CIET has worked in Botswana since 2002. The INSTRUCT trial of a package of structural and behavioural interventions will take place in Botswana. Botswana is the centre for training in the CIET ADAPT (African Development of AIDS Prevention Trials capacities) programme.
Botswana is a land-locked country in Southern Africa, home to the Kalahari desert, and with an estimated 2011 population of 2 million. The estimated prevalence of HIV among adults (aged 15-49) in Botswana was 23.4% in 2011, with an annual HIV incidence of around 1.5%.
Previous work in Botswana
In 2002 and 2003, CIET conducted a survey of gender violence and HIV knowledge, attitudes and practices among households and schools in eight southern African countries, including Botswana, where the survey covered some 2,500 adults and 4,700 school going youth.
CIET repeated the survey in 2007, now covering 10 countries, again including Botswana (about 2,500 adults and 10,300 school going youth). A summary of the 2002 and 2007 findings in Botswana is available.
Several published papers cover aspects of the survey findings in Botswana and the region.
Ho-Foster A, Laetsang D, Masisi M, Anderson M, Tlhoiwe D, Cockcroft A, Andersson N.. Gender-specific patterns of multiple concurrent sexual partnerships: a national cross sectional survey in Botswana. AIDS Care 2010; 22(8): 1006-1011 (doi: 10.1080/09540121003758598)
Mitchell S, Cockcroft A, Lamothe G, Andersson N. Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries. BMC International Health and Human Rights 2010; 10: 23 (doi: 10.1186/1472-698X-10-23)
Andersson N,Paredes-Solis S, Milne D, Omer K, Marokoane N, Laetsang D, Cockcroft A. Prevalence and risk factors for forced or coerced sex among school-going youth: national cross-sectional studies in ten southern African countries in 2003 and 2007. BMJ Open 2012; 2: e000754. doi:10.1136/bmjopen-2011-000754
Community views about HIV testing and anti-retroviral treatment
In 2006, CIET conducted a household survey of 1536 people in a stratified random sample of communities across Botswana, asking about use and experience of government health services, views about ART, and testing for HIV in the previous 12 months. Focus groups further discussed issues about ART.
Public awareness and approval of RHT was very high. The high rate of RHT has contributed to the overall high rate of HIV testing in Botswana. The government’s programme to increase HIV testing and uptake of ART was apparently working well.
See: Cockcroft A, Andersson N, Milne D, Mokoena T, Masisi M. Community views about routine HIV testing and antiretroviral treatment in Botswana: signs of progress from a cross sectional study. BMC International Health and Human Rights, 2007, 7:5. Available from: http://www.biomedcentral.com/1472-698X/7/5