HIV/AIDS in Zambia

Last updated August 15, 2023

HIV/AIDS is considered the deadliest epidemic in the 21st century. It is transmitted through sex, intravenous drug use and mother-to-child transmission. Zambia is experiencing a generalized HIV/AIDS epidemic, with a national HIV prevalence rate of 11.3% among adults ages 15 to 49 as of 2018.^[1] Per the 2000 Zambian census, the people affected by HIV/AIDS constituted 15% of the total population, amounting to one million, of which 60% were women.^[2] The pandemic results in increased number of orphans, with an estimated 600,000 orphans in the country. It was prevalent more in urban areas compared to rural and among all provinces, Copperbelt Province and Lusaka Province had higher occurrence.

The government of Zambia created an AIDS surveillance committee as early as 1986, and created an emergency plan to control the spread by 1987. By 2005, the government made antiretroviral therapy free for every individual. There are several UN and NGO voluntary organizations that are helping combat the disease.

Background

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a set of conditions caused by infection with the human immunodeficiency virus (HIV).^[3]^[4] HIV is transmitted by three main ways: sexual contact, significant exposure to infected body fluids or tissues, and from mother to child during pregnancy, delivery, or breastfeeding (known as vertical transmission). There is no risk of acquiring HIV if exposed to feces, Nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood.^[5] It is possible to be co-infected by more than one strain of HIV—a condition known as HIV superinfection.^[6]

Zambia is a landlocked, economically backward county in Africa. It is rated 166th in Human Development Index in 2006 out of a total of 177 countries based on the Human Development Report of the United Nations. By the end of 2006, a total of 39.5 million people in the world were infected by HIV and 2.9 million people died on account of ailments arising out of AIDS. Africa is the leader in AIDS with close to 60% of HIV victims and has been the leading cause of death in Africa.^[7]

Statistics

As per the 2000 Zambian census, the people affected by HIV or AIDS constituted 15 per cent of the population, amounting to one million, of which 60% estimated were women. The pandemic results in increased number of orphans, with an estimated 600,000 orphans in the country. It is estimated that by 2014, 974,000 children would be orphaned.^[8] The victims are high in Lusaka and Copperbelt provinces in spite of the provinces being the most urban. As per the estimate from 2006, the HIV positive cases is 5 per cent in the age group 15–19 years, 25 per cent from 30 to 34 years and 17% from 45 to 49 years. HIV was more prevalent in urban areas compared to rural areas.^[9]

HIV infected people in provinces of Zambia^[10]
Infected with HIV	Central	Copperbelt	Eastern	Luapula	Lusaka	Northern	North-Western	Southern	Western	Grand Total
1985	1,448	6,719	779	427	1,518	539	250	23,960	1,067	36,707
1990	12,516	154,131	11,864	6,971	23,828	6,529	3,104	65,467	9,171	293,581
1995	49,682	235,586	49,750	32,447	111,753	32,452	15,855	103,202	35,208	665,935
2000	79,902	265,518	76,213	46,293	155,729	56,050	25,735	117,477	54,123	877,040
2003	86,654	270,590	81,509	48,988	159,409	62,430	27,418	120,425	57,844	915,267
2001	83,080	270,781	78,511	47,465	158,506	58,683	26,517	120,188	55,919	899,650
2002	85,490	270,945	80,157	48,426	160,240	60,802	27,045	120,347	57,252	910,704
2004	87,435	270,525	81,785	49,462	157,997	63,812	27,587	120,768	58,347	917,718
2005	87,144	268,790	81,680	49,798	155,687	65,020	27,676	120,672	58,224	914,691
2006	86,734	266,706	81,504	50,127	153,187	65,385	27,738	120,309	58,015	909,705
2007	86,238	264,358	81,228	50,435	150,408	65,567	27,772	119,829	57,673	903,508
2008	85,637	261,807	80,938	50,685	147,584	65,749	27,769	119,200	57,298	896,667
2009	84,993	259,111	80,560	50,959	144,640	65,772	27,795	118,417	56,861	889,108
2010	84,321	256,374	80,193	51,211	141,663	65,787	27,815	117,471	56,308	881,143

