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Health system support and strengthening for cross-border HIV services: key informants' perspectives on testing and linkage for Lesotho-South Africa migrant workers.

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Progress toward HIV epidemic control in Lesotho.

Kyaw Thin1, Koen Frederix, Stephen McCracken

  • 1aLesotho Ministry of Health bICAP at Columbia University in Lesotho, Maseru, Lesotho cCenters for Disease Control and Prevention, Atlanta dICAP at Columbia University, New York, USA eWorld Health Organization in Lesotho fCenters for Disease Control and Prevention in Lesotho, Maseru, Lesotho.

AIDS (London, England)
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Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • HIV remains a significant public health challenge in many regions.
  • Understanding HIV prevalence, incidence, and treatment outcomes is crucial for effective intervention strategies.
  • Population-based surveys provide essential data for assessing the national HIV response.

Purpose of the Study:

  • To measure HIV prevalence, incidence, and viral load suppression (VLS) in Lesotho.
  • To assess the uptake of HIV testing and antiretroviral treatment (ART).
  • To identify factors associated with HIV status awareness and treatment adherence.

Main Methods:

  • A nationally representative sample of 9403 households was surveyed.
  • Blood samples were tested for HIV using a national algorithm and confirmed with supplemental assays.
  • Antiretroviral drug levels were measured, and viral load testing was performed on HIV-positive samples.

Main Results:

  • Overall HIV prevalence among adults aged 15-59 was 25.6%.
  • Among those living with HIV, 81.0% knew their status, 91.8% were on ART, and 87.7% achieved viral load suppression.
  • Younger age was associated with lower HIV status awareness.

Conclusions:

  • The survey indicates encouraging progress in HIV testing and treatment coverage in Lesotho.
  • Targeting youth with HIV interventions is critical for achieving epidemic control.
  • Continued monitoring and targeted strategies are necessary to improve outcomes.