Beating HIV/AIDS in Botswana

Each year on Dec. 1, the global community uses World AIDS Day to remember lives cut short by HIV/AIDS and to renew a sense of urgency around ending the epidemic. The occasion holds particular significance in Botswana, where more than one in five people have contracted the virus. The southern African nation has the third highest HIV prevalence rate in the world, trailing only Swaziland and Lesotho.

Project Concern International (PCI) and its partners play a critical role in complementing the health sector’s 2020 goal to get 90% of people with HIV knowing their status, 90% of those who are HIV-positive receiving sustained antiretroviral treatment, and 90% of those treated achieving viral suppression. Together, we are working on multiple levels to get people tested and treated. Most importantly, PCI and its partners are addressing the underlying social-psychological issues that hinder such critical practices as knowing one’s HIV status, practicing safe sex, and adhering to treatment.

In the first year of the Botswana Comprehensive Care and Support for Orphans and Vulnerable Children (OVC) project, PCI and partners reached 9,988 OVC. Of this total, 959 reported having a positive HIV status, with 941 on treatment. However, 4,204 reported an unknown HIV status, with another 149 declining to disclose. Our partners have referred more than 1,000 beneficiaries for testing.

To address the large number of those reporting an unknown status, PCI uses an assessment tool to prioritize their risk. Those at high risk are referred for HIV testing and counseling, those who test negative are provided HIV prevention intervention, and those with positive test results are linked to treatment services.

PCI’s efforts to combat HIV are most evident at the household level, where the project delivers basic counseling, psychosocial and adherence to HIV medication support, and provides basic HIV information. All complement the health sector’s efforts to mediate the disease for the patient and community at large.

One example of why grassroots efforts are critical to changing attitudes and behaviors occurred earlier this year in Good Hope, a village in the Southern District of Botswana. During a home visit, the community service provider from Stepping Stones International found a client who acknowledged an HIV-positive status but who was reluctant to go on treatment. The client was then offered education about HIV and AIDS and additional encouragement, which culminated in treatment enrollment. Subsequent visits reinforced the importance and value of treatment adherence, with the beneficiary remaining faithful to the medication regimen.

Such a story is repeated again and again in all six districts where the OVC program is conducted. HIV status is one of the core indicators for the project and every effort is made to have beneficiaries know their status, so they can be guided to treatment and counseling and to conduct follow-up for treatment adherence for those on medication.

Each success story builds upon the next. In so doing, PCI and partners are helping Botswana address its most critical health problem. These cumulative individual successes also lay the groundwork for Botswana’s contribution to achieving the end of the HIV/AIDS epidemic by the year 2030, as set by the United Nations Programme on HIV/AIDS.

In the meantime, Botswana will observe World AIDS Day 2017 with an appreciation for how far it has come and a resolute commitment to push forward until an end to the epidemic is realized.