I HIV/AIDS eSwatini

I-HIV/AIDS Eswatini yacala kubikwa nga-1986 kepha kusukela lapho seyifinyelele ezingeni lelibhubhisako. Kusukela ngemnyaka wa 2016, i-Eswatini beyinelinani lesisetulu kakhulu le-HIV kubantfu labadzala labaneminyaka lengu-15 kuya ku-49 emhlabeni wonkhe (27.2%).

Kubhebhetseka kwe-HIV/AIDS Eswatini kufake sandla kakhulu ekutseni kube nekufa lokusezingeni lelisetulu emkhatsini wemacembu ebantfu ladzala labamaSwati. Ngekuhamba kwesikhatsi, lesifo kanye nalabo labaphendvulako sabangela tingucuko letinkhulu temasiko lahlobene nemikhuba yendzawo kanye nemibono yekufa, kanye nekugula, kanye nekukhuliswa kwemshuwalensi wekuphila kanye nemakethe yetinsita temngcwabo kanye netinhlangano letingekho ngaphasi kwahulumende letihlobene netemphilo.

Kute kusitwe i-Eswatini kanye nalamanye emave mhlabawonkhe ekulweni ne-HIV ne-AIDS, i-Joint United Nations Programme on HIV/AIDS (UNAIDS) yasungula tinhloso tekuhlola kanye nekwelashwa letingu-95-95-95. Imetamo yendzawo neyavelonkhe isebente kufinyelela kuletimigomo letintsatfu letilandzelako nga-2020: 90% webantfu labaphila ne-HIV batawubona simo sabo se-HIV; 90% walabo labatfole i-HIV batawuhlala batfola kwelashwa kwe-antiretroviral (ART); kantsi 90% wabo bonkhe bantfu labemukela i-ART batawuba nekucindzetelwa kweligciwane. Nanobe Eswatini icishe yafinyelela kuhlolwa kanye nekwelashwa kwetinhloso temodeli ye-90-90-90, labanye bantfu betfwale umtfwalo lomkhulu. Luhlelo Lwekwelashwa Lwekusita Nge-AIDS (PEPFAR) lwaMengameli wase-US lukhombe bantfu labamcoka labasengotini yekungenwa yi-HIV, ngenca yetinkinga tekubhebhetseka kwaleligciwane, tekuphila, kanye netemvelo kanye naletinye tizatfu tekuphila. Ikakhulukati, i-PEPFAR ivete bantfu labatsatfu labamcoka e-Eswatini laba balulekile ekuvimbeleni i-HIV/AIDS kanye netinhlelo tekwelashwa: emantfombatana laseminyakeni yekutfomba kanye nebafati labasebancane (laba neminyaka leyimfica kuya ku-29), emadvodza laneminyaka lengu-15 kuya ku-39, kanye nebantfwana labatintsandzane nalabasengotini (OVC). I-PEPFAR iphindze yatfola bantfu labatsatfu labamcoka: emadvodza lalala nemadvodza (MSM), labasikati labasebenta ngetemacansi (FSW), kanye nebantfu labashintjashintja bulili.

## Kutfolakala kwe-HIV/AIDS

I-HIV/AIDS isolo ingulenye yetinkinga letinkhulu ekutfutfukisweni kwemnotfo wase-Eswatini. Ngemnyaka wa 2010, Litiko Letisebenti neNhlalakahle Yato yalinganisela kutsi emaphesenti langu-43 ebantfu "bebasebenti labangasebenti" bafundzi, lasebakhulile, labagulako, labakhubatekile, bantfu "labete imali" nobe "labanakekela" loko "labakudzingako" futsi labangasiyo incenye yemisebenti lesemtsetfweni.

Kuhlolwa njalo kwemitfolamphilo yangaphambi kwekubeleka kulelive ikhombise kwenyuka lokuchubekako kwekusakateka kwe-HIV kubomake labakhulelwe labaya kulemitfolamlilo. Kuhlolwa kwamuva kwebantfu labasikati labatawubeleka kwabika kutsi bekunebantfu labangu-42.6% nga-2004. Kubhebhetseka kwa 28% kwatfolakala kubomake labasebancane labaneminyaka lengu-15-19. Kubomake labaneminyaka lengu-25 budzala, kubhebhetseka bekungu-56%.

I-Human Development Index levela ku-UN Development Programme ibika kutsi ngenca ye-HIV/AIDS, sikhatsi sekuphila e-Eswatini sehla sisuka eminyakeni lengu-61 nga-2000, siye eminyakeni lengu-32 nga-2009. Ngakulelinye luhlangotsi, imininingwane yekugcina ye-World Health Organization (WHO) (2002) ikhombisa kutsi 64% wabo bonkhe labafile kulelive babangelwe yi-HIV/AIDS.  Ngemnyaka wa 2009, bantfu labalinganiselwa ku 7,000 bafa ngenca yetimbangela letihlobene ne-AIDS. Kubantfu labacishe babe ngu-1 185 000 loku kusho kutsi i-HIV/AIDS ibulala bantfu labamaSwati labalinganiselwa ku-0.6% njalo ngemnyaka.  Tifo letingapheli letibangela kufa kakhulu emaveni latfutfukile emhlabani tibangela incenye lencane yekufa Eswatini; sibonelo nje, sifo senhlitiyo, kushaywa stroke, kanye namdlavuza kubangela ingcikitsi lengaphansi kwa-5% yekufa Eswatini, uma kucatsaniswa na-55% wabo bonkhe labafa njalo ngemnyaka e-US.

