HIV/AIDS

In Zambia, UNICEF works with the Government to prevent HIV transmission, and partners with adolescents to raise awareness on HIV prevention and treatment.

Health officer examines HIV tests
UNICEF/UN0207194/Sibiloni

The challenge

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.

The solution

During the first half of 2017, the Government of Zambia completed the National AIDS Strategic Framework 2017-2021 and the new Adolescent Health Strategy 2017-2021. While the HIV Strategic Framework prioritises global treatment and prevention specifically for children, mothers and adolescents; the Adolescent Strategy emphasizes sexual reproductive health and HIV, with prevention of teenage pregnancy, scaling up HIV testing, and condom programming, among priorities.

Zambia has a successful Prevention of Mother to Child Transmission programme, which includes testing at antenatal care clinics and providing counselling and antiretroviral drugs for pregnant and breastfeeding women diagnosed with HIV. 

“UNICEF’s HIV programme centres on quality, accessible and proven HIV prevention and treatment interventions for children, adolescents and pregnant women”

UNICEF’s HIV/AIDS programme supports the Government of Zambia in implementing the:

  • National Paediatric and Adolescent Prevention, Treatment and Care Implementation Plan 2017-2021
  • AIDS Response Fast Track Strategy 2017-2021 
  • National AIDS Strategic Framework (NASF) 2017-2021
  • Adolescent Health Strategy (ADH) 2017-2021 
  • Elimination of Mother-to-Child Transmission of HIV and Syphilis (eMTCT) Plan 2018-2022.

The programme is centred on quality, accessible and proven HIV prevention, treatment, care and support interventions for children, adolescents and pregnant women. It also focuses on rights- and gender-sensitive quality services, enhanced awareness, demand for services, the use of data and evidence to strengthen accountability. 

The UNICEF HIV programme's primary focus is on responding to the HIV burden by supporting the Government of Zambia provide high quality interventions along the continuum of HIV care during the first and second decades of life. This is achieved by increasing coverage of the following high impact interventions to high level targets as below: 

  • Pregnant women living with HIV receiving antiretroviral treatment, to 90 per cent. 
  • Children aged 0-14 years living with HIV receiving antiretroviral treatment, to 90 per cent.
  • Sexually active adolescents aged 15-19 years who had an HIV test in the last 12 months, to 90 per cent.
  • Eligible adolescents living with HIV on antiretroviral treatment, to 90 per cent.
  • Consistent condom use among sexually active adolescents aged 15-19-years
  • Children, adolescents and women living with HIV achieving viral suppression (significantly low numbers of viruses in the body) to 90 per cent-

In order to achieve these results, UNICEF supports the Government of Zambia at policy level (policy, strategy development, review and monitoring), national and sub-national coordination of service implementation (governance structures like technical working groups), and service delivery for children, adolescents and women. In rendering this support, UNICEF is guided by the following principles: evidence-based programming; innovation; equity; and working in partnership with other stakeholders in the HIV response including development partners, NGOs and civil society.

Resources

These resources represent just a small selection of materials on HIV/AIDS produced by UNICEF and its partners in Zambia. The list is regularly updated to include the latest information.

Zambia Demographic and Health Survey 2013-14

Zambia U-Report

UNICEF Zambia Country Programme Document (CPD) 2016-2021

National AIDS Strategic Framework 2017-2021

Adolescent Health Strategy 2017-2021