Swaziland
Total Treatment Sites:		1
Treatment Site Location(s):		LaMvelase Help Center, Manzini
Patients on ART:		1,845
Patient Enrolled:		3,532
Report in PDF Format:		Swaziland Country Report

Background & HIV/AIDS in Swaziland

Swaziland, which became independent in 1968, is slightly smaller than the state of New Jersey.  Its capital is Mbabane but its principal commercial city is the more populous Manzini.  Life expectancy is only 40 years, due mostly in part to the extremely high adult HIV prevalence rate (26.1% according to UNAIDS/WHO) and 69% of the country lives in poverty.

Most of the population is ethnic Swazi but there are a small number of Zulus and non-Africans.  Though Swaziland’s official languages are English and SiSwati (a language related to Zulu), government and commercial business are conducted mainly in English (US State Department, 2009).

Swaziland’s response to the epidemic is led by the National Emergency Response Council on HIV and AIDS.  In general, despite the Swaziland government’s high level of political commitment to fighting the spread of HIV, the response has been ineffective and prevalence rates have steadily increased since the first AIDS case was reported in 1987.  Overall trends in 2009, however, indicate that HIV prevalence is stabilizing (UNDP, 2009). 

Condoms have been widely available in Swaziland since the 1990s but use remains unpopular.  The government’s Behavioral Surveillance Survey of 2002, however, showed that condom use among at-risk populations is relatively high; female sex workers reported 90% use of condoms.  Behavior change campaigns have been generally ineffective and the same survey found that risky behavior is common, despite high levels of knowledge regarding how HIV is transmitted.

Testing must be increased in Swaziland.  The Swaziland government estimates that only 20% of people know their HIV status yet in 2005, there were only 37 voluntary counseling and testing (VCT) sites throughout the country (WHO, 2005).  Antiretroviral therapy (ART) has been free since 2003 but the lack of infrastructure and human resources greatly impedes effective treatment delivery.  59,000 people with HIV need ART but only 25,000 (42%) are currently receiving it.  Further, rural populations have very limited access to VCT and health services.

AHF Activities in Swaziland

The LaMvelase clinic in Manzini, Swaziland has been operating since September 2007, engaging in rapid scale up of treatment and care by a dedicated team.  The LaMvelase Help Center provides the full continuum of integrated HIV/AIDS services, providing free confidential HIV/AIDS testing and counseling and, if needed, high-quality HIV/AIDS care and treatment.  In AHF’s family care model, parents are encouraged to bring their children and husbands and wives are encouraged to come together.  In the past year, the client numbers have nearly doubled, with the clinic providing treatment and care services to over 2,500 people living with HIV/AIDS, including 48 pediatric patients. Patients on the waiting list at the government clinics were able to transfer to the LaMvelase for more immediate access to ART. 

The clinic is a partnership between AHF, the Alliance of Mayors’ Initiative for Community Action on AIDS at the Local Level (AMICAALL), and the Family Life Association of Swaziland (funded by Population Services International). AHF works in close partnership with Baylor University’s program that focuses on pediatrics, and refers many of our pediatric cases to that specialized center.  Before the opening of LaMvelase Help Center, Manzini, the largest city in Swaziland, had only one hospital providing ART.  The strong partnership between the NGO partners in Swaziland ensures that all people who visit the clinic receive the best possible care. Other partners include the Kingdom of Swaziland’s Ministry of Health, and the Manzini City Council. 

Models of Care

HIV Testing and Counseling

Direct Care

Training and Supervision 

Current Partners

Kingdom of Swaziland Ministry of Health

Manzini City Council

Alliance of Mayors' Initiative for Community Action on AIDS at the Local Level (AMICAALL)

Family Life Association of Swaziland