Basic facts about HIV/AIDS, its prevalence within Botswana's citizens and their workplaces, and statistics about various treatment methods.

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Given the importance of HIV and AIDS surveillance in establishing the prevalence and trends in HIV as well as in providing useful information to inform programmes, policy and decision making, Botswana also conducts yearly HIV and AIDS surveillance among pregnant women aged 15-49 years. When this surveillance was first instituted in 1992, it focused on the collection of data to determine the magnitude and trends of the epidemic for resource mobilization and for policy development. However, as the epidemic matured, it became necessary to review the strategy to include additional behavioural data in order to understand the dynamics of the epidemic. The Second Generation Surveillance was thus introduced in 2001. The HIV prevalence among pregnant women aged 15-49 years has shown a flattening trend over the past decade as indicated in Figure 1..  Since 2002 the system has expanded in terms of number of ANC HIV sentinel surveillance sites, geographical coverage, and rural/urban representation. This helps to understand the dynamics of the epidemic in order to make sound decisions on how to respond.

Sentinel Surveillance data are collected:

This report is one of the deliverables in a tender awarded to the Centre for Actuarial Research (CARe) at the University of Cape Town by the National AIDS Coordinating Agency (NACA) and the United Nations Development Programme, Botswana, to investigate the impact of HIV/AIDS on the population of Botswana.

Until very recently HIV prevalence seems to have been following a steady upward trend, although there is now some evidence of stabilisation – and even reversal - of prevalence rates.

Prevalence rates amongst specific sub-groups of the adult population are higher, with sentinel surveys of pregnant women in Botswana showing rates of 40-50 percent in some age cohorts.  The impact of such high HIV prevalence rates is widespread. For many of those infected, HIV infection results in death within a few years, although the gradual roll-out of medical treatment for the disease has enabled it to be transformed into a manageable chronic condition.

This report describes the use of the sentinel surveillance and the BAIS II data to estimate national prevalence in Botswana today and the implications of that estimate for other indicators of interest, such as the number of people infected, the annual number of new infections and the number of people  in need of ART. These estimates are based on the entire history of HIV surveillance among women attending antenatal clinics (to establish the trends) and the results of the national survey, BAIS II, (to set the level in 2004). These data have been used in two computer models EPP and Spectrum.