Luhlelo Lwekutfutfukiswa Kwemave Emhlaba lubhale kutsi uma kusakateka kwalolubhubhane kulelive kuchubeka kungapheli, "kuphila kwesikhatsi lesidze kwe-Eswatini njengelive kutawusongelwa kakhulu".

## Umlandvo
Kubikwa kwekucala kweligciwane le-HIV e-Eswatini kwenteka nga-1986 ephephandzabeni i-Times of Swaziland. Kusabalala kwe-HIV kulo lonkhe lase-Eswatini ngemnyaka wa-1980 na-1990 kwahambisana nekukhula kwebasebenti labasuka Eswatini baya etimayini taseNingizimu Afrika. Bacwaningi, bososayensi betemphilo kanye netemphilo yemphakatsi, kanye nebasunguli betincumo bonkhe bacela hulumende kutsi atsatse tinyatselo kusukela ekupheleni kweminyaka yabo-1980; Litiko Letemphilo lasungula Luhlelo LweSwaziland lwe-AIDS (SNAP) nga-1987. Vusi Matsebula kanye na Thulasizwe Hannie Dlamini babhalisa licembu labo le-Emahlahlandlela lelisekela i-AIDS, lekucala kulelive, njenge-SASO, i-Swaziland AIDS Support Organisation, nga-1994. Ngemnyaka lowendlulile, Hannie Dlamini washo embikwebantfu kutsi une-HIV, umuntfu wekucala lowenta njalo kulelive. Tifundziswa tebesifazane baseSwatini Mamane Nxumalo kanye na Phumelele Thwala babangulabanye bekucala lababhala ngekugceka nge HIV/AIDS eSwaziland, bakhuluma ngekutsi tindlela tekungalingani ngekwebulili tidlale njani indzima ekusakatekeni kwalesifo, futsi "ngesikhatsi i-SASO ivula lihhovisi layo lekucala eMbabane nga-1998, lizinga lalelive labalinganiselwa ku-5.5%".

Ekugcineni, iNkhosi Mswati III yase-Eswatini yamemetela kutsi i-HIV/AIDS iyinhlekelele yesive Eswatini ngaFebruary 1999. Ngemnyaka wa 1999, "bekune bantfwana labatintsandzane nalabasengotini [OVC] labalinganiselwa ku-112 000, cishe incenye yemaphesenthi langu 40 yabo bonkhe bantfwana kulelive; Litiko Letemfundvo labika kutsi balahlekelwa bothishela labane ngeliviki ngenca yekugula lokuhlobene ne-AIDS, futsi banikati bemabhizinisi besaba kulahlekelwa kusitwa nge kwetimali bantfu bakulamanye emave ngenca yekwehla kwemkhicito kubasebenti labagulako. Litiko Letemphilo Nekwenhlalakahle kwebantfu alizange likhone kukhokhela ngalokuphelele kwelashwa kwemphakatsi. Ngisho nangemuva kwekusebentelana ne-Joint United Nations Programme on HIV/AIDS (UNAIDS) kanye nema-NGO endzawo, bonkhe behluleka".

## Umlandvo wemasiko
Etindzaweni, kunemikhuba leminyenti yemasiko emdzabu lekhutsata kutibamba kanye nemfundvo lehlukaniswe ngekwebulili kanye nemfundvo yetenhlalakahle yebantfu labasha, kugwema kutsintsana ngekwebulili kwebantfu labatsandzanako ngaphambi kwemshado, kanye nekubalekela kutiphatsa lokubi emphakatsini (njengekukhombisa kuvukela kwebantfu).

Ngalokunye, labanye labasekela tintfo letibitwa ngekutsi 'lisiko lemaswati' abayikhutsati imikhuba lephephile yetemacansi, njengekusetjentiswa kwelijazi lemkhwenyane kanye nebudlelwane bemuntfu munye. Ambalwa emadvodza lamuhla lasebentisa indlela yesintfu yekutsatsa sitsembu. Kuhlukunyetwa ngekwelicansi kuyintfo leyetayelekile, lapho 18% webafundzi besikolwa lesiphakeme batsi bebaphocelelekile kutsi bahlangane kwekucala ngekwelicasi.

## Imphendvulo yavelonkhe
Ngemnyaka wa-2003, i-National Emergency Response Committee on HIV/AIDS (NERCHA) yasungulwa kute ihlele iphindze yente kube lula kuphendvula kwe-HIV/AIDS, ngesikhatsi Litiko Letemphilo neNhlalakahle (MOHSW) belitawakwenta lemisebenti. Luhlelo lwekucala lwe-HIV/AIDS lwavelonkhe lwahlanganisa sikhatsi semnyaka wa-2000-2005; luhlelo lolusha lwe-HIV / AIDS kanye neluhlelo lwekuvikela i-HIV /AIDS lavelonkhe lwanga-2006-2008,  lisasungulwa licembu lelikhulu lebantfu labatsintsekako kuvelonkhe. Kuze kube ngunyalo, tindzawo letisitfupha letibalulekile taloluhlelo kuvimbela, kunakekela kanye nekwesekela, kunciphisa umtselela, kuchumana, kugadza kanye nekuhlola, kanye nekuphatsa/kuchumana.

