학술논문
Comparison of HIV prevalence, incidence, and viral load suppression in Zambia population-based HIV impact assessments from 2016 and 2021
Document Type
Academic Journal
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, Jr.; 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.
Source
AIDS. May 01, 2024 38(6):895-905
Subject
Language
English
ISSN
0269-9370
Abstract
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.