Estimated people killed by AIDS in provinces of Zambia^[10]
Estimated killed in AIDS	Central	Copperbelt	Eastern	Luapula	Lusaka	Northern	North-Western	Southern	Western	Grand Total
1985	028	107	012	006	024	010	004	635	019	845
1990	410	4,664	384	198	640	207	087	3,690	314	10,594
1995	2,306	17,485	2,688	1,478	4,786	1,476	655	8,397	1,684	40,955
2000	5,833	26,801	6,721	3,682	12,188	4,166	1,848	11,379	4,097	76,715
2003	7,877	27,704	8,818	4,761	15,597	5,712	2,522	12,143	5,438	90,572
2001	6,648	27,549	7,597	4,141	13,658	4,727	2,119	12,075	4,641	83,155
2002	7,311	27,798	8,316	4,486	14,758	5,247	2,336	12,331	5,076	87,659
2004	8,399	27,609	9,319	4,995	16,274	6,103	2,684	12,524	5,763	93,670
2005	8,747	27,553	9,614	5,131	16,569	6,418	2,792	12,578	5,971	95,373
2006	8,978	27,477	9,730	5,204	16,617	6,657	2,856	12,586	6,097	96,202
2007	9,098	27,405	9,719	5,232	16,468	6,807	2,887	12,574	6,150	96,340
2008	9,133	27,275	9,627	5,234	16,211	6,901	2,892	12,541	6,150	95,964
2009	9,097	27,094	9,481	5,224	15,849	6,949	2,880	12,485	6,109	95,168
2010	9,016	26,799	9,338	5,209	15,429	6,958	2,859	12,403	6,044	94,055

Causes

The primary modes of HIV transmission are through sex, intravenous drug use and mother-to-child transmission. HIV prevalence rates vary considerably within the country. Infection rates are highest in cities and towns along major transportation routes and lower in rural areas with low population density. HIV prevalence among pregnant women can range from less than 10 percent in some areas to 30 percent in others. In general, however, young women ages 25 to 34 are at much higher risk of being infected by HIV than young men in the same age group. The prevalence rates are 12.7 and 3.8 percent, respectively.^[11] Risk for the disease is higher for people with sensory, intellectual, physical and psychosocial disabilities, despite the 2012 Persons with Disabilities Act.^[12] Other at-risk populations include military personnel, people in prostitution, truck drivers, and people who work in fisheries. Although men who have sex with men have a higher risk of HIV transmission than those who do not, the government-operated National AIDS Control Program does not address same-sex relationships.^[11] While Zambia's national prevalence rate remains high and shows no sign of declining, the country has been noted for its significant increases in antiretroviral treatment (ART) access.^[13]

Measures

The government of Zambia created an AIDS surveillance committee as early as 1986 and created an emergency plan to control the spread by 1987. As per the plan, all blood transfusion should be screened for HIV. By 2002, the government created a mission to make antiretroviral therapy available for every individual. By 2005, the government made antiretroviral therapy free for every individual.^[14]

With about one million Zambians living with HIV/AIDS and 200,000 of these persons requiring ART, the Government of the Republic of Zambia has prioritized making ART available to all Zambians in need. A 2006 rapid assessment of the Zambian ART program identified several important constraints including: inadequate human resources for counseling, testing, and treatment-related care; gaps in supply of drugs in the public sector; increase in value of the Zambian kwacha; lack of adequate logistic/supply chain systems; stigma that hinders people from seeking treatment and care; lack of information on the availability of treatment services; a high level of misinformation about ART; need for a continuous funding stream as an accumulation of patients on ART results in a growing need for support; high cost of ART to patients, despite subsidies from the public sector; lack of referral between counseling and testing services and ART; and lack of referral between home-based care services, testing and ART.^[13]

Notes

↑ "Zambia UNAIDS". UNAIDS. 2018. Retrieved 14 October 2020.
↑ Romm, Norma. "Report on HIV/AIDS in Relation to the Informal Sector in Zambia". oit.org.
↑ Sepkowitz KA (June 2001). "AIDS—the first 20 years". N. Engl. J. Med. 344 (23): 1764–72. doi: 10.1056/NEJM200106073442306 . PMID 11396444.
↑ editors, Alexander Krämer, Mirjam Kretzschmar, Klaus Krickeberg (2010). Modern infectious disease epidemiology concepts, methods, mathematical models, and public health (Online-Ausg. ed.). New York: Springer. p. 88. ISBN 9780387938356.{{cite book}}: |last1= has generic name (help)CS1 maint: multiple names: authors list (link)
↑ Kripke, C (1 August 2007). "Antiretroviral prophylaxis for occupational exposure to HIV". American Family Physician. 76 (3): 375–6. PMID 17708137.
↑ van der Kuyl, AC; Cornelissen, M (24 September 2007). "Identifying HIV-1 dual infections". Retrovirology. 4: 67. doi:10.1186/1742-4690-4-67. PMC 2045676 . PMID 17892568.
↑ Kapungwe 2009, pp. 1–2
↑ Land Tenure, Housing Rights and Gender in Zambia Volume 3 of Land Tenure, Housing Rights, and Gender in [name of Country], United Nations Human Settlements Programme Law, land tenure and gender review: Southern Africa. UN-HABITAT. 2005. pp. 36–37. ISBN 9789211317749.
↑ Kapungwe 2009, p. 3
1 2 "AIDS and HIV statistics". Central Statistical Office of Zambia. 2011. Retrieved 17 October 2016.
1 2 LGBT in Zambia (PDF) (Report). Huachen.org. 2011. Archived from the original (PDF) on 1 October 2008. Retrieved 15 October 2016.
↑ "Zambia: People With Disabilities Left Behind in HIV Response". Human Rights Watch. 15 July 2014. Retrieved 19 July 2014.
1 2 "2008 Country Profile: Zambia". U.S. Department of State. 2008. Retrieved 25 August 2008. This article incorporates text from this source, which is in the public domain .
↑ Kapungwe 2009, p. 9

