HIV prevention and response for children and adolescents
HIV is one of the key pressing challenges affecting adolescents in Eswatini and is also one of the leading cause of deaths. There has been substantial investments in the HIV programme by both the government and development partners over the last decade. These investments have had a 44 per cent reduction in new infections, but this progress has not been seen among the adolescent and young people population). The issue of adolescents and HIV has previously not been a key focus on the national development agenda but is continuing to gain importance. Adolescents’ access to transformative behaviour change interventions, HIV testing, treatment and care therefore remains an ongoing challenge.
Eswatini has the highest HIV prevalence globally with a prevalence rate of 27 per cent among the 15-59 year-old. Although there have been declining incidence over the last 5 years in all age cohorts, the rate of new infections remains at 1.4 per cent in the population aged 18 to 49 years, but with even higher levels among female young people aged 15- 24 years (1.9 per cent) with young women 15-24 years 5 times more likely to be infected with HIV than their male counterparts. This is attributed to biological factors, negative gender and social norms, inability to negotiate protected sexual intercourse, coerced sex and a myriad of factors that promote intergenerational sex, coupled with insufficient comprehensive and age appropriate behaviour change communication and HIV prevention education coupled with low perception of HIV risk and low condom efficacy, particularly among females. A comprehensive sex education/life skills education programme is being rolled out at secondary level, but as 70 per cent of 13 to 15-year-olds (secondary-age pupils) are still at primary school, this is not meeting the needs of the target audience.
As a result of the above, an estimated 10,754 adolescents are living with HIV, out of whom, only 37 per cent are on antiretroviral treatment (ART). HIV-related stigma continued to affect prevention and treatment efforts. Between 2010 and 2014, HIV related stigma increased by over 20 per cent and only one in four adolescents had accepting attitudes towards people living with HIV.
The country has policies and strategic plans to guide programming for this important populations, but key gaps still exists in design and delivery of effective high impact interventions at sufficient coverage to impact the epidemic and in monitoring and evaluation of programmes.
How is UNICEF Eswatini supporting HIV prevention and response for children and adolescents
To meet the changing demands of the labour market and social dynamics, a holistic response is required for working with and for adolescents and young people to create healthier, safer and wealthier lives. UNICEF will work with partners to improve adolescent HIV prevention and improve equitable prevention of and response to violence. Using innovative technology, UNICEF will also work with adolescents and young people and their communities to improve knowledge on HIV and AIDS and the impact of violence, focusing on empowering adolescent girls and young women and promoting their participation, and adolescent boys and young men as agents of change. UNICEF will support the school-to-employment transition, including provision of vocational training are further keeping many adolescents and young people from achieving a better future and empowered livelihoods.