The DHS Program

February 24, 2006 
One in four adults in Lesotho is HIV positive

Calverton, MD. The 2004 Lesotho Demographic and Health Survey (LDHS) included population-level HIV testing for the first time. Testing was anonymous and strictly voluntary. According to LDHS data, 24% of adults are HIV-positive. LDHS data point to the unequal distribution of the virus. Women are far more likely to be infected than men (26% and 19%, respectively). Prevalence among women age 25-39 and men age 30-39 is very high at around 40%. Women who have had 2 sexual partners in the year before the survey have a higher prevalence than those who had no partners during that period (39% and 27%, respectively). Both women and men who have ever attended school tend to have a lower HIV prevalence than those with no education. HIV infection rates for women and men combined vary greatly by district (18% in Mokhotlong and Thaba-Tseka; 30% in Leribe).

Results from the 2004 LDHS also confirm that awareness of AIDS is high, especially among women; 71% of them (60% among men) know that together, using a condom during sex and limiting sex to one uninfected partner can reduce their risk of HIV infection. Knowledge about the use of special drugs during pregnancy to reduce transmission is low (50% among women and 39% among men). Data also show that in the year prior to the survey, a sizeable proportion of women (around 40%) and men (60%) engaged in higher-risk sexual behavior (i.e., with a non-cohabiting, non-marital sexual partner). Of those, less than half (around 44%) used a condom at their most recent higher risk sex.

Other findings indicate that fertility has been declining steadily in the last 30 years with women now having an average of 3.5 children, compared to 5.4 children at the time of the 1976 Census. More than 1 married woman in 3 is using a modern contraceptive method, the fourth highest proportion among sub-Saharan African countries that have carried out similar DHS surveys. The two most popular methods are the injectable (used by 15% of married women) and the pill (11%).

Only slightly more than half of babies are delivered with the assistance of a skilled health professional, mainly because 45% of women still deliver at home. Seven in 10 children have received all of the recommended childhood vaccinations. The 2004 LDHS findings also indicate that 42% of women in Lesotho are overweight, including 16% who are obese, underscoring the importance of addressing this public health problem nationally.

The 2004 Lesotho Demographic and Health Survey was based on interviews with more than 7,000 women age 15 to 49 and 2,800 men age 15 to 59 from the 10 districts of the country. The survey was implemented by the Lesotho Ministry of Health and Family Welfare in collaboration with the Lesotho Bureau of Statistics. Technical assistance was provided by ORC Macro through its MEASURE DHS project. Financial support was provided by the Government of Lesotho and a number of donor agencies namely, the Development Cooperation of Ireland, The World Bank, the United Nations Children’s Fund (UNICEF), the British Department for International Development, the World Health Organization and the U.S. Agency for International Development (USAID).