WHO/HIV/2017.59 HIV Country Profile: 2016

Demographic and socioeconomic data 90-90-90 progress towards 2020 targets

2.3 million 15 510 US$ 100% Total population (2016) $ GNI per capita, PPP (2015) 100%100%100% 85% UNPOP Bank 84% 83% % 78% 129 5.4 22%60% 80%80%80% Maternal mortality per Health expenditure, total 80% 100 000 live births (2015) $ (% of GDP) (2014) World Health Stat., WHO 57% World Bank Estimated ART coverage 60%60%60%60% 68 years 385 US$ children and adults at birth Health expenditure per (2015-2020) $ capita (2014) 40%40%40%40% UNPOP World Bank 23% 2.7 0.70 20%20%20%20% N/A Total fertility rate (births Development >95% per woman) (2015-2020) Index Value (2015) UNPOP UNPOP 0%0%0%0% PLHIVPLHIV PLHIVPLHIV PLHIVPLHIV 264 PLHIVPLHIV PLHIVPLHIV PLHIVPLHIV Number of births (thou- Estimated % of pregnant women diagnoseddiagnoseddiagnosed receivingreceivingreceiving virallyvirallyvirally r 900 r sands) (2015-2020) diagnosed receiving virally 400 a living with HIV who received ARVs a ART suppressed e ARTART suppressedsuppressed e UNPOP y y for PMTCT r 800

ART suppressed r e

e 350 p

r p

n e

n 700 o p

Estimated number of people newly Estimated number of deaths due to o 300 r s n r s e o e

p 600 r s p

infected with HIV r

AIDS e r

250 e p e p

r p

500

30 000 25 000 e r s r s p a

l a 200 l l l r s

o 400 a o l d r l

25 000 d

20 000 a S o 150 S e d U 300

U y

S n i n

i U

20 000 100 e e n c 200

15 000 i c

r i r i e p c

p

n 15 000 r i 50 100 n a p i a

10 000 i d n d e a i e 0 0

10 000 M d M e 2010 2011 2012 2013 2014 2015 2016 2010 2011 2012 2013 2014 2015 2016

5 000 M 5 000 [ZDV+3TC+NVP] [150+200+300] [TDF+FTC+EFV] [600+200+300] [TDF+FTC]+[LPV/r] [ZDV+3TC]+[ATV/r] [TDF+3TC]+[ATV/r] [TDF+3TC+EFV] [600+300+300] [TDF+3TC]+[LPV/r] 0 0 [ZDV+3TC]+[LPV/r] 2000 2005 2010 2016 2000 2005 2010 2016 Trend since 2010 Trend since 2010 Elimination of mother-to-child Value Epidemiological HIV data Value [range] transmission (EMTCT) of HIV and syphilis [range] Year Estimated number of people living with HIV 360 000 [320 000 - 390 000] Antenatal care coverage - at least one visit (%) 94% 2007 Estimated number of children aged 0 to 14 Antenatal care coverage - at least four visits (%) ... living with HIV 12 000 [10 000 - 15 000] % of pregnant women with known HIV Estimated number of women (15+) living with HIV 200 000 [180 000 - 210 000] 87% 2015 status Estimated adult (15-49) prevalence 21.9% [19.2% - 23.8%] Antenatal care attendees who were tested 92% 2011 Estimated number of deaths due to HIV 3 900 [3 300 - 4 600] for syphilis (%) Estimated number of children dying due to HIV <500 [<500 - <500] Antenatal care attendees who tested posi- 1% Estimated number of people newly infect- tive for syphilis (%) 2011 ed with HIV 10 000 [7 400 - 13 000] Estimated number of children newly infect- Antenatal care attendees who tested posi- 100% ed with HIV <1000 [<500 - <1000] tive for syphilis and who received benzathi- 2011 ne penicillin IM (%) Estimated incidence rate per 1 000 unin- 5.52 [4.03 - 7.17] Reported number of pregnant women living fected population 11 300 2016 with HIV who received antiretrovirals for PMTCT Estimated % of pregnant women living with Antiretroviral therapy (ART) >95% [75% ->95%] HIV who received antiretrovirals for PMTCT*2 2016 Reported number of people receiving ART 298 000 % of infants born to women living with Estimated ART coverage 83% [73% - 91%] HIV receiving a virological test within two 50% [44% - 63%] 2016 months of birth (EID)*1 Reported number of children receiving ART 7 400 Final mother-to-child transmission rate 1 4.8 Estimated ART coverage (children, 0-14)* 60% [50% - 72%] including breastfeeding period*3 2016 * Tracing indicators for elimination of mother-to-child transmission. A colour scheme (green, orange, red) is used to indicate if the country is on target to meet 2020 targets: ¹90% ²95% ³Less than 5 WHO/HIV/2017.59 WHO/HIV/2017.59 Botswana HIV Country Profile: 2016 HIV Country Profile: 2016