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HIV/AIDS in India is an epidemic. The National AIDS Control Organisation (NACO) estimated that 2.14 million people lived with HIV/AIDS in India in 2017. Despite being home to the world's third-largest population of persons with HIV/AIDS, the AIDS prevalence rate in India is lower than that of many other countries. In 2016, India's AIDS prevalence rate stood at approximately 0.30%—the 80th highest in the world. Treatment of HIV/AIDS is primarily via a "drug cocktail" of antiretroviral drugs and education programs to help people avoid infection.

Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.

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Although Senegal is a relatively underdeveloped country, HIV prevalence in the general population is low at around 0.08 per 1000 people, under 1% of the population. This relatively low prevalence rate is aided by the fact that few people are infected every year – in 2016, 1100 new cases were reported vs 48,000 new cases in Brazil. Senegal's death due to HIV rate, particularly when compared it to its HIV prevalence rate, is relatively high with 1600 deaths in 2016. Almost two times as many women were infected with HIV as men in 2016, and while almost three times as many women were receiving antiretroviral therapy (ARV) as men, only 52% of HIV positive people in Senegal received ARV treatment in 2016.

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HIV and AIDS is a major public health issue in Zimbabwe. The country is reported to hold one of the largest recorded numbers of cases in Sub-Saharan Africa. According to reports, the virus has been present in the country since roughly 40 years ago. However, evidence suggests that the spread of the virus may have occurred earlier. In recent years, the government has agreed to take action and implement treatment target strategies in order to address the prevalence of cases in the epidemic. Notable progress has been made as increasingly more individuals are being made aware of their HIV/AIDS status, receiving treatment, and reporting high rates of viral suppression. As a result of this, country progress reports show that the epidemic is on the decline and is beginning to reach a plateau. International organizations and the national government have connected this impact to the result of increased condom usage in the population, a reduced number of sexual partners, as well as an increased knowledge and support system through successful implementation of treatment strategies by the government. Vulnerable populations disproportionately impacted by HIV/AIDS in Zimbabwe include women and children, sex workers, and the LGBTQ+ population.

UNAIDS has said that HIV/AIDS in Indonesia is one of Asia's fastest growing epidemics. In 2010, it is expected that 5 million Indonesians will have HIV/AIDS. In 2007, Indonesia was ranked 99th in the world by prevalence rate, but because of low understanding of the symptoms of the disease and high social stigma attached to it, only 5-10% of HIV/AIDS sufferers actually get diagnosed and treated. According to the a census conducted in 2019, it is counted that 640,443 people in the country are living with HIV. The adult prevalence for HIV/ AIDS in the country is 0.4%. Indonesia is the country is Southeast Asia to have the most number of recorded people living with HIV while Thailand has the highest adult prevalence.

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Nicaragua has 0.2 percent of the adult population estimated to be HIV-positive. Nicaragua has one of the lowest HIV prevalence rates in Central America.

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With 1.28 percent of the adult population estimated by UNAIDS to be HIV-positive in 2006, Papua New Guinea has one of the most serious HIV/AIDS epidemics in the Asia-Pacific subregion. Although this new prevalence rate is significantly lower than the 2005 UNAIDS estimate of 1.8 percent, it is considered to reflect improvements in surveillance rather than a shrinking epidemic. Papua New Guinea accounts for 70 percent of the subregion's HIV cases and is the fourth country after Thailand, Cambodia, and Burma to be classified as having a generalized HIV epidemic.

With an estimated 150,000 people living with HIV/AIDS in 2016, Haiti has the most overall cases of HIV/AIDS in the Caribbean and its HIV prevalence rates among the highest percentage-wise in the region. There are many risk-factor groups for HIV infection in Haiti, with the most common ones including lower socioeconomic status, lower educational levels, risky behavior, and lower levels of awareness regarding HIV and its transmission.

References

Kapungwe, Augustus Kasumpa (2009). Youth and Government's Fight Against HIV/AIDS in Zambia: A Closer Look at Some Underlying Assumptions. African Books Collective. ISBN 9789994455393.f

v t e HIV/AIDS in Africa
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