Ngisho nobe lesimo sekusakateka kwalomkhuhlane Eswatini, i-HIV/AIDS isolo ihlukumeteka kakhulu. Bantfu labambalwa labaphila ne-HIV/AIDS, ikakhulukati bantfu labatiwako labafana nebaholi benkholo kanye nemasiko kanye nebantfu betindzaba/emidlalo, labake bavela embikwebantfu futsi baveta simo sabo. Kuhlukunyetwa kuvimbela kuhamba kwelwati emiphakatsini, kuvimbela imitamo yekuvimbela, kanye nekunciphisa kusetjentiswa kwetinsita.

Ngenyanga yeNhlaba  4, 2009, i-US kanye ne-Swaziland yasayina "Swazilandi Partnership Framework on HIV and AIDS for 2009−2014". Luhlelo Lwekuphutfuma lwaMengameli Lwekusita nge-AIDS (PEPFAR) lutawuhlanganyela ekusetjentisweni kwe-Eswatini's multi-sector "National Strategic Framework on HIV/AIDS". Loluhlelo lwaphindze lwasetjentiswa nge-NSF lensha (National Strategic Framework) yanga-2014-2018.

Imetamo leyehlukahlukene yemphakatsi isetjentisiwe ngenca yaloluhlelo, lokufaka ekhatsi kusetjentiswa kwekuhlanganiswa kwebantfu. Sibonelo saloku, kwakhiwa kwetakhiwo letintsatfu tetigodzi kanye netemiphakatsi, kufaka ekhatsi i-Nhlangano AIDS Training Information and Counseling Center eSifundzeni sase Shiselweni.

Imitsetfo yekwelashwa kwe-ART ya-2015 levela Etikweni Letemphilo "imemetela kutsi ngemuva kwekuhlola, tigulane tiniketwa lwati lwe-HIV ngemagama lalula kute kucaciswe imibono lengasilo liciniso kanye netinganekwane. Baphindze batjelwe ngekudla lokunemphilo, lokunciphisa bungoti, nekutsi balutfole kuphi lwati lolwengetiwe nge-HIV. Uma batfolakele ba-positive, bayacinisekiswa kutsi bangaphila imphilo lendze lenemphilo. Ema-ARVs anikwa ngekushesha etigulaneni leti-seropositive: letinemibalo ye-CD4 lengu-350 nobe ngaphansi; letineminyaka lengetulu kwemashumi lasihlanu nobe ngaphasi kweminyaka lesihlanu; letikhulelwe; letinesifo se-tuberculosis; futsi/nobe letinemlingani lonesifo se-"serodiscordant", lokusho kutsi umlingani lonesifo se-HIV. Tifo letitsatsa ematfuba tilashwa ngaphambi kwe-ART. "

## Umehluko lohlobene ne-HIV/AIDS
Nanobe kuphendvula kwe-Eswatini ku-HIV ne-AIDS kutfole imiphumela lemihle, kusakateka kwe-HIV/AIDS kuchubeka kukhule kantsi kufinyelela etinhlelweni tekutivikela kuyo kuchubeka kwehla kubantfu basemaphandleni nakucatsaniswa nebantfu basemadolobheni, kanye nakubantfu labaphuyile kutemnotfo nakucatsanisiwa nebantfu labanenzuzo kutemnotfweni.

### Bantfu basemaphandleni nalabasemadolobheni
I-United Nations International Children's Emergency Fund (UNICEF) yalinganisela kutsi, kusukela nga-2009 kuya ku-2013, 70% webesifazane basemadolobheni labaneminyaka lengu-15 kuya ku-24 budzala bebanelwati loluphelele lwe-HIV/AIDS. Emaphesenti langemashumi lasihlanu nesihlanu ebantfu labasikati kuphela basemaphandleni labasesigabeni lesilinganako kusukela nga-2009 kuya ku-2013 lebebatfola lwati loluhlobene ne-HIV/AIDS. Noma kunjalo, ngenca yebukhulu lobuncane belive, cishe tonkhe takhamuti tihlanganiswe ngemindeni kanye netinhlelo tekuchumana futsi tivame kuhamba emkhatsini wemadolobha kanye netindzawo tasemakhaya.

### Bantfu labaphuyile ngekwetemnotfo nalabo labanjingile ngekwetemnotfo
Kwatiswa kwasukela nga-2009 kuya ku-2013 kwembula kutsi, kulabaphuyile labangu-20% labasikati labaneminyaka lengu-15 kuya ku-24 Eswatini, labangu-49% bebanelwati loluphelele lwe-HIV/AIDS. Uma kucatsaniswa, 72% webantfu labasikati labanjingile labangu 20% labavela ecenjini lelifanako bebanelwati loluphelele lwe-HIV/AIDS.

Umehluko lobonakalako emkhatsini webantfu labadvuna labanjingile nalabaphuyile uma ucatsaniswa nemehluko welwati loluphelele lwe-HIV/AIDS emkhatsini webantfu labasikati labanjingile nalabaphuyile kusukela nga-2009 kuya ku-2013: 44% webantfu labaphuyile labangu-20% uma kucatsaniswa na-64% webantfu labangu-20% labanjingile labadvuna baseSwatini labaneminyaka lengu-15 kuya ku-24 bebanelwati loluphelele nge-HIV/HIV.

