The Kingdom of Swaziland is a lower-middle-income country. Its Gini coefficient of 0.61 is one of the highest in the world, indicating wide disparities in household income. Sixty-three percent of the population subsists on less than US $1.25 per day.1 Swaziland has made some improvements in the past three decades; however, one of its greatest challenges is an HIV prevalence of 26 percent among 15–49 year olds—the highest in the world.