Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - July 6, 2006
Belinda Beresford
It is hoped this will counter the widespread human tendency to consider HIV to be someone else's problem - confirmed by a South African survey released last year that found that more than half the people convinced they were safe from HIV, were in fact already carrying the virus.
Lesotho is thought to have one of the world's highest levels of HIV prevalence among its two million population.
Last year, Lesotho's government launched an operational plan to ensure that every person over the age of 12 received voluntary counselling and testing for HIV by the end of 2007. The Know Your Status campaign is designed to be rolled out as part of a wave of prevention and care interventions.
It is a grassroots initiative that plans to send counsellors to visit every household in the country. Strategies are being developed that will allow children over the age of 12 to have voluntary counselling and testing without the consent of their parents or guardians.
The intention is to encourage people to have repeated counselling and testing. This will enable HIV-positive individuals to be given prophylactic medical care, and given access to anti-retrovirals when they are first required, instead of waiting until they are seriously ill, which can exacerbate the side effects of starting the treatment.
Experts anticipate that repeated HIV testing will encourage people to have safer sex. The hope also is that if almost every teenager and adult in the country has at least one HIV test, this will reduce stigma and discrimination both against testing and against people who are affected by the virus.
The benefits of universal counselling and testing for HIV have been hailed by Aids experts as one of the most focused ways of intervening in the spread of HIV/Aids and the social and developmental impact.
Lesotho does not know the true extent and character of the epidemic, which makes it difficult to plan and implement ways of helping affected people and communities - and to measure and evaluate the successes and failure of prevention, care and treatment programmes. Mass testing will fill this information gap and provide a way of pulling affected children and households into social safety nets.
Almost half of Lesotho's population are thought to live below the poverty line. Just under one in four adults is thought to be HIV-positive and about 50 000 people are thought to need anti-retroviral therapy. The HIV/Aids epidemic is being spread mainly by heterosexual activity, fuelled by high levels of migrant labour and poverty.
Awareness of HIV/Aids is high in Lesotho, but this has failed to translate into safer sexual activity. More than a quarter of men and 18% of women surveyed in Lesotho's Demographic and Household Survey 2004 thought that a woman was not justified in refusing her husband sex if she knew he had a sexually transmitted infection, although 82% of men and 91% of women felt a woman was justified in refusing if her husband would not wear a condom. Sexually transmitted infections are thought to be one of the drivers behind the sexual spread of HIV.
The Lesotho government said earlier this year that it still needed $12,5-million to fund the Know Your Status campaign.
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