Prevention of Mother to Child Transmission

Botswana a leader in Africa for its coverage rates for both ART and prevention of mother-to-child transmission (both are above 80%) and the country seeing the benefits – mother to child transmission of HIV was reduced from 40% in 2001 to 4% in 2007.

Awareness and Behaviour Change
Comprehensive knowledge on HIV transmission is very low in young people 37.6% (2005 Botswana AIDS Impact Survey) presenting and urgent prevention need, particularly considering that 7% of young people reported having sex before age 15 (2005). Botswana lacks data on multiple partners and condom use in these situations which is urgently needed to target and improve prevention.

Prevention: What is Being Done?

Government planning

• Medium Term Plan and National Strategic Framework for HIV/AIDS (NSF) (2003-2009) and National Strategy for Behaviour Change (2006)
• Monitoring implemented through The Botswana HIV and AIDS Response Information Management System (BHRIMS) and data collection tools
• Implementer information fed to the national level to the National Coordinating Agency (NACA)
• Legal environment not supportive of targeting high risk groups (prisoners, men who have sex with men, migrants, displaced persons and sex workers) but review of the NSF identified these as areas for prevention focus
• Penal code (Amendment) Act 5 of 1998 makes HIV testing compulsory for those convicted of rape and gives harsher sentences where the result is positive

Condom programming
• 24 million male condoms distributed through the private sector in 2007
• Female condoms distributed on a small scale
• In 2006 government removed Value Added Tax from condoms to increase demand

Behaviour Change Campaigns
• Youth HIV Prevention and Blood Safety Project – relies on the ‘Pledge 25 Club’ where young blood donors are encouraged to retain their status and to keep donating blood
• Other recent behavior change programmes implemented by civil society (e.g. Test for Life Campaign implemented by Tebelopele using national football team as role models for testing)
• PSI Botswana introduced a life to skills programme (Choose Life) targeted at out of school youths aged 8 to 18 years to help support healthy choices within relationships
• Awareness raising of risks of MCP currently underway – radio programmes such as ‘Silent Shout’
• Training of youth and community leaders as counselors to address MCP

Male Circumcision
• As of 2009 government has launched a campaign to circumcise 460,000 men, over the five years.