CARELESS NATION
High cases of casual, condomless sex worry authorities Too much sex with people who are not everyday partners New HIV infections a concern, but lives lost to HIV reduce
The Fifth Botswana AIDS Impact Survey (BAIS V), which was released recently, reveals a worrying trend that some people are having sex willy-nilly without protection.
According to the survey, 55.9 percent of those interviewed reported having sex with non-marital, non-cohabiting partner in the last 12 months. Out of this population, only 73.8 percent used a condom.
“This means that people are having sex with people who are not their everyday partners and without protection. This means that there is casual unprotected sex still taking place,” National AIDS and Health Promotions Agency (NAHPA) Manager, Research, Monitoring and Evaluation, Robert Selato said. Selato added that part of the solution to ending new HIV infections lies with almost 30 percent of these people. He said the population of people living with HIV is constantly increasing, according to the new BAIS V. The survey shows that 20.8 percent of Botswana’s population is living with HIV, an increase from 18.5 percent recorded in BIAS lV and 17.6 percent recorded in BIAS lll. Selato said these statistics indicate that there are new infections every year but very few infected people who are exiting the HIV community. He attributed this to the effective Anti-Retroviral Therapy programme. “This is the only way you can get an increase. Our ART programme is doing a wonderful job because it means we are not losing people from HIV. Infected people continue to live, while unfortunately new infections come in,” he said. He is also worried that at 26.2 percent, women are worse off in prevalence compared to males at 15.2 percent, and even higher than the national prevalence.
“Women find themselves at the receiving end because of several reasons. Firstly, their biological make-up means that during sexual activity, women receive from their male counterparts. This predisposes them at an elevated level,” Selato said. Secondly, there are structural issues that include economic employment status, access to money and the ability to negotiate safe sex among others. “In our society, there is a certain
way women are viewed, this leads to manipulation during sexual activity where if the man does not want to use protection, it cannot be used,” he said. As far as HIV new infections are concerned, Selato said within the last 12 months, Botswana is at 0.2 percent. He said this is good progress because it means infections are decreasing having come from 1.35 percent in the previous survey.
“This practically means that statistics of new infections have gone down,” he said. He explained that women who have never been pregnant as per the results, show low viral suppression when they test positive. This means that women who access health facilities usually through Antenatal Care, majority of them are tested, put on treatment and eventually virally suppressed. And this results in less than two percent of predisposed babies, who are born of HIV mothers. “This calls for us to work hard to close the two percent gap,” Selato said, adding that the country should be ready to spend money to look for such pockets of the population. Young people, especially young women and
adolescent girls are also at the receiving end. 20 percent of young women, aged 30 to 34 are already living with HIV, but for the same population, 6.5 percent of males are living with HIV. “What is happening to our young women? For us to ensure a future generation without HIV, we should start looking at adolescent girls and young women,” he said.
The survey shows that among adults aged 15 to 64 years in Botswana living with HIV in 2021, 95.1 percent were aware of their status, 98.0 percent of those aware of their status were on ART, and 97.9 percent of those on ART achieved viral load suppression. BAIS V was a nationally representative household-based survey that was conducted between March and August 2021 to provide information on national and district-level progress towards key HIV targets and measures the status of Botswana’s HIV response. It was led by the Government, through NAHPA, the Botswana Ministry of Health, and Statistics Botswana.