Key findings from the second Swaziland HIV Incidence Measurement Survey, SHIMS2, reveal impressive progress in confronting the HIV epidemic in the country. Results show a doubling in population viral load suppression since 2011 and a decrease by nearly half in the rate of new HIV infections. The findings were released at a press conference held by the Prime Minister’s office in Mbabane, Swaziland and at the International Aids Society (IAS) 2017 Conference.

The data come from one of the population–based HIV impact assessment (PHIA) surveys led by the Government of the Kingdom of Swaziland (GKoS) through the Ministry of Health (MOH) and Central Statistical Office (CSO). The survey (SHIMS2) was implemented by ICAP at Columbia University's Mailman School of Public Health and the US Centers for Disease Control and Prevention (CDC), with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR).

SHIMS2 is the second national incidence survey to be conducted in Swaziland, following the 2011 survey (SHIMS1) among adults 18–49 years of age.

In SHIMS2, over 14,000 children and adults participated in this nationally representative survey by agreeing to be interviewed and providing a blood sample for HIV testing.

Key SHIMS2 survey results include:

• HIV incidence among adults ages 15 years and older was 1.36 percent: 1.70 percent among females and 1.02 percent among males. Among adults 18–49 years, HIV incidence was 1.39 percent, nearly half of the prior HIV incidence rate in 2011 2.48 percent.
• HIV prevalence” was 27.0 percent: 32.5 percent among females and 20.4 percent among males. The HIV prevalence among adults 18–49 years was 30.5 percent, similar to the 2011 HIV prevalence of 32.1 percent.
• The percentage of all HIV–positive adults with viral load suppression (VLS), an indication that the infection is under control, was 73.1 percent: 76.0 percent among females and 67.6 percent among males. VLS was estimated using all people living with HIV (PLHIV) as a denominator, regardless of knowing their HIV status or use of antiretroviral drugs. Among all HIV+ adults aged 18–49 years, twice as many had VLS in SHIMS2 as compared to SHIMS1 (71.3 percent compared to 34.8 percent in 2011).
• The percentage of all HIV–positive adults who knew their HIV status was 84.7%; of these individuals, 87.4% reported current use of antiretroviral treatment and, among those reporting treatment, 91.9 percent had VLS. These results indicate Swaziland has made substantial progress toward achieving all three of the “90–90–90’ targets set by UNAIDS to help end the HIV epidemic.

The progress represented by the findings is attributed to the expansion of HIV testing in the country as well as a substantial increase in the number of HIV–positive individuals on antiretroviral drugs from 2011 to 2016. This is combined with other HIV control interventions expanded in the country.