While applauding Botswana for its extensive rollout of antiretroviral therapy, the latest 2020 report of the Global HIV Prevention Coalition entitled “Implementation of the HIV Prevention 2020 Road Map” says data on HIV among prisoners and detainees is insistently invisible in Botswana’s official statistics. In the fight against the HIV epidemic, the report also cautions against overlooking key populations such as sex workers and transgender people and gay men and other men who have sex with men.
“Data on HIV prevention among prisoners and detainees are also scarce and often limited to whether services are available,” states the report adding that “while data on HIV prevention among prisoners and detainees was scarce in Botswana, antiretroviral therapy is available.”
The report says scarcity of data is mainly caused by political reluctance, lack of investment and legal and policy barriers, adding that another hindrance is how the prisons are congested and have poor living conditions. “Increased access to the continuum of HIV testing, prevention and treatment services in prison settings is a major need and opportunity,” states the report.
The report acknowledges that while population sizes are known and largely documented, data on use of HIV prevention services are rarely available.
“Incarcerated people are often neglected in national responses even though they are at high risk of HIV infection because of unprotected sex, sexual violence and unsafe injecting practices as well as higher risk of acquiring HIV before they were incarcerated,” states part of the report.
The 90-90-90 target set by UNAIDS encourages countries to aim to achieve diagnosis of 90% of people living with HIV by 2020, initiation of treatment by 90% of diagnosed people by 2020 and viral suppression in 90% of people on treatment by 2020. Botswana has already surpassed this target at 91-92-95%. Recently on World Aids Day, the government said they are now looking at improving this target further to 95-95-95%.
Botswana has shown strong commitment in responding to its HIV epidemic and has become a standard within sub-Saharan Africa. It was the first country in the region to provide universal free antiretroviral treatment (ART) to people living with HIV. The impact of its treatment programme has been extensive as it resulted in a decrease of new infections and AIDS-related deaths.