In 2018, the HIV prevalence in Lesotho was a generalised high of 23,6%, and has been that way since 2005. This case study was designed to gain empirical insights into the factors that contribute to HIV infection among domestic workers in Maseru, and to explore measures that could contribute to improved HIV management among the target group.

Snowball sampling was used to recruit participants, domestic workers living with HIV and working in Maseru, and data was collected through in-depth interviews. The findings revealed that stigma and discrimination discouraged domestic workers from obtaining information about HIV, testing for HIV and using HIV prophylaxis. HIV information and prevention services were not accessible. Domestic workers had multiple sexual partners and did not use condoms regularly. Alcohol and peer pressure also influenced respondents to engage in risky behaviours, while religious beliefs discouraged them from using condoms and obtaining sex and HIV education. Their low wages resulted in respondents having many male sex partners in exchange for money.

The proposed measures for improving HIV management among domestic workers were increasing accessibility, addressing health vacancies, social protection benefits, increasing the wages of domestic workers, HIV laws and policy reinforcement, addressing staff challenges and focused HIV testing and literacy.