Over the past decade, Zambia has made tremendous progress in HIV response. According to UNAIDS, annual HIV infections (for all ages) in Zambia have declined from 63,000 in 2010 to 48,000 in 2017. New infections among children 0-14 years declined from an estimated 14,000 in 2005 to 7,300 in 2017. Annual AIDS-related deaths have also declined significantly from 25,000 in 2010 to 16,000 in 2017, a decline of more than a third.
Despite the progress, the HIV burden remains high and disproportionately affects females. In 2017, it was estimated that there were 23,000 new HIV infections among women 15+ years, compared to 17,000 among males. The Zambia Population based HIV Impact Assessment (ZAMPHIA) reports that HIV prevalence among females aged 15-59 years is 14.6 per cent, compared to 9.3 per cent for males of the same age. With an HIV prevalence of 15.9 per cent and 15.7 per cent, Western and Lusaka provinces respectively have the greatest HIV burden, with Muchinga province being the least burdened at 5.7 per cent.
“Young people make up the largest age group accessing HIV testing”
HIV testing among pregnant women at antenatal clinics has increased significantly, with 9 out of 10 pregnant women getting tested and almost all (99 per cent) of those diagnosed with HIV (at the antenatal clinic) being initiated on treatment (ARVs). However, there is a large gap around children – with only about 46 per cent of HIV exposed children (born from a mother living with HIV) receiving early infant diagnosis, and only 64 per cent of children 0-14 years living with HIV are on treatment. Despite large increases in HIV testing and voluntary medical male circumcision among adolescents, condom use by sexually active adolescents remains low. The 2013/14 Demographic and Health Survey reported that only 37 per cent and 43 per cent of adolescent boys and girls aged 15-19 years old respectively used a condom at the last sexual intercourse.
Although 65,000 (females 40,000; males 25,000) adolescents are estimated to be living with HIV, only about 60 per cent are on HIV treatment (ARVs).
Other key statistics include:
- Only four in 10 adolescents, aged 15-19 years have comprehensive knowledge of HIV (defined as knowing that condom use and limiting sexual intercourse to one uninfected partner are HIV prevention methods, knowing that a healthy-looking person can have HIV, and rejecting the two most common local misconceptions about HIV transmission).
- Only about half of adolescent girls aged 15-19 years know their HIV status, while only 1 in 3 adolescent boys know their HIV status, according to Demographic and Health Survey.