## Emadvodza laneminyaka lengu-15 kuya ku-39 budzala
Kusetjentiswa kwekuhlola kwe-HIV kanye netinsita tekwelashwa kwanyalo kusasephansi emadvodzeni nakucatsaniswa nabomake. Ngetulu kwaloko, ngekusho kwe-Joint United Nations Programme on HIV/AIDS (UNAIDS) nga-2018, emadvodza aseSwatini achubeka nekungasebentisi kahle kuhlolwa kanye nekusita umlayeto webalingani njengendlela yekuvikela kudluliswa kwe-HIV.

"Test and Start" luhlelo lwekwelashwa kwe-antiretroviral (ART) lolunconywe yi-World Health Organization (WHO). Ngaphansi kwaloluhlelo, bantfu labatfolakale bane-HIV bacala i-ART ngekushesha ngemuva kwekutfolwa, kungakhatsaleki kutsi lesifo sichubeke kangakanani. Luhlolo lolungakahlelwa nalolulawulwako lwe-Test and Start lukhombise kusebenta kahle tinhlelweni tekunciphisa lizinga le-HIV. Nomakunjalo, lucwaningo lwekubona Kucondza kwemadvodza-lamaswati kwe-Test and Start lutfole kutsi emadvodza lamanyenti ehlulekile kufuna tinsita tekuhlola i-HIV ngenca yekwesaba imiphumela yekutfolakala unaleligciwane, kukanye kanye nekubona simo se-HIV-lesi positive njengesigwebo sekufa. Lolucwaningo luphindze lwaveta kwesaba kwebantfu ngemiphumela lebuhlungu ye-ART njengentfo lengavimbela kucala kanye nekulandzela luhlelo lwe-Test and Start. Ngetulu kwaloko, emadvodza bekangaciniseki ngekusimama kwetimali kwahulumende waseSwatini, bakhomba kungabata ngelikhono lahulumende lekuniketa tintfo letitfolakalako te-ART njengesizatfu sekungafuni kucala kwelashwa. Babhali balolucwaningo bancoma kungenelela lokubuke kakhulu kuhlolwa kwe-HIV kanye nekwelashwa, kufaka ekhatsi teluleko leticondzile kanye nemfundvo lecatulula kukhatsateka ngekusungula i-ART, imiphumela yetenhlalakahle yekutfola tinsita te-ART, kanye nelikhono lahulumende waseSwazi lekucatulula tinkinga letihlobene ne-HIV/AIDS.

## Bantfu labakhishwe inyumbazane, labanganakwa, kanye nalabasengotini
Kungenelela lokusebentela kusita bantfu baseSwatini, njengemikhankaso kanye netinhlelo letigcugcutela kusoka kwebantfu labadvuna ngekutitsandzela, kukhutsata kwelashwa lokukhulu kanye nekulandzela, kanye nekuniketa teluleko tekunciphisa bungoti, kufake sandla ekunciphiseni lokukhulu kwe-HIV kanye nasetindzabeni tekutfola. Nanobe kunjalo, lokungenelela kwebantfu labavamile kungenteka kungaphumeleli kubantfu labakhishwe inyumbazane lababhekene nekuhlukunyetwa lokukhulu kunalokuvamile, kufaka ekhatsi labasebentisi betemacansi labasikati (FSW), labadvuna labadlala nemadvodza (MSM), kanye nebantfu labashintja bulili. Labanye bantfu, njengebantfwana labaphila ne-HIV kanye nebantfwana labatintsandzane nalabasengotini (OVC), bashiywa basengotini ngenca yelubhubhane lwe-HIV/AIDS kanye nemandla emphakatsi.

### Besifazane labatsengisa ngemtimba (FSW)
Ngisho nasendzabeni yekubhebhetseka kwe-HIV e-Eswatini, lapho khona kubhebhetseka nge-HIV kukhulu kubomake kunalamadvodza, batsengisi bemtimba (FSW) Eswatini tinemtfwalo lomkhulu kakhulu. Linani lebantfu be-FSW alidadishwa kahle futsi alihlangani kahle, lokwenta kutsi kube nekungachazeki ekuvimbeleni i-HIV, kwelashwa, kanye netidzingo tekunakekelwa kwe-FSW, kanye nekuniketwa lokuncane kanye nekutsatfwa kwemitfombo lelusito yetemphilo. Lokutsatsa lokuncane kubangelwe kwesaba kuphumela ebaleni mayelana nekwenta umsebenti wekutsengisa ngemtimba. Umsebenti wekutsengisa ngemtimba Eswatini awukho emtsetfweni. Ngenca yekubekwa licala kwemsebenti wekutsengisa ngemtimba, kulukhuni kakhulu kufinyelela kubantfu labasikati nalabadvuna labasebenta ngalomsebenti. I-World Health Organization (WHO) yalinganisela kutsi kusakateka kwe-HIV emkhatsini walabatsengisa ngemtimba (besifazane nalabadvuna) kungu-61%.

