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At a glance: HIV in Zambia

A renewed focus on HIV prevention  

Key statistics

In 2020:

  • 1.5 million people with HIV 
  • 11.1% adult HIV prevalence 
  • 69,000 new HIV infections 
  • 24,000 AIDS-related deaths 
  • 1.2 million people on antiretroviral treatment 

Progress towards targets

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

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Did you know?

Life expectancy among people with HIV has improved significantly as a result of scaled-up treatment programmes in recent years. 

Prevention

Preventing HIV in Zambia focuses on: 

  • prevention of mother-to-child transmission  
  • voluntary medical male circumcision (VMMC) 
  • social and behaviour change communication 
  • male and female condoms 
  • STI management 
  • PrEP (a daily pill is available; a vaginal ring and injectable are being trialled) 
  • PEP (ARV drugs taken just after being exposed to HIV to prevent infection) 
  • a range of prevention services for young people, particularly adolescent girls and young women. 

Did you know?

Despite the outbreak of the COVID-19 pandemic in 2020, Zambia managed to expand its VMMC programme by 15% when most other countries in the region were scaling theirs back. 

Testing

Testing for HIV is: 

  • lower among men and young people than women 
  • available in health facilities, community spaces, at home (as door-to-door testing or self-testing), workplaces and during testing events 
  • encouraged for couples, and for the partners and children of people newly diagnosed with HIV (called partner notification and index testing). 

Did you know?

HIV tests are offered to young people as part of HIV prevention campaigns, along with free condoms and advice on how to reduce the risks of getting HIV. 

Treatment

Treatment for HIV is: 

  • free 
  • available immediately after diagnosis  
  • available in multi-month refills (for people who are stable on treatment and virally suppressed) 
  • monitored by viral load testing 
  • includes nutrition and psychosocial support to help people stay on treatment 
  • available in most health facilities 
  • includes home and community-based adherence support  
  • first-line treatment is an antiretroviral regimen that contains Dolutegravir, which is recommended by the World Health Organization as it has fewer side effects. 

Did you know?

In 2017, Zambia adopted ‘test and treat’, which offers immediate treatment to anyone diagnosed with HIV. Since then, 20% more people with HIV have started treatment. 

Local context

Prevalence among adults in Zambia has changed little over the last decade despite decreasing infection rates. As a result, HIV prevention has been a key focus in recent years – PrEP has been rapidly scaled up, comprehensive sexuality education is now offered in primary and secondary schools, and the country’s VMMC programme is one of the most successful in the region. 

Zambia’s HIV epidemic affects different groups in different ways. w/node/161are far more likely to have HIV than men – young women (ages 15-24) are three times as likely to get HIV than their male peers, for example. But men are more likely than women to die from an AIDS-related illness because they are less likely to test for HV and seek treatment. 

There are also regional variations, with HIV prevalence highest in the urban provinces of Lusaka and Copperbelt. 

Violence against women remains common and helps to drive the epidemic among females. Demographic Household Survey data suggests that from the age of 15 onwards, almost half of all Zambian women will experience physical violence from a partner or others. 

Zambia criminalises men who have sex with men, who face a prison sentence of up to 14 years, sex workers and people who use drugs. This stops many people from these groups from getting the HIV prevention, testing and treatment they need, despite being at high risk of infection. As a result, these groups are extremely vulnerable to HIV, although data on HIV prevalence is limited. 

Abortion is only legal in limited circumstances on health grounds (for example, to save a woman’s life or in cases of foetal impairment).  

HIV-related stigma remains an issue in Zambia, as one in four people hold discriminatory attitudes towards people with HIV.  

Zambia’s HIV response is reliant on international funding, which accounts for 84% of spending, compared to 14% provided the Zambian Government and 2% from the private sector. In 2019, the Zambian Government introduced a National Health Insurance Scheme to increase domestic resources for the health sector, including for HIV. 

Next: At a glance: HIV in Zimbabwe

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