VUSI MATSEBULA: YES WE ARE WINNING THE FIGHT AGAINST HIV BUT POVERTY IS THE REASON GIRLS BETWEEN 15-24 ARE MORE POSITIVE THAN BOYS

The country is winning the fight against HIV as all indicators are showing eSwatini to be emerging with an upper hand in this fight but concerns still linger on young girls between the ages of 15--24.

"Poverty is the reason young girls between the ages of 15--24 are far mor vulnerable to the virus than their male counterparts," says Vusi Matsebula, a leading activist for the prevention of HIV.

Matsebula was among the first Swazis to openly come out to be HIV positive in the late 90's. He subsequently became a leading voice for HIV prevention and treatment in the country.

Matsebula worked with the private sector, government and none governmental organizations during the most devastating years of the virus. Even as the virus shows signs of decreasing in various age groups, those in the adolescent ages still lead to new infections.

According to the 2021 eSwatini HIV estimates and projection report produced by NERCHA, the median age of HIV in the country is 24 and females between the ages of 15--24 account for 16.2 percent of those who are HIV positive.

Across all statistics given in the report, adolescents between those ages were the most impacted leading to question why? Matsebula argues the reason can be reduced to poverty and how it makes those within those age groups more vulnerable than their male counterparts.

He reasons that the achilles heel in the fight against the virus has always been ignoring poverty as a cause of new infections especially on young girls. This is not the first time that poverty has been singled as a contributing factor to HIV.

Former South African President Thabo Mbeki was the first to suggest that in Africa poverty could not be discounted as a leading contributor to the surge of the virus across the continent and Southern Africa in particular.

"The reason is clear; these girls are being infected by us older men. You can tell from the data that as poverty levels sour the young girls end up with older males and they get infected. This explains why males between the same ages are not that infected," Matsebula said in an interview with The Bridge.

According to the NERCHA report, there are about 200 000 HIV positive people in the country and 33 percent of them live in Manzini. Matsebula told The Bridge that poverty was responsible for risky behaviors that make young girls end up sleeping with older men who then infect them.


He said poverty makes young girls vulnerable and that if this continues unattended we will soon see even males within the same age range starting to get the virus.

The NERCHA report states that in 2020, new HIV infections were higher among female adolescents and young adults, aged 15 to 24 (1,600), compared to other population groups. Even new infections were higher in females compared to males across all age groups.

But in the overall, the country has made remarkable progress in the fight against HIV. According to the World Health Organization (WHO), the number of new HIV infections has steadily declined over the years, falling from 14 000 in 2010 to 4 800 in 2020, and is anticipated to fall further to 4 300 by the end of this year.

HIV-related deaths have also decreased, from a peak of almost 10 000 in 2005 to 2 600 in 2021 and 2 370 in 2022. Mother-to-child transmission of HIV has also dropped from 6.3 percent in 2017 to 1.2 percent in 2022.

The country has also met the 2020 global HIV target that calls for 95:95;95 towards ending HIV as a public threat. Despite this progress, the country still has the highest HIV prevalence in the world as 28 percent of the population has the virus. However, HIV testing and treatment programmes have expanded considerably in the last decade. Since 2010, HIV infections have fallen by 52 perents and AIDS-related deaths by 57 percent.

NERCHA's Manager of Information and Knowledge Management Sibusiso Ngubane was contacted for comments and promised to come back to us as he was still busy with World Aids day commemorations at the time. He had still not responded to us at the time of compiling this report.