Lucwalingo lwe-FSW lwalabangu-328 Eswatini, lolwentiwe emkhatsini wenyanga yeNgci 2011 kuya enyangeni yeMphala 2011, lutfole kutsi lokungaba ngu-75% we-FSW labaphila ne-HIV labahlanganyela kulolucwalingo bebasati simo sabo. Noma kunjalo, bangu-40% kuphela walabafati lababike kutsi bayelashwa. Ngekwengeta kuletinombolo, lolucwaningo lutfole kutsi i-FSW lene-HIV lebeyati simo sayo, nayicatsaniswa ne-FSW ye-HIV-lete leligciwane, beyingeke igcoke ema-condom. Ngekwengeta, i-FSW lebeyikulolu cwaningo inelwati loluncane ngetindlela tekuya ecansini letiphephile, futsi ngu labatsatfu kuphela lebebati kutsi kuya ecansini nge-anal kunengoti lenkhulu yekudlulisa i-HIV. Nanobe labangu-86% welolucwaningo babika kutsi batfole lwati lwekuvikela i-HIV etinyangeni letingu-12 letendlulile, cishe ihhafu yebantfu balolucwaningo babika kutsi batfole tinhlelo tekuvimbela i-HIV letitsite kubatsengisa ngemtimba. Incenye lenkhulu (73%) yalabo labatsintsekako kulolucwaningo babika kutsi bahlangabetane netehlakalo tekuhlukunyetwa. Ngetulu kwaloko, lomcondvo wekuhlukunyetwa ubonakala emazingeni laphansi ekuvetwa kwemsebenti wabo welicansi emalungeni emindeni kanye netisebenti tetemphilo.

Kute kucatululwe kungasebenti kahle kweluhlelo lwekuvikela i-HIV/AIDS kanye nelwelashwa lwe-FSW, letinye tifundvo tihlolisise tindlela letingaba khona tekungenelela. Sibonelo, lucwaningo lutfole kutsi emazinga lasetulu ekuhlangana kwebantfu kanye nekuhlanganyela kwebantfu emkhatsini we-FSW Eswatini bekuhlobene kahle nekutiphatsa lokuvikelako, njengekusebentisa ema-condom, kuhlolwa kwe-HIV emnyakeni lowendlulile, kanye nekuhlangana nalabanye batsengisi bemtimba emihlanganweni netinkhulumo letihlobene ne-HIV. Ngesikhatsi lesifanako, lucwaningo lolufanako lutfole emazinga lasetulu ekuhlangana kwebantfu kanye nekuhlanganyela kwebantfu kutsi kuhlobene netintfo letiyingoti letihlobene ne-HIV, njengekubandlulula kwebantfu ngekwemtimba, ngekwelicansi, kanye nebudlova bemivelo.

### Emadvodza lalala nemadvodza (MSM)
Kutfolakala kwe-HIV emadvodzeni lalala nemadvodza (MSM) laneminyaka lengu-16 kuya ku-44 budzala ngu-17.7% Eswatini, kantsi kutfolakala kwe-AIDS kukhula ngekuhamba kweminyaka kulelicembu. I-MSM imele bantfu labanganakwa: linani le-HIV/AIDS ye-MSM ayicondzakali ngebantfu base-Swatini, futsi hulumende wase-Eswatini usandza kucondzisa imali yemphakatsi etinhlelweni letihloselwe kucatulula lesifo emkhatsini we-MSM. I-MSM ibhekene nebugebengu, kuhlukumeteka, kanye nekubandlululwa uma itfola tinsita te-HIV/AIDS. Nanobe kute imitsetfo Eswatini levimbela bunkonkoni, tento tebantfu bebulili lobufanako tingamangalelwa njengentfo lengcolile ngaphasi kwemtsetfo lowetayelekile, futsi letento titsatfwa njengentfo lesemtsetfweni ngaphasi kweMtsetfo weSodomy.

Bantfu labangetulu kwencenye yesitsatfu ye-MSM e-Eswatini babika kutsi bahlushwe ngenca yekutiphatsa kwabo ngekwelicansi, njengobe kutfolwe ekuhloleni lokushicilelwe yi-U.S. Agency for International Development (USAID) Research to Prevention program. Incenye yinye kuletisihlanu yalabo labaphendvula kulolucwaningo nabo bakholelwa kutsi batfole kunakekelwa kwelashwa lokusezingeni leliphansi ngenca yekucondziswa kwabo. I-MSM iphindze yabika kutsi ihlangabetene nalamanye emalungelo laphatselene nemikhuba yabo yetemacansi, njengekungabanaki, budlova lobucondziswa ngemaphoyisa, kanye nekuhlukunyetwa ngemlomo kanye/nobe ngekwenyama.

