goes on to reveal to the general population just how we as the youth in this contemporary society are gradually miring in a landmine of HIV infection due to such factors as misinformation, downright negligence and disbelief. These can be referred to as the secondary tributaries that flow into the ocean of the countless other factors that serve as wider conduits of HIV infection.
ATTRIBUTED
That is to say, the spread of HIV can further be attributed to inconsistent and low condom usage. Other issues, such as sexually transmitted diseases and teenage pregnancies, have remained high as a result of low and inconsistent condom use. Teenage pregnancy is largely due to unprotected sexual activity, which increases rapidly from about three per cent by the age of 15 to about 50 per cent by the time the adolescent girls reach the age 17; this is with reference to an assertion made by Kangmennaang, Mkandawire, et al., 2019.
Cited as the prime driver for new HIV infections in Eswatini, low condom use boasts of an array of determinants of its own. These include, but are not limited to condom size, packaging, allergies, partner trust, traditions, decreased pleasure, and failure to negotiate condom use with older partners. Even though a majority of new infections occur as a result of unprotected sexual contact, numerous other factors are still at play as far as new HIV transmission is concerned. It would be folly of me not to cite the perpetual misuse of intoxicating substances, predominantly among adolescent boys and young men, and mother to child transmission as other drivers of the spread of HIV in the country of Eswatini.
In the initial opening of this entry I made mention of how women in the country are the most disproportionately affected by HIV. According to the Eswatini HIV-1 Recent Infection Surveillance, young women aged 15-24 years account for nearly half of all new HIV infections in Eswatini. So, of the approximate 6 000 new cases each year it can be said that about 3 000 of those are females.
These appalling findings can be attributed to numerous factors such as multiple concurrent partners (MCPs), serial monogamy, an early sexual debut, intergenerational relationships, gender inequality, transactional sexual intercourse, and gender-based violence.
EMANATES
The latter emanates from other societal ills such as toxic masculinity and heteronormativity- a socialisation where the society endorses, recognises and also legitimises only the heterosexual norms around sexuality, and to some extent prescribing how boys and girls, and women and men are expected to behave, and with whom they are expected to have emotional and sexual relationships with.
The advent of the COVID-19 global pandemic cannot be spared as yet another driver that also played an impactful role in the spread of HIV in Eswatini. Due to prolonged lockdowns caused by the COVID-19 pandemic, Eswatini saw an increase in teenage pregnancies, indicating low condom use. In 2021, over 260 pregnancies were reported from 280 schools, with 44 of the pregnancies involving girls in primary school. In its very primary nature, pregnancy increases the likelihood of contracting STDs and HIV.
In summary, it is in this particular regard that Sexual Reproductive Health-based (SRH) Civil Society Organisations (CSOs) ought to review their implementation strategies of Comprehensive Sexuality Education (CSE) to both in-school and out-of-school youth in the country. Urgent intervention must be put in place so as to gauge whether or not the existing methods of SRH information dissemination are still as efficient as they were at their inception.
Celucolo Simelane