At a glance: HIV in Eswatini

• 220,000 people with HIV
• 27.9% adult HIV prevalence
• 6,900 new HIV infections
• 2,600 AIDS-related deaths
• 91% people on antiretroviral treatment

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

In 2021 in Eswatini:

Did you know? 

Eswatini has reached the second and third 95 targets, but is recording lower progress on ensuring people with HIV take a test and receive their result.

Preventing HIV in Eswatini focuses on: 

• condom dissemination especially for people at high risk of HIV 

• HIV education, especially for young people who have low knowledge on preventing HIV 

• preventing mother-to-child transmission 

• voluntary medical male circumcision

• PrEP, which is available at all health facilities. 

Did you know?

A comprehensive lifeskills education programme is offered in all primary and secondary schools in Eswatini, and at community level to reach young people who are out of school.

Testing for HIV is:

• lower among young people, and young men in particular
• higher among women than men due to a reluctance among men to access healthcare
• hampered by stigma – people don’t want to attend a clinic to test for HIV
• available to do at home via a self-test kit.

Did you know?

Eswatini provides community-based HIV testing and self-testing, which has increased testing levels as it means people do not have to travel to clinics.

Treatment for HIV is: 

• free, and has been since 2003
• higher among women than men
• lower among children than adults
• given to people straight away when they test positive
• well adhered to, with high levels of people reaching viral suppression.

Did you know?

Services are integrated at health facilities, so people with HIV can receive HIV, tuberculosis, and sexual and reproductive health services in a single visit to a clinic or hospital.

King Mswati III declared HIV a national emergency in 1999, saying that “HIV is our collective concern.” This sparked a national drive to bring the HIV epidemic under control. Despite huge progress, Eswatini still has the highest HIV prevalence in the world – around 28% of its population has HIV.

HIV testing and treatment programmes have expanded considerably in the country in the last decade. Since 2010, HIV infections have fallen by 52% and AIDS-related deaths have fallen by 57%. Of the 210,000 adults with HIV in Eswatini in 2021, around 130,000 are women. Gender inequality means that women face greater economic and educational barriers than men, and women and girls with HIV experience high levels of stigma and discrimination.

The country’s preventing mother-to-child transmission programme is effective, as >98% of pregnant women with HIV are on antiretroviral treatment.

However, challenges remain. Groups that are socially marginalised and criminalised are most affected by HIV. For example, Eswatini has the highest HIV prevalence among sex workers in the world (60.8%). The country also faces dual epidemics of tuberculosis and HIV.

The country’s legal environment stops many people from accessing services for HIV and sexual and reproductive health. Male homosexuality, sex work and drug use are all illegal. Abortion is legal but only in limited circumstances, such as in cases of rape, incest, foetal abnormalities and mental illness.