Letintfo letivimbela kufinyelela tihlobene nemazinga laphansi elwati loluhlobene ne-HIV/AIDS, imfundvo, kanye netinsita tekuchumana letitfolwa yi-MSM, uma kucatsaniswa nalabanye bantfu labadzala labasebudzaleni beminyaka, lokwenta lwati loluncane lwetingoti letihlobene ne-HIV / AIDS letihambisana nemikhuba yebantfu bebulili lobufanako. Sibonelo saloku, ekuhloleni kwe-Swatini lwe MSM lwebantfu labangu-324, labatsintsekako kungenteka batfole lwati mayelana nekutfolakala kwe-HIV ngekuya ngekwelicansi nalabasikati, kunekutsi batfole lwanga ngesikhatsi balala nalabanye labadvuna. Kutfolakala lokuncane kwelwati lwe-HIV/AIDS lolubalulekile lwe-MSM kungenta kutsi kungabi nekunganaki mayelana nekudluliswa kwe-HIV kwebantfu bebulili lobufanako. Emkhatsini walolucwaningo, bekunemazinga laphansi ekusetjentiswa kwe-condom kubantfu labadvuna nalabasikati labadvuna nalabadvuna nalabalala nabo, kugcizelela sidzingo selwati lolutsite mayelana nekutfola kanye nekudlulisa i-HIV yebantfu bebulili lobufanako. Cishe ihhafu kuphela yalabo labaphendvula bakhombisa kukhatsateka nge-HIV. Ngetulu kwaloko, yinye kuphela yesine yemadvodza laphila nge-HIV lafaka sandla kulolucwaningo labati kutsi anesifo se-HIV. Kuniketwa kwetinsita tetemphilo te-MSM kanye nelucwaningo lwe-HIV/AIDS emkhatsini we-MSM kugcile kakhulu etifundzeni letisemadolobheni. Nanobe simo se-HIV/AIDS sibikiwe kutsi sitfutfuka ku-MSM etindzaweni letisemadolobheni ase-Eswatini, lesimo siba sibi kakhulu etindzaweni tasemakhaya, lapho khona kuhlukumeteka lokukhulu lokuhambisana nemikhuba yebantfu bebulili lobufanako kuchubeka.

### Bantfwana labaphila ne-HIV kanye nebantfwana labatintsandzane nalabasengotini (OVC)
Kulinganiselwa kutsi kunebantfwana labangu-15 000 labaneminyaka lengu-0 kuya ku-14 labaphila ne-HIV. Ngenca yekutsi kwelashwa kwe-antiretroviral (ART) kubantfu labadzala bekungu-80% nga-2016, kucatjangwa kutsi kwelashwa nge-ART kubantfwana bekungaphansi kakhulu, nga-64%. Kusukela ngemnyaka wa 2016, kunakekelwa kwebantfwana kukhule kwafika ku 75%, ngekusho kwe Joint United Nations Programme on HIV/AIDS (UNAIDS).

Kukhula kwelizinga lekufa ngenca yekusakateka kwe-HIV kanye ne-AIDS e-Eswatini kuphindze kwafaka sandla ekukhuleni kwelinani letintsandzane kanye nebantfwana labasengotini (OVC) kanye nemindeni lenetinhloko tebantfwana. Loku kwashintja ngemnyaka wa 2019 kwentela kusekelwa nguhulumende ngetimali. I-OVC, nayicatsaniswa nebontsanga yayo, isengotini lenkhulu yekubhekana nemiphumela lemibi, njengekulahlekelwa yimfundvo yayo, kungatfolakali kwekudla, kungondleki kahle, kanye nekugula. I-United Nations International Children's Emergency Fund (UNICEF) yalinganisela ngemnyaka wa-2013 kutsi cishe 70% wetintsandzane taseSwazi talahlekelwa batali babo ngenca ye-AIDS. Emkhatsini wetigodzi letine tase-Eswatini, linani lelisetulu le-OVC litfolakala eLubombo (35.9%). Loku kulandzelwa ngu-35.5% eShiselweni, 33.2% eManzini, na-21.6% eHhohho.

Luhlelo lolwasekelwa yi-United States Agency for International Development (USAID) lwakhelwa kuniketa emandla kutemnotfo kubantfu labasikati labanakekela i-OVC etindzaweni tasemakhaya e-Eswatini. Loluhlelo lukhombise kutsi lunemtselela lomuhle ekuvikeleni bantfwana, enhlalakahleni, kanye nasemphilweni. Bafati lababhalisile kulokungenelela bahlanganyela emisebentini lehlobene nekunakekela kanye nekusekela i-OVC kanye nekuvikela i-HIV, kanye nemisebenti lebukene nekonga kanye netimiso tekubolekisa, kugcina emacembu, kusungulwa kanye nekusekelwa kwemabhizinisi lamancane, kumaketha, kanye nekutfola imali. Lokungenelela kwasita banakekeli besifazane be-OVC ekwakheni emabhizinisi lamancane lakhokha imali, ngesikhatsi kwakhiwa indzawo lapho labomake bangafundza futsi bacocisane ngekuhlangabetana netidzingo tetemphilo, tekuya ecansini kanye netekubeleka, tekusebenta kwengcondvo, kanye netemfundvo te-OVC yabo.

Ngalokuvamile, hulumende waseSwatini uphumelele ekutfutfukiseni lizinga lekuya esikolweni ngesikhatsi lesifanako aniketa lusito lwetemnotfo ku-OVC ngaphandle kwesikolwa. Nomakunjalo, lucwaningo loluhlola budlelwane emkhatsini wetimphawu temndeni kanye nesimo sekufundza se-OVC e-Eswatini lutfole kutsi bantfu labangasiwo ema-OVC banematfuba lamanyenti kunalawo e-OVC kutsi baye esikolweni. Lucwalingo lolufanako lutfole kutsi ema-OVC lavela emakhaya laphuyile ngekwetemnotfo kanye nema-OVC lahlala etindzaweni letisemadolobheni bekungeke kwenteke kutsi aye esikolweni.

