Pascalinah Kabi
LESOTHO has made huge strides in addressing the scourge of HIV and Aids with a recent study revealing that 90.2 percent of people living with HIV were now on antiretroviral (ARVs) treatment.
This figure surpasses the second of three ambitious 90-90-90 treatment targets seeking to end the Aids epidemic by 2020.
The first 90 target seeks to ensure that by the year 2020, 90 percent of all people living with HIV know their HIV status and the second target seeks to ensure that 90 percent of all people diagnosed with HIV receive sustained antiretroviral therapy. The third target is to ensure that 90 percent of all people receiving ARVs will have viral suppression by 2020.
Lesotho embarked on different campaigns as part of efforts to ensure that the set targets were met by 2020, including the Know Your Status, Prevention of Mother to Child (PMTC) and Test and Treat campaigns.
The country subsequently embarked on the Lesotho Population-Based HIV Impact Assessment (LePHIA) to measure the impact of these campaigns and the study revealed that the Lesotho had made huge progress in the fight against HIV/AIDS and surpassed the second of the 90-90-90 treatment targets.
LePHIA is a nationally representative study led by the government through the Ministry of Health, with funding and technical support from the US government through PEPFAR, Centre for Disease Control and Prevention (CDC) and ICAP at Colombia University.
The PHIA project consists of household population surveys to collect information related to HIV in approximately 15 countries and in Lesotho, the survey involved 10 000 households and 15 000 participants.
The LePHIA preliminary results were released on Tuesday, with Deputy Prime Minister, Monyane Moleleki, saying there was significant progress in controlling the HIV epidemic.
The full report will be reportedly released on World Aids Day on December 1 this year.
“In terms of the first 90 percent target, 77.2 percent of people living with HIV in Lesotho from the ages 15 to 59 years reported knowing their HIV status,” Mr Moleleki said, adding, “81.5 percent of HIV-positive females and 71 percent of HIV-positive males know their HIV status”.
“In terms of the second 90 percent target, among people living with HIV, from the ages 15 to 59 years who know their HIV status, 90.2 percent self-report current use of ART. 90.6 percent of HIV positive females and 89.4 percent of HIV positive males who know their HIV status self-support current use of ART.
“In terms of the second 90 percent target, among people living with HIV, from the ages 15 t0 59 years who self-report current use of ART, 88.3 percent are virally suppressed. 88.3 percent of HIV-positive females and 88.4 percent of HIV positive males who self-support current use of ART are virally suppressed.”
Mr Moleleki said that Lesotho reported the first case of HIV in 1986 and this was at a rural district from a non-national.
“Little did we know that it was the beginning of a journey that will impact negatively to our health system as well as devastating communities and families”.
“Today my country is ranked second in the world and many children are orphaned by the HIV and Aids pandemic,” he said.
Lesotho has HIV prevalence rate of 25 percent, making it the second highest in the world after Swaziland.
Mr Moleleki said together with its partners, Lesotho engaged in numerous proven innovative strategies to curb the pandemic, becoming the first Southern African country to implement the Test and Treat strategy in June 2016.
“The annual incidence of HIV among adults aged 15-59 years in Lesotho is 1.5 percent new infections per 100 persons (1.7 percent among females and 1.2 percent among males).
“The prevalence of HIV among adults aged 15 to 59 years in Lesotho is 25.6 percent broken down to 30.4 percent among females and 20.8 percent among males. This corresponds to approximately 300 000 people living with HIV from the ages 15 to 59 years in Lesotho,” Mr Moleleki said.
He said this however does not mean there was more carelessness among females.
He said the prevalence of viral load suppression among HIV-positive adults aged 15-59 years was 67.6 percent with 70.6 percent among females and 63.4 percent among males.
“As a country we note that despite the great progress achieved, there are still challenges particularly in the areas of prevention and testing.”
He said government would soon pronounce itself in combating the gaps that had been identified in the survey.
Mr Moleleki said HIV/AIDS was a reality for all Mosotho, adding that every household had not been affected by the epidemic.
He said he had personally experienced the devastating impact of HIV and Aids in Lesotho, saying that his orphanage – Lesiba Children’s Home – housed 90 children “virtually orphaned by HIV”.
Meanwhile, United States Ambassador to Lesotho, Matthew Harrington said the information gathered by the LePHIA was invaluable and would be used to influence programming to avert new HIV infections and to save lives in Lesotho.
He said his country had committed more than US$343 million (M4, 6 billion) to the HIV response in Lesotho.
“The US government through PEPFAR will continue to commit substantial resources and work hand-in-hand with government, implementing partners, and civil society to help Lesotho achieve the UNAIDS 90-90-90 goals,” Mr Harrington said.
“While we are here to celebrate the release of some very encouraging news, it is important to remember that there is much work left to do in order for Lesotho to gain control of this epidemic.”
Mr Harrington said while the LePHIA results showed a remarkable progress towards achieving the 90-90-90 targets, it also provided critical information that will enable them to gauge where their collaborative efforts had worked and where they needed to make adjustments.
He said he was optimistic that Lesotho would achieve the ultimate goal of an Aids-fee generation in Lesotho.
For his part, ICAP Technical Director, Koen Frederix, said the results revealed that the recent severe El Nino-induced drought did not have a negative impact on the medication adherence.
Dr Frederix was responding to a question of whether the results on medication adherence would have been far much better in the absence of drought as people reportedly stopped taking medication due to lack of food.
The 2015/16 drought left over 600 000 Basotho food insecure.
“The results on the adherence to treatment will also be released tentatively on World Aids Day as not all data has been analysed yet. However, the preliminary results show that people are adhering well to treatment despite the challenges like drought,” Dr Frederix said.
