HIV Prevalence by Age Group, Botswana 2004 and 2008

0

5

10

15

20

25

30

35

40

45

Age Group

2004

2008

2004 6.3 6 3.9 6.6 19 33 40.2 35.9 30.3 29.4 20.9 14 12 9 13.1 17.1

2008 2.2 4.7 3.5 3.7 12.3 25.9 39.7 40.5 40.6 29.8 24.8 22.8 15.4 10.8 9.4 17.6

1.5 - 4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 Total

HIV Prevalence by Age group, Botswana 2004 and 2008

0

5

10

15

20

25

30

35

40

45

1.5 - 4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74

Age group

Pre

vale

nce

rat

e

2004

2008

HIV Prevalence by Age group and Gender, Botswana 2008

0

10

20

30

40

50

60

Age group

Prev

alen

ce Males

Females

Males 2.3 4.6 3.5 2.4 7.4 16 28.6 37.3 43.6 27.7 28.8 19.5 16.7 13.6 14.4 14.2

Females 2.1 4.8 3.5 5 16 33.9 48.9 42.8 38.4 31.2 22.2 25.1 14.4 16.6 7.6 20.4

1.5 - 4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 Total

HIV Prevalence by Gender, Botswana 2004

0

5

10

15

20

25

30

35

40

45

50

Age Group

Pre

vale

nce

rate

males

females

males 5.9 5.9 3.8 3.1 9.1 22.9 36.2 33.3 33.6 31.7 23.3 11 15.2 8.1 15.8

females 6.8 6.2 3.9 9.8 26.2 41 43.7 37.8 28.1 27.9 19.3 16.3 9 9.6 10.5

1.5 - 4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74

0

5

10

15

20

25

30

35

40

45

50Pr

eval

ence

(%)

15-19 16.4 21.8 20.7 32.4 27.2 28 28.6 21.5 22.9 24.7 21 22.8 18.1 17.5 17.2 13.1

20-24 20.5 27.1 31.5 34.8 40.9 41.4 42.8 38.7 39.4 38.7 37.4 38.6 31.2 29.4 27.9 24.3

25-49 13.6 16 18.3 25.9 27.2 31.1 34 35.9 35.5 40 40.5 42.8 40.7 39.4 43.7 42.4

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2005 2006 2007 2009

Trends in age-specific HIV prevalence rate among antenatal women 1992-2009, Botswana sentinel surveillance

Incidence and key populations

• Incidence is becoming important measure for tracking epidemic

• 2008, BAIS III made an effort to measure incidence and data is still being analysed with expert support

• Lack of HIV data on key populations• Know Your Epidemic Study being finalized

will assist to learn more about epi and where new infections are coming from

Key drivers/risk factors

multiple and concurrent partnerships by men and women with low consistent condom use and in the context of low levels of male circumcision”, and:– male attitudes and behaviours – inter-generational sex /age-disparate sex– sexual and gender based violence – stigma, denial, lack of openness– untreated viral STIs– Lack of/inadequate male involvement

Underlying context - gender and socio-economic inequalities, mobility, and other structural factors

HIV Testing In Botswana

Source: RHT, TEBELOPELE, BOCAIP AND BOFWA QUARTERLY M&E REPORTS

Botswana NSF II (2010-2016)

• Accelerate Prevention to reduce HIV incidence by at least 50% by 2016: Country wide campaign against MCP launched mid 2009, scale up MC to cover > 400,000 by 2016, move towards virtual elimination of MTCT, strengthen social and community mobilization and empowerment for prevention ownership and effective engagement to drive the agenda. Combination prevention interventions

• Strengthen institutional and community capacity including improvement of enabling environment to access services.

• Improve management of strategic information• Scale up treatment , care and support including TB/HIVFocusing on quality improvements, efficiencies, effectiveness &

sustainability of programmes/interventionsESA reduction in incidence will avert 2.25 mil new infections, 08-

15 and cumulative Rx costs averted, 11.5 billion dollars

Resources

Reduced/flat funding will• Affect prioritization of prevention (MC, MCP interventions etc)

• Hamper efforts to increase Rx coverage and negate the gains made towards universal access and quality

• Lead to an increase in MTCT and pediatric AIDS.

• Compromise ability to strengthen institutional and community capacity

• Affect operations research