## Labanye bantfu labane-HIV/AIDS

### Tisebenti tetemphilo
Kubhebhetseka kwe-HIV Eswatini akuzange kushiyele ngaphandle tisebenti tetemphilo, lapho khona kusetjentiswa kwetinsita te-HIV/AIDS kuphansi. Kwesaba kuhlukumeteka lokuhlobene ne-HIV kuvamile kumalunga etisebenti temphilo. Loluhlelo lusebenta njengentfo levimbela tisebenti tetemphilo kutsi titfole futsi tisebentise tinsita tekunakekelwa kwe-HIV/AIDS kanye netekutivikela emsebentini wato kanye naletinye tindzawo. Ngalokukhetsekile, basebenti bakhulume ngekwesaba kuhlukumeteka kwebantfu labagulako kanye nebalingani babo, kanye nekwesaba kwephula imfihlo, njengetizatfu tekutsatsa sincumo sekungafinyeleli ekuhlolweni kwe-HIV nobe kunakekelwa. Kutihlazisa kwebasebenti betemphilo kukhula kakhulu. Batitibona njengalabatehluleki futsi labanelwati lolunyenti kunebantfu labavamile labangenwa yi-HIV, lokwenta kutsi kube nesidzingo sekuba bete i-HIV. Tisebenti letinyenti tetemphilo letine-HIV tiva tiphelelwe ngemandla kanye nekudvumateka emsebentini, njengoba titfole sifo labaceceshelwe kutsi basigweme futsi bativikele kuso.

Umkhakha wetemphilo Eswatini ubhekene nekushoda kwetisebenti tetemphilo, futsi netisebenti tetemphilo letinyenti tikhatsateke ngesidzingo sekunakekelwa. Lokuncishiswa kwetisebenti tetemphilo kubangelwe yi-HIV/AIDS. Ecinisweni, kubhebhetseka kwe-HIV etisebentini temphilo kulinganiselwa kutsi kulingana naloko lokwenteka emkhatsini webantfu baseSwatini. Kutigcek anekutihlupha ngenca ye-HIV/AIDS kwetisebenti tetemphilo kuvimbela tisebenti tetemphilo kutsi tingatfoli kunakekelwa lokudzingekako, lokungafaka sandla ekufeni lokuhlobene ne-HIV kanye nekungabikho kwebanakekeli betemphilo.

## Kungalondvolotwa kwekudla kanye ne-HIV/AIDS
Kusukela ekucaleni kweminyaka yabo 1990, live lase Eswatini belikadze litsembele ekusitweni kwekudla lokuvela kulamanye emave kwentela kondla bantfu bayo. Ngetulu kwaloko, hulumende waseSwatini wamemetela inhlekelele yesomiso seNdlovana 2016, eminyakeni lelishumi nesikhombisa ngemuva kwekumenyetelwa kwe HIV/AIDS njengenhlekelele yavelonkhe. Kweswelakala kwekudla lokwabangelwa simo selitulu i-El Niño kwashiya bantfu labangetulu kwa-300,000 bangaphephile etindzabeni tekudla.

ENingizimu ye-Afrika, kwesweleka kwekudla akuzange kugcine ngekuhlobana nekukhula kwelizinga lekutfola i-HIV, kepha kuphindze kube nebulukhuni bekuhlala baphilile kubantfu labaphila ne-HIV. Ikakhulukati, eningizimu ye-Afrika, kungatfolakali kwekudla kuhlotjaniswa nekutiphatsa ngekwelicansi lokusezingeni lelisetulu kwebantfu labasikati, kufaka ekhatsi imikhuba lefana nekwehlisa kusetjentiswa kwe-condom, kuya ecansini, kanye nemsebenti welicansi. Kungalondvoloteki kwekudla kuphindze kwahlanganiswa nekwehla kwekunamatsela kwe-antiretroviral therapy (ART) kanye nekukhula ngekushesha kwe-HIV. I-ART iphindze yatfolwa ingasebenti kahle ekulondvoloteni linani le-CD4 cell, lokukhombisa imphilo yesimiso semtimba, kubantfu labahlushwa kungondleki kahle noma kungatfolakali kwekudla.

Budlelwane emkhatsini wekungavikeleki kwekudla kanye ne-HIV/AIDS busuka etindzaweni letimbili. Akusiko nje kutsi kungatfolakali kwekudla kuvame kwenta bantfu base-Eswatini batiphatse ngendlela lengakhulisa bungoti babo bekutfola i-HIV, i-HIV/AIDS ibekwe yi-Food and Agriculture Organization (FAO) ye-United Nations kanye ne-World Food Programme (WFP) njengentfo lebangela kungatfolakali kwekudla emindenini yemaSwati, njengoba kunciphisa kukhicita kanye nelikhono lekutfola imali.

Ecinisweni, labasikati labatsengisa ngemtimba baseSwatini labaphila ne-HIV babike kutsi batfunjwe yindlala, i-HIV, kanye nemsebenti wekutsengisa ngemtimba. Bafati labanyenti base-Eswatini labaphuyile futsi labangenako kudla benta umsebenti wekutsengisa ngemtimba kute batfole kudla lokwenele bona nemindeni yabo. Kuhlanganyela emsebentini wekutsengisa umtimba kukhulisa bungoti babo bekutfola i-HIV. Batsengisi bemtimba labaphila ne-HIV bese betama kulawula kugula kwabo kanye nekuvikela imiphumela lemibi ye-ART ngekwetama kutfola kudla lokunyenti, ikakhulukati kudla lokunemphilo. Lokwandza kwekwetsembela ekudleni kuphindze kuholele kubomake labanyenti ekutseni batsembele kakhulu emalini labayitfolako ngemsebenti wekutsengisa umtimba.

