title: Recent patterns in population-based HIV prevalence in Swaziland.
abstract: BACKGROUND
  The 2011 Swaziland HIV Incidence Measurement Survey (SHIMS) was conducted as part of a national study to evaluate the scale up of key HIV prevention programs.
  
  
  METHODS
  From a randomly selected sample of all Swazi households, all women and men aged 18-49 were considered eligible, and all consenting adults were enrolled and received HIV testing and counseling. In this analysis, population-based measures of HIV prevalence were produced and compared against similarly measured HIV prevalence estimates from the 2006-7 Swaziland Demographic and Health. Also, measures of HIV service utilization in both HIV infected and uninfected populations were documented and discussed.
  
  
  RESULTS
  HIV prevalence among adults aged 18-49 has remained unchanged between 2006-2011 at 31-32%, with substantial differences in current prevalence between women (39%) and men (24%). In both men and women, between since 2006-7 and 2011, prevalence has fallen in the young age groups and risen in the older age groups. Over a third (38%) of the HIV-infected population was unaware of their infection status, and this differed markedly between men (50%) and women (31%). Of those aware of their HIV-positive status, a higher percentage of men (63%) than women (49%) reported ART use.
  
  
  CONCLUSIONS
  While overall HIV prevalence remains roughly constant, age-specific changes strongly suggest both improved survival of the HIV-infected and a reduction in new HIV infections. Awareness of HIV status and entry into ART services has improved in recent years but remains too low. This study identifies opportunities to improve both HIV preventive and care services in Swaziland.
authors.affiliation: Centers for Disease Control and Prevention (CDC), Mbabane, Swaziland.
authors.forename: George T
authors.initials: GT
authors.lastname: Bicego
authors.forename: Rejoice
authors.initials: R
authors.lastname: Nkambule
authors.forename: Ingrid
authors.initials: I
authors.lastname: Peterson
authors.forename: Jason
authors.initials: J
authors.lastname: Reed
authors.forename: Deborah
authors.initials: D
authors.lastname: Donnell
authors.forename: Henry
authors.initials: H
authors.lastname: Ginindza
authors.forename: Yen T
authors.initials: YT
authors.lastname: Duong
authors.forename: Hetal
authors.initials: H
authors.lastname: Patel
authors.forename: Naomi
authors.initials: N
authors.lastname: Bock
authors.forename: Neena
authors.initials: N
authors.lastname: Philip
authors.forename: Cherry
authors.initials: C
authors.lastname: Mao
authors.forename: Jessica
authors.initials: J
authors.lastname: Justman
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D013541:Eswatini / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents