Botswana's first AIDS case was reported in 1985 and since then HIV prevalence has continued to rise dramatically. Today, HIV prevalence in Botswana is among the highest in the world. In 2003, Botswana's second generation surveillance system (National AIDS Coordinating Agency (NACA)) Technical Report, November 2003: Botswana 2003 Second Generation HIV/AIDS) estimated HIV prevalence to be 37% among pregnant women aged 15-49 attending Government antenatal clinics. This level appears to be stabilizing at around 30%-40%. In 2004, a first population-based survey estimated that 17% of the population aged 1.5-89 years were living with HIV.

Botswana mounted a strategic response to the HIV epidemic in three phases. The first phase (1987-89) focused mainly on the screening of blood to eliminate the risk of HIV transmission through blood transfusion. The second phase (1989-97) saw the introduction of an information, education and communication (IEC) programme. The third phase (1997-2002), was multi-pronged, with a focus on areas including education, prevention, comprehensive care and the provision of ART. The NACA, which was established in 2000, was given responsibility for mobilizing and coordinating a multi-sectoral national response to HIV (NACA, 2003).