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New HIV infections high among women


The new recency testing surveillance system has revealed that new HIV infections are relatively high among women compared to their male counterparts, Newsday has learnt.

According to the data from the survey, women constitute 79 percent of new infections and 21 percent are men.

This was revealed by the ministry of health’s HIV and AIDS Manager Tapiwa Tarumbiswa this week during the national HIV and AIDS symposium.

Tarumbiswa said the surveillance system was established in partnership with development partners including the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Africa Centres for Disease Control and Prevention (CDC) and the World Health Organisation (WHO).

He said this work started in 2019 but got affected significantly by Covid-19. The scaling up of the intervention only started in April this year.

A recency test is a laboratory-based test that detects whether an HIV infection is recent (less than six months) or not.

By determining recent infections among people newly diagnosed as living with HIV, the authorities can identify the geographic areas and subpopulations where HIV transmission is happening.

They can then effectively interrupt HIV transmission by building evidence-informed policies, guiding resources to the right place and measuring the impact of HIV prevention programmes.

The incorporation of HIV recency testing in national HIV case reporting systems will help to assess how HIV is being transmitted, describe behaviours that are facilitating HIV transmission and optimize HIV-related data collection and information on risk factors.

Tarumbiswa told the symposium on Monday that the preliminary findings of the surveillance intervention indicated that 10 percent of newly diagnosed people living with HIV had recently been infected.

“We have up to date 198 public facilities that are implementing this intervention but the numbers are still small relative to the entire population but it is a study that we are starting to scale up to ensure we have the appropriate surveillance system in place,” he said.

He revealed data from the surveillance system shows that 79 percent of these new infections were among women and 21 percent of them among men.

“Out of the 7592 cases from August 2019 up until now that are in the study who are newly diagnosed, we tested 490 that came out as recent infections and out those recent infections 382 of them were women compared to 107 that were men,” he said.

He said what that meant was that although the number of recent infections was relatively small at 490 infections, it was worrying that 79 percent or 382 cases were females.

He also said the bulk, nearly 39 percent of these new infections, were among young people aged between 15 and 24.

“When we look at men, they account for 21 percent of these recent infections. 20 percent of them are between the ages of 15 and 24,” he said.

He called on all stakeholders in the fight against HIV and AIDS to start by addressing the social determinants of the pandemic.

He said this requires all the stakeholders at the individual level, and community level to do more to address poverty, food insecurity, gender-based violence (GBV), stigma and discrimination and unemployment, among others.

Social determinants of health can affect an individual’s probability of acquiring HIV through influences on behaviour, limited access to preventive measures, and limited access to healthcare providers or testing sites.

Tarumbiswa said the ministry of health was at the moment primarily focused on biomedical interventions which include HIV testing, condoms, ARVs, prevention of mother-to-child transmission, PREP and Voluntary Male Medical Circumcision (VMMC).

“But we have to be cognizant that HIV prevention is not just these interventions. As we are aware, there are also structural interventions such as decriminalization of key populations, addressing gender-based-violence, laws that protect the rights and interventions fights stigma and discrimination,” he said.

Luckily, on October 25, the high court issued a judgment on a constitutional challenge to certain sections of the Sexual Offences Act that impose mandatory HIV testing on persons accused of sexual offences, and subsequently, impose a death sentence on persons convicted of sexual offences solely based on their HIV-positive status.

In a judgment written by Justice Makara, the high court, sitting as a constitutional court, declared that section 32(a)(vii) of the Sexual Offences Act was unconstitutional to the extent that it imposes a death sentence solely based on a person’s HIV status, as this was discriminatory and amounted to inhumane treatment.

The Court said that people convicted of sexual offences should be sentenced according to the mitigating or aggravating circumstances rather than HIV status alone and that the law should be interpreted so as not to require a mandatory death sentence for a person living with HIV.

In August last year, the ministry of health, the U.S. embassy in Lesotho and representatives from ICAP at Columbia University announced the final results of the Lesotho Population-based HIV Impact Assessment (LePHIA 2020) survey.

LePHIA 2020 was a household-based national survey that was conducted between December 2019 and March 2020 to measure the status of Lesotho’s national HIV response.

The survey provided evidence of the excellent achievements of Lesotho’s HIV program.

It demonstrated that Lesotho had achieved the first of the UNAIDS 90-90-90 targets and had exceeded the second and third 90 targets.

These findings positioned the country well as it aims to achieve the revised and more ambitious UNAIDS targets of 95-95-95.

In a country with a population of 2.1 million, the survey found 22.7 percent – approximately 324,000 – of adults (aged 15 years and older) were living with HIV.

Among adults, the annual incidence of HIV was 0.45 percent (0.64 percent among women and 0.28 percent among men), corresponding to about 5,000 new infections per year.

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