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The Swaziland HIV Incidence Measurement Survey (SHIMS) is a nationally representative, population-based survey that collected demographic and HIV-related measures in 2010-2011.  It is the first national-level survey to measure HIV incidence through direct observation of new infections.

Conducted by the Government of Swaziland in collaboration with ICAP at Columbia University and the Centers for Disease Control and Prevention (CDC), SHIMS updates previous measures on the magnitude of HIV in Swaziland and provides new estimates on the population-level impact of HIV services in the country.

A multi-phased, household-based survey, SHIMS found that, as of 2011, 31% of adults in Swaziland, age 18-49 are living with HIV. When compared to prior estimates, this suggests that the HIV epidemic in Swaziland may have begun to stabilize, albeit at still high levels.

The accurate measurement of HIV incidence is critical to identifying high-risk populations and accurately measuring HIV program effectiveness. SHIMS found that HIV incidence is higher among women compared to men.  The need for targeted efforts to reduce the number of new infections in Swaziland remains key.

Results from SHIMS highlight the need for a sustained effort to increase HIV testing coverage and frequency in the general population of Swaziland, with a particular emphasis on increasing access for men.

The HIV epidemic in Swaziland is the Kingdom’s leading public health concern. Findings from SHIMS have been used to inform health policy and programming, emphasizing the continued scale-up of a combination approach to HIV prevention.