Regional Profile for Eastern and Southern Africa

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Southern Africa
Nine Southern Africa countries account for 35 per cent of all HIV infections and 38 per cent of AIDS deaths in 2007 (Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe)
South Africa continues to have the largest epidemic of any country with an estimated 5.7 million people living with HIV.
Among 15-24 year olds in South Africa women and girls account for more than 90 per cent of new infections.
Swaziland has the world’s highest national adult HIV prevalence of 26 per cent.
In Mozambique the epidemic continues to grow with some provinces exceeding 20 per cent prevalence and infections among young people increasing across the country.
Compared to previous years the South African epidemic does appear to have stabilized as have the epidemics in Malawi and Zambia.
Reductions in HIV prevalence were notable in Zimbabwe and Botswana.
In Zimbabwe HIV prevalence among pregnant women attending antenatal clinics fell from 26 per cent in 2002 to 18 per cent in 2006.
In Botswana figures for pregnant 15-19 year-olds dropped from 25 per cent HIV prevalence in 2001 to 18 per cent in 2006.

Eastern Africa
Many of the national HIV epidemics of East Africa appear to be receding or have stabilized at around 5 per cent adult prevalence.
For example Uganda’s adult prevalence appears to have stabilized at around 5.4 per cent but signs of resurgence in sexual risk taking could trigger a further growth in the epidemic.
However Kenya reported an HIV prevalence of between 7.1 per cent and 8.5 per cent this year compared with the 2003 estimate of 6.7 per cent.
 
Need to continue improving access to treatment
Nearly 3 million people were receiving antiretroviral treatment in low and middle income countries at the end of 2007
Increases in treatment coverage have been extraordinary in many countries for example Namibia, where treatment coverage was only 6 per cent in 2003 and 57 per cent on 2007.
Botswana has achieved one of the world’s highest coverage rates of HIV treatment, delivering drugs in 2007 to more than 90 per cent of those who need them.
Treatment and prevention must go hand in hand

Need unprecedented scale-up of HIV prevention
Heterosexual intercourse is the main driver of the epidemic in the region with women and girls most affected - the following priorities to improve the region’s AIDS responses:
Increased social mobilization with the strong involvement of males, that addresses multiple and concurrent partnerships, age-disparate/intergenerational sex and transactional sex
Scaling up public health interventionsthat include adolescent friendly health services, the acceleration of programmes that prevent mother to child transmission of HIV and the expansion of male circumcision services
Structural interventions that keep girls in school, increase women’s economic independence and recognize women’s property and inheritance rights
Improved Surveillance and Monitoringthrough greater investment in tools and capacities to monitor the effects and the evolution of the HIV epidemic
Further research on the structural drivers of the epidemic including the relationship between alcohol and HIV risk as well as HIV prevention efforts targeting sero-discordant couples