National Emergency Response Council on HIV/AIDS

HIV TESTING AND TREATMENT VITAL IN ENDING AIDS AS A PUBLIC HEALTH THREAT……Unlike other viruses, the human body cannot get rid of HIV completely


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22 February 2021

NERCHA HEAD OFFICE- With the multitude of achievements eSwatini has attained in the HIV response, most notable is providing treatment for People Living with HIV (PLHIV), mainly through domestic resources, and maintaining this commitment despite the fiscal challenges facing Government.


This in itself is investment in our people and addressing the basic human rights of Emaswati. This outstanding government investment has been paralleled by an equally impressive high enrolment of People Living with HIV and AIDS on life-saving anti-retroviral treatment. This has been one of the major contributors to the impressive achievement of the 95-95-95 global targets. Today we stand proud to say Eswatini is the only African country to reach the 95-95-95 target 10 years before the global target of 2030. This means that 95% of people living with HIV in the kingdom know their status, 95% of all people who know their status are accessing HIV treatment and 95% of those on life saving treatment have achieved virus suppression.

In last week’s article we emphasized the importance of HIV testing for couples and this week we delve deep into the significance of testing for HIV and starting treatment early, as we endeavour to end AIDS as a public health threat by 2022. We will go about this by outlining the first two achievements of the 95-95-95 milestones we have excelled in as a country. The aim is to continue to encourage the remainder of the population who still do not know their HIV status and are reluctant to take an HIV test, to do so. 


What is HIV Testing

HIV testing begins with a diagnosis for HIV. Receiving an HIV diagnosis can be life changing. You may feel many emotions such as sadness, hopelessness, or anger. If you receive an HIV diagnosis, it means that you have HIV. Unlike some other viruses, the human body can’t get rid of HIV completely. Once you have HIV, you have it for life. But with proper counselling and  medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect themselves and their partners.


What is HIV treatment and when should I start treatment

HIV treatment involves taking medication that reduces the amount of HIV in your body, called Anti-Retroviral Therapy (ART). It is also prudent to remind Emaswati that even after 3 decades of the virus in the country, there is still no effective cure for HIV. But with proper medical care, you can control HIV. And the good news is that most people can get the virus under control (viral suppression) within the first six months of taking medication correctly. However, taking HIV medication does not prevent transmission of other sexually transmitted diseases. It is highly recommendable to start treatment as soon as possible after diagnosis. HIV treatment is suitable for everyone with HIV, regardless of how long they’ve had the virus or how healthy they are. It is also very important to talk to your health care provider about any medical conditions you may have or any other medicines you are taking before being initiated into ART. It is also important to let your health care provider know if you or your partner is pregnant or thinking about getting pregnant at the time of ART initiation. Your health care provider will determine the right type of HIV medicine that can help prevent transmitting HIV to your baby.

What if I delay treatment?

In the LAST MILE of ENDING AIDS as a public health threat, there is absolutely no room for delaying treatment because by so doing, HIV will continue to harm and weaken your immune system. This will put you at higher risk for developing AIDS. And with the active ENDING AIDS Agenda  messaging, Eswatini endeavours to put a stop to any opportunistic infections that may lead to AIDS. Delaying treatment also puts one at higher risk for transmitting HIV to their sexual partner.


Treatment Helps Prevent Transmission to Others

  • If you have an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. However, condom use is still highly recommended to prevent other sexually transmitted infections.
  • Having an undetectable viral load also helps prevent transmission from mother to child, which is one area the country has excelled in towards achieving an HIV-free generation. If an HIV positive mother takes HIV medication as prescribed throughout her pregnancy, labour, and delivery, the risk of transmitting HIV to her baby can be minimized.


Benefits of taking ART everyday as prescribed


  • Treatment Reduces the Amount of HIV in the Blood
  • The amount of HIV in the blood is called viral load.
  • Taking your HIV medicine as prescribed will help keep your viral load low and your CD4 cell count high.
  • HIV medication can make the viral load very low (called viral suppression).
  • HIV medication can make the viral load so low that a test can’t detect it (called an undetectable viral load).
  • If your viral load goes down after starting HIV treatment, that means treatment is working. Continue to take your medicine as prescribed.
  • If you skip your medications, every now and then, you are giving HIV the chance to multiply rapidly. This could weaken your immune system, and you could become sick.
  • Getting and keeping an undetectable viral load (or staying virally suppressed) is the best way to stay healthy and protect others.

Taking Treatment as Prescribed Helps Prevent Drug Resistance

  • Taking HIV medication consistently, as prescribed, helps prevent drug resistance.
  • Drug resistance develops when people with HIV are inconsistent with taking their HIV medication as prescribed. The virus can change (mutate) and will no longer respond to certain HIV medication.
  • If you develop drug resistance, it will limit your options for successful HIV treatment.
  • Drug-resistant strains of HIV can be transmitted to others.


Dealing with Treatment fatigue

Some people find that sticking to their treatment plan becomes harder over time. Make it a point to talk to your health care provider about staying on your treatment plan. Your health care provider can offer tips and ideas for addressing these problems. Others suffer side effects from medication such as nausea or diarrhoea can make a person not want to take their pills. There are medicines or other support, like nutritional counselling to make sure you’re getting important nutrients. This can help with the most common side effects. It is also best to plan ahead and keep extra medicine with you. A busy schedule. Work or travel away from home can make it easy to forget to take pills. It may be possible to keep extra medicine at work or in your car. But talk to your health care provider first. Some medications are affected by extreme temperatures and it is not always possible to keep medications at work.

Treatment fatigue can also lead to missing a dose. In most cases, you can take your medicine as soon as you realize you missed a dose. Then take the next dose at your usual scheduled time (unless your health care provider has told you something different). It is always wise to talk to your health care provider about ways to help you remember your medicine. You and your health care provider may even decide to change your treatment routine to fit your health care needs and life situation. Another winning idea that most People Living with HIV in the Kingdom have adopted, is the formation of support groups, so join a support group or ask your family and friends for support. All these support systems can help you stick to your treatment plan.

Next week we delve deep into the third pillar of the 95-95-95 global targets, which is viral suppression and what it means for people living with HIV in the Ending AIDS Agenda.