Today, Ambassador Rebecca Gonzales joined Lesotho Minister of Health Semano Sekatle and representatives from ICAP at Columbia University for a virtual event to announce the final results of the Lesotho Population-based HIV Impact Assessment (LePHIA 2020) survey.  LePHIA 2020 is a household-based national survey that was conducted between December 2019 and March 2020 to measure the status of Lesotho’s national HIV response.  LePHIA 2020 is the second LePHIA survey; the first was completed in 2016-17. 

Led by the Government of Lesotho through the Ministry of Health and the Lesotho Bureau of Statistics, LePHIA 2020 was conducted with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and was implemented by ICAP at Columbia University with technical assistance from the U.S. Centers for Disease Control and Prevention (CDC).  LePHIA 2020 was conducted in 9,665 households and included 16,468 participants aged 15 years and above.  The survey offered HIV counseling and testing with immediate return of results, HIV viral load testing, and collected information about the uptake of HIV care and treatment services.

LePHIA 2020 provides evidence of the excellent achievements of Lesotho’s HIV program.  It demonstrates that Lesotho has achieved the first of the UNAIDS 90-90-90 targets and has exceeded the second and third 90 targets.  These findings position the country well as it aims to achieve the revised and more ambitious UNAIDS targets of 95-95-95.

In a country with a population of 2.1 million, the survey found 22.7 percent – approximately 324,000 – of adults (aged 15 years and older) were living with HIV.  Among adults, the annual incidence of HIV was 0.45 percent (0.64 percent among women and 0.28 percent among men), corresponding to about 5,000 new infections per year.  The survey also highlighted the following findings: 

• 90 percent of adults living with HIV reported awareness of their HIV status (91 percent of women and 88 percent of men); 
• 97 percent who were aware of their HIV-positive status also reported current use of antiretroviral treatment (97 percent of women and 96 percent of men); and 
• 92 percent who reported taking antiretroviral treatment had viral load suppression (92 percent of women and 90 percent of men).

As a milestone on the path towards control of the HIV epidemic by 2030, the Joint United Nations Programme on HIV and AIDS (UNAIDS) set targets that by 2020, 90 percent of all people living with HIV would know their HIV status (diagnosed); 90 percent of all people with diagnosed HIV infection would receive sustained antiretroviral therapy (on treatment); and 90 percent of all people receiving antiretroviral treatment would have viral load suppression (supressed viral load).

Since the first LePHIA in 2016-17, Lesotho has also achieved substantial progress in reducing HIV incidence by 55 percent among adults (aged 15-59 years).  During this period, the proportion of adults living with HIV who were successfully treated – measured by their viral load suppression – increased by 18 percent.  Despite overall progress in Lesotho’s HIV response, viral load suppression among younger adults remains an area for improvement.  In LePHIA 2020, viral load suppression was below 80 percent for adults 35 years and younger and below 70 percent for adults 25 years and younger. 

To access the newly released summary sheet, visit the PHIA Project website.

To read about LePHIA’s contributions to the global HIV response, access the newly released Journal of Acquired Immune Deficiency Syndrome (JAIDS) supplement on ‘HIV Population Surveys: Shaping the Global Response.’