HIV Prevention Efforts Lower Incidence Rates in Low Income Regions

The CDC recently reported that Swaziland, located in southern Africa, made significant progress against the HIV epidemic faced by the country. These results show that global HIV efforts have been successful in reducing the global burden of the disease.

Swaziland has the highest HIV prevalence rate in the world, according to the CDC. Despite high prevalence, results from the Swaziland HIV Incidence Measurement Survey (SHIMS2) indicate that the rate of new infections decreased by 50% between 2011 and 2016. During this time, the rate of HIV viral suppression was doubled, which was significant.

SHIMS2 was a type of population-based HIV impact assessment (PHIA), which is a national survey that measures progress towards global control of the HIV epidemic, the CDC reported. These surveys include in-house visits, interviews, HIV testing, and novel technology.

The CDC partners with other countries through the President’s Emergency Plan for AIDS Relief (PEPFAR).

“CDC plays an essential role in the global HIV response by ensuring that programs rapidly respond to new data for greatest impact,” said Brenda Fitzgerald, MD, director of the CDC. “These findings show a dramatic transformation in Swaziland where, at one time, HIV was destabilizing family structures, communities, and its economy. CDC’s commitment as a longstanding stakeholder in the global HIV response, working side-by-side with ministries of health on evidence-based programs, has helped transform some of the world’s most severe HIV epidemics.”

These latest findings add to the results of PHIA surveys from 3 other countries, which pointed to improved control of the HIV epidemic. The results from Malawi, Zambia, and Zimbabwe indicate that 87% of HIV-positive individuals were receiving treatment and 89% of patients achieved viral suppression, according to the CDC.

“Results from Swaziland, Malawi, Zambia, and Zimbabwe clearly show that our efforts, through PEPFAR, and, in concert with partners are working,” said Rebecca Martin, PhD, director of CDC’s Center for Global Health. “As a key partner in PEPFAR, CDC supports countries’ sustained responses to their HIV epidemics, as well as to other global health threats, ultimately protecting the health and economic well-being of America and the rest of the world. Today’s investments in controlling the global HIV epidemic will save lives and costs into the future.”

The 4 PHIA surveys have helped the community determine which patients need to be reached to control the epidemic, such as those in specific populations and geographic areas.

The CDC said that young individuals, especially girls and women, are less likely to know their HIV status and receive treatment, according to the release. Additionally, the SHIMS2 showed that men aged 20 to 35 years needed access to more tailored treatment approaches and prevention.

“These groundbreaking findings from Swaziland show that we are making strong progress toward controlling the HIV epidemic in the country with the highest HIV prevalence rate in the world,” said Ambassador Deborah L. Birx, MD, US Global AIDS coordinator and special representative for Global Health Diplomacy. “Combined with the results from 3 additional PEPFAR-supported surveys that we released last December, we now have clear evidence that four African countries are approaching control of their HIV epidemics using the 90/90/90 fast track strategy.”