Service Contract No 2007 / 147-446 Strategic ... - Swaziland

common to the extent that no individual, community or organisation has not been affected insome way. ‘Entrenched’ given the high percentage of those with the virus.The HIV prevalence rate in Swaziland is said to be amongst the highest in the world 34 :- An estimated 18.8% of the population (aged two and older) was infected with thevirus in 2006/0735. In 2007 the number estimated to be living with HIV was 185,005.- The prevalence level was 5.8% among youth in the 15-19 age group, rising to 26.3%for those 20-24 years of age and 39.2% for those aged 25-29. The highest level ofinfection (44.9%) was in the 30-34 age group, followed by 40.7% for those aged 35-39. The HIV rate declined to 32.3% for the 40-44 age group and to 24.2% for peoplebetween 45-49 years of age, rising slightly to 25.9% among those aged 50-54.- The age patterns of HIV infection differ for women and men. Overall in 2006/07 morewomen (22.1%) were HIV positive than men (14.9%) 36 . Among the population under35 years of age, HIV rates for women were higher than for men, peaking to 48.9% inthe 25-29 age cohort. For men the infection rate was at its highest level in the 35-39age group (44.9%).- In 2006/07 the estimated rate of infection amongst adults (aged 15-49) was 26.1%:31.5% in urban areas, and 23.7% in rural areas. By region the adult HIV rate variedfrom 23.1% in Shiselweni, 25.0% in Manzini, 26.2% in Lubombo, and 28.8% inHhohho. The rate of HIV prevalence was higher among adults who never attendedschool than those who attended school. Among educated women the rate generallydeclined with the level of schooling, while among men the pattern was more variable.The main causes of the epidemic are biological, behavioural and socio-economic. Biologicalincludes a proneness to women contracting the disease due to physical makeup; socioeconomicfactors, that poverty and income inequality levels expose people to providing sexfor financial and material gain. Behavioural aspects include the subordinate social status ofwomen to men, placing them in a vulnerable position to the risk of HIV infection; a lack of(correct) knowledge about virus transmission and methods of protection; and negativeattitudes to prevention through abstinence, faithfulness and condom use. There is the viewthat the country “has a number of potentially high-risk traditions and current practices thatmake the population vulnerable to HIV infection (which) include multiple sexual partners,changing sexual partners, sex at social gatherings … intergenerational sex, the early onsetof sexual activity, (and) gender inequality” (UNDP, 2007).The causes of the high levels of HIV/AIDS in the sugar sector can be attributable to a rangeof factors, amongst which has been the in-migration of males to seek work, not only fromSwaziland but from neighbouring countries such as Mozambique, an increase in the numberof casual seasonal workers, the raised social status and disposable income of those withwork, and single-sex accommodation on the sugar estates, all leading to an increase in thenumber of commercial sex workers in the area. The dependence of women on men incontrolling the terms under which they have sex, including whether a condom is used, andthe vulnerability of neighbouring communities to the offer of money for sexual favours,compound the issue. In addition there are no structural HIV/AIDS prevention/educationprogrammes in place for some smallholder sugar cane schemes.34 Sources: Central Statistical Office (2008) and www.unaids.org35 The total population of the country was 1,018,449 according to the 2007 Population and Housing Census, conducted bythe Central Statistical Office (CSO).36 According to the 2007 Census, 537,021 inhabitants of the country were women, and 418,428 were men.RDMU (Strategic Environmental Assessment of the National Adaptation Strategy) - Page 76