HIV

With an adult HIV prevalence of 20.3 per cent. Botswana is ranked among the top four countries in the world most affected by HIV and AIDS behind South Africa, eSwatini and Lesotho. Among the 370,000 estimated people living with HIV in Botswana in 2018, 29, 500 were young people aged 15-24, the majority of them female (64 per cent). Of greater concern, three in every ten new HIV infections in Botswana in 2018 occurred among adolescents and young people aged 15 – 24 years. Young females in this age group were twice as likely to be newly infected than males the same age and adolescent girls 10-19 years were three times more likely to be infected than boys of the same age.

Botswana is on track to achieve the 90-90-90 treatment targets by 2020. At the end of 2018, 91% of people living with HIV knew their status, 92% of those were on ART and more than 95% of those on treatment were virally suppressed. This achievement however, masks the fact that young children living with HIV are being left behind in HIV treatment scale up and too few are being diagnosed and treated early to prevent HIV-related morbidity and mortality. The picture remains unclear for adolescents 10 – 19 years living with HIV on treatment.

While there is increased awareness of HIV in general, comprehensive knowledge of HIV remains low, condom use among sexually active young people is declining, and rates of forced sex and teenage pregnancy are ominously high. Transactional and age disparate sex, peer pressure, stigma and discrimination, harmful social and gender norms, gender inequality and unequal power dynamics contribute to the constrained progress in reducing new HIV infections amongst adolescents and young people. Furthermore, adolescent girls and young women continue to be disproportionately affected by the HIV epidemic, with early sexual debut, forced marriage and gender-based violence further increasing their vulnerability to acquiring HIV.