Although the headline might be astounding, the actual figures on the ground are much lower.
The latest 2020 report of the Global HIV Prevention Coalition entitled “Implementation of the HIV Prevention 2020 Road Map” says although Botswana managed to reduce the number of people acquiring HIV, the country still experienced exceptionally high HIV incidence among adults (15–49 years old) in 2019.
“In Botswana, Eswatini, Lesotho and Mozambique, the incidence of HIV infection among adults in the general population was higher than 8 per 1000, and at least 20 times higher than the estimated global HIV incidence of 0.4 per 1000,” states the report.
The number of adults newly infected with HIV declined from 13 000 in 2010 to 9 300 in 2019, a 27% decline. Botswana missed the 2020 target of 3 200.
While Botswana is applauded for the significant progress made in the fight against HIV, the report cautions that there is need to ensure that the annual number of people acquiring HIV declines in the coming years by focusing on key populations.
“Most Coalition focus countries––including those with successful HIV responses––have geographical areas and/or populations that are not being reached with effective prevention services and options,” states the report.
The most recent data shows that of the estimated 18 000 sex workers in Botswana, at least 42% of female sex workers (all ages) are living with HIV, while 88% are receiving antiretroviral therapy. In 2019, 76% of sex workers are reported to have used a condom with most recent client (self- reported). Botswana also has the third lowest number of sex workers among the 28 coalition countries while the highest was Nigeria with 874 000, followed by Democratic Republic of the Congo with 350 000.
The recent data shows that of the 10 000 gay men and other men who have sex with men (all ages), the HIV prevalence is 15%, while 74% are receiving antiretroviral therapy. In 2019, 76% of gay men and other men who have sex with men reported to have used a condom at the last anal sex. Among the 28 coalition countries, Botswana also has the third lowest number of gay men and other men who have sex with men, while the highest was Brazil with 2 000 000, followed by Mexico with 1 200 000.
Since it was launched in 2017, the Global HIV Prevention Coalition has helped to bring fresh momentum and clarity to HIV prevention programmes in its 28 focus countries. It has identified and promoted priority prevention approaches and interventions, rekindled political commitment for prevention, encouraged interventions to address structural drivers of the epidemic, and guided and supported programme innovations.