One of the strategies employed by the Swaziland Ministry of Health through Swaziland National AIDS Program in the National HIV response is development of documents such as policies, Standard Operating Procedures (SOPs), guidelines, job aids and training manuals. The documents are developed in collaboration with stakeholders including Partners and other programs.
The program has experts coordinating the development of these documents relating to the different technical areas of HIV management including Care and Treatment, HIV Testing Services (HTS), Key Populations & Vulnerable Groups, Sexually Transmitted Infections (STIs), Quality Assurance, Palliative Care, Psychosocial Care and Support, Adherence and Psychosocial Support, VMMC and TB / HIV and Monitoring and Evaluation.
HTS is the entry point to prevention, care and treatment services. Testing is a process and does not stop at the test itself: results need to be provided to the client and clients need to be linked to either prevention or HIV care and treatment services– ideally on the same day of testing.
Swaziland still leads with high prevalence rates of HIV and AIDS in her population. With a population of just over a million (1,018,449), the prevalence of HIV among those aged 15 to 49 years was estimated at 26 percent. The HIV prevalence is higher among females compared to males which are 22 percent and 15 percent respectively (CSO 2007).
Isoniazid Preventive Therapy (IPT) is a course of prophylactic antibiotics (Isoniazid) to prevent the progression from latent TB to active TB. Although IPT is a therapy for individuals, it is important as a preventive measure for communities affected by HIV. Preventing active TB in one individual can prevent thousands of people from being infected in the community and in health care services.
Sexually transmitted infections remain a priority to the Ministry of Health because of their correlation with HIV. This edition of the guidelines represents the updated version which should be used by all health institutions in Swaziland.
The emergence of resistance to anti-tuberculosis drugs, and particularly of multidrug-resistant TB (MDR-TB) in Swaziland brought to our realization the fact that we are not only confronted with a major public health threat, but also a formidable an obstacle to bringing the TB epidemic under control.
HIV pandemic presents a massive challenge to the control of tuberculosis (TB) at all levels. In Swaziland, the interaction of TB and HIV is increasing the burden of both diseases. At present, an estimated 74% of TB patients are also co-infected with HIV.