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Mulenga, Lloyd B; Hines, Jonas Z; Stafford, Kristen A; Dzekedzeke, Kumbutso; Sivile, Suilanji; Lindsay, Brianna; Chola, Mumbi; Ussery, Faith; Patel, Hetal K; Abimiku, Alash'le; Birhanu, Sehin; Minchella, Peter A; Stevens, Jr, Thomas; Hanunka, Brave; Chisenga, Tina; Shibemba, Aaron; Fwoloshi, Sombo; Siame, Mwiche; Mutukwa, John; Chirwa, Lameck; Siwingwa, Mpanji; Mulundu, Gina; Agbakwuru, Chinedu; Mapondera, Prichard; Detorio, Mervi; Agolory, Simon G; Monze, Mwaka; Bronson, Megan; Charurat, Man E
AIDS, 2024-May-01, Letnik: 38, Številka: 6Journal Article
The Zambian government has implemented a public health response to control the HIV epidemic in the country. Zambia conducted a population-based HIV impact assessment (ZAMPHIA) survey in 2021 to assess the status of the HIV epidemic to guide its public health programs. ZAMPHIA 2021 was a cross-sectional two-stage cluster sample household survey among persons aged ≥15 years conducted in Zambia across all 10 provinces. Consenting participants were administered a standardized questionnaire and whole blood was tested for HIV according to national guidelines. HIV-1 viral load (VL), recent HIV infection, and antiretroviral medications were tested for in HIV-seropositive samples. Viral load suppression (VLS) was defined as <1000 copies/ml. ZAMPHIA 2021 results were compared to ZAMPHIA 2016 for persons aged 15-59 years (i.e., the overlapping age ranges). All estimates were weighted to account for nonresponse and survey design. During ZAMPHIA 2021, of 25 483 eligible persons aged ≥15 years, 18 804 (73.8%) were interviewed and tested for HIV. HIV prevalence was 11.0% and VLS prevalence was 86.2% overall, but was <80% among people living with HIV aged 15-24 years and in certain provinces. Among persons aged 15-59 years, from 2016 to 2021, HIV incidence declined from 0.6% to 0.3% ( P -value: 0.07) and VLS prevalence increased from 59.2% to 85.7% ( P -value: <0.01). Zambia has made substantial progress toward controlling the HIV epidemic from 2016 to 2021. Continued implementation of a test-and-treat strategy, with attention to groups with lower VLS in the ZAMPHIA 2021, could support reductions in HIV incidence and improve overall VLS in Zambia.
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