## I-HIV kanye ne-TB (TB) ngekuhlanganyela
I-Eswatini ayigcini nje ngekuba nelizinga lekubhebhetseka kwe-HIV kubantfu labadzala emhlabeni wonkhe, iphindze ibe nesilinganiso sesibili lesisetulu sekungenwa yi-HIV-tuberculosis (i-TB) emhlabeni wonkhe. Ngekuhambisana nalesibalo, kufa lokuhlobene ne-TB kubantfu labaphila ne-HIV Eswatini (kufa kwebantfu labangu-135 kubantfu labangu-100,000) kukhulu kakhulu kunekufa lokuhlobene ne-TB emkhatsini webantfu base-Swatini (51 kubantfu labanga-100,000).

Eminyakeni lelishumi leyendlulile, lelive litsetse tinyatselo tekucinisa tinsita tekusebentisana te-HIV-TB kanye nekungenelela. Sibonelo saloko kutsi, kwabhalwa nga-2014 kutsi 97% wetigulane taseSwatini letiphetfwe yi-TB letati simo sato se-HIV tinesifo se-HIV. Kusukela ngemnyaka wa 2017, lamaphesenthi ehle aba ngu-70%. Njengobe i-Eswatini yandzise kwelashwa kwe-antiretroviral (ART) kanye naletinye tinsita tekunakekelwa kwe-HIV kanye nekuvinjelwa, emazinga ekwatisa nge-TB ehlile. Ngemnyaka wa 2014, 79% kuphela webantfu labagula nge-TB labane-HIV labacala i-ART. Kusukela ngemnyaka wa 2017, lamaphesenthi akhule aba ngu-94%. Kubakhona kwe-TB kwehle ngesilinganiso semnyaka lesingu-18% kusukela nga-2010 kuya ku-2017 Eswatini, emkhatsini wetilinganiso letisheshako emashumini eminyaka lendlulile.

Sibonelo sinye sentfutfuko kutemphilo yemphakatsi kusungulwa kwetikhungo letiniketa tinsita te-TB kanye ne-HIV etifundzeni taka-Hhohho, Manzini, Lubombo, kanye nase-Shiselweni Eswatini. Imitfolamphilo ye-ART, ngetulu kwekuniketa tinsita letivamile te-HIV, iniketa kuhlolwa kwe-TB, kanye nekwelashwa kwebantfu labagulako. Ngalokufanako, imitfolamphilo ye-TB, ngetulu kwekuniketa tinsita letivamile te-TB iniketa luhlolo lwe-HIV, kwelashwa nekwekutivikela, kanye netinsita tekucalisa kanye nekulandzela i-ART. Lucwalingo lwanga-2018 lobeluhlola kuniketwa kwetinsita te-HIV kanye ne-TB emtfolamphilo we-HIV ne-TB Eswatini lwaphetsa ngekutsi kunesilinganiso lesisetulu sekutfola i-ART ngesikhatsi lesifanele kubantfu labagulako be-TB labati kutsi bane-HIV.

Bantfu labasikati labangetulu kwencenye yinye kuletintsatfu baseSwatini labasemkhatsini weminyaka lengu-15 na-49 baphila ne-HIV; loku kuhambisana nemazinga lasetulu ekungenwa yi-HIV-TB Eswatini, lokwenta labasikati babe sengotini lenkhulu yekutfola i-TB uma kucatsaniswa nemadvodza. Ngenca yalesibalo, hulumende waseSwatini utsatsa tinyatselo tekuhlanganisa kuhlolwa kwe-TB, kuvinjelwa, kanye nekwelashwa ngetinsita tetemphilo tabomake kanye netinsita letivamile te-HIV kubomake. Kusukela ngenyanga yeNdlovu emnyakeni wa 2019, tisebenti letingasebenti emtfolamphilo letibitwa ngekutsi tisebenti letihlolisisa tigulane te-TB nyalo tiyincenye yekunakekelwa lokujwayelekile kwebantfu labasikati labavakashela imitfolamphilo kute bahlele umndeni, kunakekelwa ngaphambi kwekubeleka, nobe kuhlolwa kwebantfwana labanemphilo.

Nanobe kube nekukhula lokukhulu kwekutfolakala kwe-ART kulabantfu labane-HIV kanye ne TB Eswatini, kuniketwa kwelashwa kwe-TB kubantfu labasandza kubhalisa ekunakekelweni kwe-HIV kuhlala ku-1% kulelive kusukela nga-2017.

## Buka futsi

* Eswatini
* Health in Eswatini
* HIV/AIDS in Africa
* HIV/AIDS
* TB-HIV co-infection

## Imibhalo lebhalwe phansi

## Ema-link langaphandle

* National Emergency Response Council on HIV/AIDS (NERCHA) Archived 2013-12-01 at the Wayback Machine
* Ministry of Health