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Herd boys Herd boys are among the most disadvantaged young people in Lesotho.Poverty encourages many to take up herding livestock as a full-time occupation, meaning many are deprived of formal education and lack access to health services, including HIV prevention, treatment and care.25 As of 2014, NGOs, in collaboration with the Ministry of Education, local government and local communities, have provided basic education to 550 herd boys from selected mountain areas.As part of this, a variety of campaigns have been launched to reach 15-24 year olds across the country.For example the Kick 4 Life campaign, which uses football to bring HIV prevention messages to young people, had reached over 250,000 15 to 24-year-olds as of 2016.22 Various communication platforms such as television and social media are also being utilised. (Your Choice) has been produced by Lesotho’s Ministry of Health and Social Welfare and its National AIDS Commission (NAC), in collaboration with behaviour change organisation Mantsoapo, to target students with messages of HIV risk and prevention.23 Cash transfer programmes have also been found to be an effective method of HIV prevention in Lesotho, particularly for young women.24 Case study: HIV services and sexual health in Lesotho In a project aiming to help young people aged between approximately 15 and 24, Phelisanang Bophelong trains community-based volunteers – usually older, respected and approachable members of the community – to run youth groups linked to clinics, debates and camps engaging parents about sexual health in the Leribe district.Interestingly, 76.7% of male and 61.6% of female inmates and 80.8% of male and 71.5% of female prison staff surveyed saw themselves as having an increased risk of contracting HIV within the prison environment.Due to this increased perceived risk, HIV testing among this group is relatively high, with over 80% of those questioned testing for HIV in the last 12 months.33 Lesotho is one of only two countries in Southern Africa implementing condom programmes in prisons, the other being South Africa.34 In Lesotho, there is limited research on men who have sex with men (sometimes referred to as MSM), which has resulted in little understanding of the HIV epidemic among this population.LDHS 2014 reported 33% of women and 40% of men expressing the belief that a husband is justified in beating his wife in certain circumstances." href="#footnote11_t8g6g94"11 A 2013 study by Gender Links found 62% of women experienced, while 37% of men perpetrated, intimate partner violence .12 Other studies have found that large proportions of men and women in southern Africa do not believe a woman has the right to refuse sex with a partner.13 A 2012 survey found 62.5% of men in Lesotho expressed the belief that they have the right to threaten their wives if they refuse sex.14 Beliefs such as these limit women's power within relationships and increase their vulnerability to sexual violence and HIV.The majority of garment factory workers in Lesotho are young women who often migrate from the rural areas towards the cities and industrial zones in search of work.

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Lesotho is one of the countries hardest hit by HIV, with the second highest HIV prevalence after Swaziland.1 HIV prevalence was 25% in 2016, and has been around this level since 2005.2 An estimated 330,000 people were living with HIV in Lesotho and 9,900 died from AIDS-related illnesses in 2016.3 Overall, HIV incidence is declining, from 30,000 new infections in 2005 to 21,000 new infections in 2016.HIV treatment coverage for children living with HIV has improved over recent years and stood at 56% in 2015.However, this is still far below recommended coverage levels.30 Progress has also been made in decreasing the number of deaths among HIV-positive children under the age of five from 860 in 2004 to 260 in 2014.31 Case study: Pre-conception support for couples living with HIV Senkatana, an ART clinic treating more than 4,000 women living with HIV, began offering integrated sexual and reproductive health services in 2012, responding to the need for reproductive health services from half of its patients and aiming to reduce mother-to child transmission.Couples who wanted to have children had their CD4 counts and viral load closely monitored, receiving folic acid and multivitamins.From more than 250 tests on children born to HIV-positive mothers between 20, none were found to have the virus32.The study found 55% of female sex workers in Maseru and 68% in Maputsoe had tested for HIV more than once.

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