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Lesotho Population-Based HIV Impact Assessment: LePHIA 2016–2017: Final Report: September 2019
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September 2019
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[PDF-6.75 MB]
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Description:Final report September 2019
The Lesotho Population-based HIV Impact Assessment (LePHIA) 2016-2017 was a nationally representative, cross-sectional, population-based survey of households across Lesotho. LePHIA focused on measuring key biological endpoints to provide direct estimates of HIV infection risk and burden, and of the effectiveness and population-level impact of the HIV-related prevention, care, and treatment interventions implemented in the country. Its primary objectives were to estimate the national-level annual HIV incidence among adults (the population aged 15-59 years), and the district-level prevalence of HIV viral load (VL) suppression (VLS) (defined as HIV ribonucleic acid [RNA] < 1000 copies per milliliter [mL]) among HIV-positive adults. In addition, LePHIA measured national and district-level adult HIV prevalence, CD4 counts, antiretroviral (ARV) drugs in blood, transmitted HIV drug resistance, pediatric HIV prevalence, and progress toward the 90-90-90 targets defined by UNAIDS. LePHIA is the first national survey to conduct these measurements in Lesotho. The survey also collected information on behaviors associated with HIV infection, such as external migration and gender-based violence (GBV).
The survey used a two-stage, stratified cluster sample design, in which census enumeration areas (EA) (clusters) were selected in the first stage and households in the second stage. Data collection was conducted between the end of November 2016 and May 2017. The survey involved interviewing 8,824 households. In the households surveyed, 14,028 adults and 4,870 children (the population aged 0-14 years) were eligible to participate in the survey. Altogether, 92% (12,887) of eligible adults were interviewed, and 91% (11,682) of interviewed adults and 81% (3,966) of eligible children provided blood for biomarker assessment to determine their HIV status. LePHIA provided home-based HIV testing and counseling (HBTC) with return of results, and point-of-care (POC) CD4 counts for those who were HIV positive. HIV VL results and early infant diagnosis (EID) results were returned to participants through the health facilities of their choice. LePHIA provides weighted estimates. Analysis weights accounted for sample selection probabilities and were adjusted for nonresponse and noncoverage.
Suggested citation: Ministry of Health, Lesotho, Centers for Disease Control and Prevention (CDC), and ICAP at Columbia University. Lesotho Population-based HIV Impact Assessment (LePHIA) 2016-2017: Final Report. Maseru, Lesotho, Atlanta, Georgia, and New York, New York, USA: Ministry of Health, CDC, and ICAP, September 2019.
This project is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC under the terms of cooperative agreement #U2GGH001226. The findings and conclusions are those of the authors and do not necessarily represent the official position of the funding agencies.
LePHIA_FinalReport_Web.pdf
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Pages in Document:261 numbered pages
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