Your daily Selection of IRIN Africa PlusNews reports, 4/8/2005

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) - 1995-2005 ten years serving the

humanitarian community

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - SWAZILAND: Some optimism despite gloomy new HIV figures

1 - SWAZILAND: Some optimism despite gloomy new HIV figures

MBABANE, 8 April (PLUSNEWS) - Reactions to news this week that Swaziland's

HIV-prevalence rate - already the world's highest - continued to climb, have

swung between deep pessimism and renewed determination by AIDS activists and

government officials.

Data taken from pregnant women visiting prenatal clinics last year as part of a

Ministry of Health surveillance study showed that the prevalence rate had

climbed by 6 percent since 2002, to 42.6 percent.

The full results of the survey are to be released later this month.

" The only way these numbers will go down is by death. The people found

HIV-positive in 2004 will remain so in 2006, when the next survey is taken, if

they are still alive. So, added to them will be those who are infected since

then, " said von Wissell, director of the National Emergency Relief

Committee on HIV/AIDS (NERCHA).

His agency funds anti-AIDS initiatives with grants from the government, private

donors and the Global Fund to Fight HIV/AIDS, Malaria and Tuberculosis.

" These statistics sound a further death knell for the Swazi nation, " said health

worker Florence Gule.

One writer in the independent Times of Swaziland called the survey's findings " a

national extermination notice " , but other health workers were less pessimistic.

" We commend the government of Swaziland for releasing these figures - only

through the truthful dissemination of sometimes-painful information can

mitigation programmes be formulated: an alarm is sounded, and action follows, "

said Lois Lunga, executive director of the Southern African AIDS Information and

Dissemination Service.

Alan Brody, country representative for the UN's Children's Fund (UNICEF),

compared the surveillance data with other studies, which helped provide a more

complete picture of the AIDS situation in Swaziland.

" We should note that the 42.6 percent HIV-prevalence rate figure is accurate for

women from 20 to 35 or 40 years old. When women get above 40, it goes down a

little, but the number of women in this age group is not that great. Men 25 to

40 are pushing 40 percent prevalence rate, " Brody said.

However, an estimate of older Swazis showed that about 15 percent were infected.

" If you put the whole population together, you get approximately 20 percent HIV

prevalence, " Brody noted.

NERCHA has estimated there are 220,000 HIV-positive Swazis, which would

correspond to a 20 percent prevalence figure for a population of about one

million people. UNICEF's figure is lower, at 200,000 infected Swazis. Most

health officials agree that the percentage for HIV-positive people ranged from

18 percent to 20 percent.

There has been debate over HIV figures because of the different methodologies

that can be used to calculate prevalence, each of which are subject to potential

biases.

In much of Africa, UNAIDS and the World Health Organisation rely on statistics

gleaned from antenatal clinics. However, data from population-based Demographic

and Health Surveys (DHS) conducted in several countries last year " suggested

that previous estimates based on sentinel surveillance were too high " , UNAIDS

acknowledged in its 2004 global report.

Health minister Sipho Shongwe emphasised a decline in HIV prevalence among

teenage girls, shown in the latest survey, as a sign that the AIDS protection

message was getting through, and the apex of the health crisis might have

passed. About 29.3 percent of pregnant girls were found to be HIV-positive in

2004, down from 33.5 percent in 2002.

" We cannot say we have turned the corner on AIDS on the basis of that sampling,

because it falls within the plus or minus 3 percent error rate of such

statistical studies, but at least it didn't go up, " said Brody.

The apparent decline in HIV infections among teenage girls conforms to a 2003

UNICEF study that found a similar lessening of HIV prevalence in this group.

Swazi health officials are looking forward to the completion of the country's

first DHS by mid-year, which they expect will give a more complete picture of

AIDS. The cost and technical expertise required for such a door-to-door survey

prevented the use of a DHS in the past.

All health experts agreed that a rise in Swaziland's overall HIV prevalence rate

in the next survey might not be a disaster, and instead could point to the

success of the country's nascent antiretroviral (ARV) treatment programme.

" The ARV rollout is continuing, and more HIV-positive Swazis are on this

programme and living longer. A higher HIV prevalence rate may actually mean that

there are fewer deaths, thanks to ARVs, " said health motivator Gule.

Brody concurred: " If we are successful in keeping people alive with our ARV

programme we will see an increase in the prevalence numbers. Over the past five

years, 15,000 people have been dying annually, while 16,000 to 17,000 people are

newly infected with HIV. If we see the [prevalence] numbers getting higher, it

shouldn't frighten us. "

Health officials insisted AIDS prevention should still be a top priority. " We

need to focus our interventions on children aged eight to 18 - the ones who are

not yet sexually active. It's much easier to influence their behaviour and

attitudes before they are sexually active, " said Brody.

Thandi Hlengetfwa, director of The AIDS Information and Support Organisation,

noted: " We must also continue reinforcing the 18 to 24 group of young adults;

you want to keep influencing them and creating an environment that reduces risk,

including stronger law enforcement against sexual abusers, greater empowerment

for women to say no to unwanted sex, and a change in the culture of casual

sex. " [ENDS]

We have sent this message from a no-reply address to avoid bounced messages into

our general email folder. Please do not hesitate to contact us at

Mail@... with any comments or questions you may have

[This Item is Delivered to the English Service of the UN's IRIN

humanitarian information unit, but may not necessarily reflect the views

of the United Nations. For further information, free subscriptions, or

to change your keywords, contact e-mail: Irin@... or Web:

http://www.irinnews.org . If you re-print, copy, archive or re-post

this item, please retain this credit and disclaimer. Reposting by

commercial sites requires written IRIN permission.]

Copyright © UN Office for the Coordination of Humanitarian Affairs 2005

IRIN Contacts:

IRIN-Asia

Tel: +90 312 454 1177

Fax: +90 312 495 4166

Email: IrinAsia@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments