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  2. Test and treat: Eswatini cuts back HIV infections

Test and treat: Eswatini cuts back HIV infections

Mbabane – Eswatini has made significant progress in combatting HIV, one of the leading causes of death in the country. With concerted efforts on testing and treatment, the country has achieved the global targets of ensuring that 95% of people living with HIV know their status, that 95% of them are receiving treatment and that 95% of those receiving treatment have their viral load suppressed. Eswatini has become the first country in Africa to reach these global HIV targets, a decade ahead of the 2030 deadline set by Member State. In the country’s northern Mayiwane area, 58-year-old Thembi Dlamini, who started treatment more than a decade ago has seen her health greatly improve and encourages others to know their status.

Test and treat: Eswatini cuts back HIV infections
Dlamini has been living with HIV since 2005. After contracting the virus “I lost weight. I weighed 35 kg. Many people though I had been bewitched,” she says. Stigma and discrimination of people living with HIV was widespread when Dlamini got infected with the virus, leading to belief among some that the illness was due to witchcraft. “People shunned me,” she recalls.
Test and treat: Eswatini cuts back HIV infections
Dlamini and other women in her village formed a support group. In addition to encouraging each other, the group runs a cottage industry making floor polish, fabric softeners and body lotion. The products are made from sisal plants that grows in the area.
Test and treat: Eswatini cuts back HIV infections
Once the leaves are harvested, they are peeled, chopped and boiled to extract the sap which the women transform to make the cosmetic products. Money from the business supports their families. “We teach each other crafting skills and advice each other on family matters,” Dlamini says. “We also teach each other farming techniques.”
Test and treat: Eswatini cuts back HIV infections
When she first learned of her HIV status, she immediately enrolled on treatment. She has been taking the medication for more than 10 years. The government has made antiretroviral drugs available and free-of-charge.
Test and treat: Eswatini cuts back HIV infections
Dlamini says the antiretroviral drugs have helped her overcome opportunistic infections which had started affecting her early on.
Test and treat: Eswatini cuts back HIV infections
The government has decentralized integrated HIV and tuberculosis care and treatment to community primary health care clinics and ensured that nurses are trained to initiate patients into antiretrovirals. Dlamini visits her local clinic to refill her drugs and to get checked.
Test and treat: Eswatini cuts back HIV infections
Dlamini says she advises people to ensure that they get tested for HIV to be aware of their status. She says this would help them start treatment since government has introduced the “Test and Start” approach which allows people to begin treatment as soon as they test positive for HIV.
Test and treat: Eswatini cuts back HIV infections
“Skipping treatment is like covering the virus with a blanket,” Dlamini point out. “When it wakes up it will be more potent.”
Test and treat: Eswatini cuts back HIV infections
People living with HIV get their viral load checked every six months and once the viral load is undetectable, they are tested once a year. This has helped the government to know the number of people who are virally suppressed and to support people struggling to suppress their viral load improve drug adherence.
Test and treat: Eswatini cuts back HIV infections
A nurse gives Dlamini her drug refill. With the COVID-19 pandemic, the government directed health facilities to provide six-month, instead of month-long, refills to limit crowding in health facilities and help curtail the spread of COVID-19.
Test and treat: Eswatini cuts back HIV infections
The government’s strong commitment to tackle HIV has seen infections decline by 66% between 2010 and 2019 and AIDS-related deaths halve. “The availability of the drugs helped me as they are free. Otherwise I would have died,” says Dlamini.
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