Comparison of HIV prevalence, incidence, and viral load suppression in Zambia population-based HIV impact assessments from 2016 and 2021

Details

• Alternative Title:
  AIDS
• Personal Author:
  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, 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.
• Corporate Authors:
  ZAMPHIA 2021 Study Group
• Description:
  Background:
  
  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.
  
  Methods:
  
  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.
  
  Results:
  
  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).
  
  Discussion:
  
  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.
  
  
• Subjects:
  Cross-Sectional Studies HIV HIV Infections Humans Incidence Prevalence Viral Load Zambia
• Keywords:
  Africa Incidence Prevalence Viral Suppression
• Source:
  AIDS. 38(6):895-905
• Pubmed ID:
  38227572
• Pubmed Central ID:
  PMC11402832
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  38
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:bde26e347d37e3d130664588b861cc67e363336945645f1661da60ed4eb5bd41ddeeb3c6541a1428c6f80d469e00e0735394e952000201a29ac6b62243158476
• Download URL:
  https://stacks.cdc.gov/view/cdc/162412/cdc_162412_DS1.pdf
• File Type:
  [PDF - 326.99 KB ]