Key populations

Percentage condom use among sex workers with most recent client 90% Percentage of men reporting using a condom the last time they had 84% anal sex with a male partner HIV prevalence among men who have sex with men (%) 13%

HIV prevalence among sex workers (%) 62%

Median annual price of ARV drug regimens for adults

First line Second line

600 600 year year r r r

e 900 r e

400 a p a

p e

e n

500 y 500 n y o r

o 800 r s e s r

e 350 r p e

r e p

p n e

p

n

r 700 o p 400 r 400

o e

300 e r s n p r s

p e

o s e s p r 600 r r s p a r a l e r l l 250 e l p e 300 300 o p o

r p

d 500 d

e

r s S r s p S a

l a 200 U l U l

l r s o

n 400 n

a 200 o i 200 i

l d

r l d e e a S o 15c 0 c S i e i d U r 300

r U y

p S n p

i n

i U n 100 100

n

100 e a e a n i c 200 i i c

d r i d r i e e e p c

p

M M n r i 50 100 n 0 0 a p i a

i 2010 2011 2012 2013 2014 2015 2016 d n 2010 2011 2012 2013 2014 2015 2016 d e a i e 0 0 M d [ZDV+3TC+NVP] [150+200+300]mg [TDF+FTC+EFV] [600+200+300]mg M [TDF+FTC]+[LPV/r] [TDF+3TC]+[LPV/r] [ZDV+3TC]+[LPV/r] e 2010 2011 2012 2013 2014 2015 2016 2010 2011 2012 2013 2014 2015 2016 M [TDF+3TC+EFV] [600+300+300]mg [TDF+3TC]+[ATV/r] [ZDV+3TC]+[ATV/r] [ZDV+3TC+NVP] [150+200+300] [TDF+FTC+EFV] [600+200+300] [TDF+FTC]+[LPV/r] [ZDV+3TC]+[ATV/r] [TDF+3TC]+[ATV/r] [TDF+3TC+EFV] [600+300+300] [ZDV+3TC]+[LPV/r] [TDF+3TC]+[LPV/r]

National HIV policies and plans

2007 Implementation of national policy on HIV self-testing (HIVST) Policy on HIVST but still not implemented Treatment initiation threshold children Treat All regardless of age Treatment initiation threshold adults and adolescents Treat All regardless of CD4 count 2015 Implementation of Treat All adults and adolescents Implemented countrywide 2011 Dolutegravir (DTG) as part of 1st line ARVs for adults and adolescents DTG introduced in national guidelines and procurement initiated Implementation of lifelong ART to pregnant & breastfeeding women Implemented in a large number (>50%) of MCH sites 2011 Implementation of national policy on viral load monitoring Fully implemented Completion of HIV services cascades Completed a national HIV cascade 2011 Adaptation of WHO Key Population guidelines in national plans Partially National M&E plan or strategy for HIV Yes, and updated in the past two years 2016 Method to de-duplicate key data (i.e. unique identifiers) No Nationally-representative quality assessment of facility-level ART data 2016 No

2016

2016 Sources: Global AIDS Monitoring (UNAIDS/WHO/UNICEF), Spectrum estimates (UNAIDS/WHO) and WHO HIV Country Intelligence Tool, 2017 * Tracing indicators for elimination of mother-to-child transmission. A colour scheme (green, orange, red) is used to indicate if the country is on target to meet 2020 targets: ¹90% ²95% ³Less than 5