HIV/AIDS in Zambia

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. 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. 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). 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. It is possible to be co-infected by more than one strain of HIV—a condition known as HIV superinfection.

Zambia is a landlocked, economically backward country 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.Kapungwe 2009, pp. 1–2

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. 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.Kapungwe 2009, p. 3

+ HIV infected people in provinces of Zambia Infected with HIV Central Copperbelt Eastern Luapula Lusaka Northern North-Western Southern Western Grand Total19851,448 6,719 779 427 1,518 539 250 23,960 1,067 36,707199012,516 154,131 11,864 6,971 23,828 6,529 3,104 65,467 9,171 293,581199549,682 235,586 49,750 32,447 111,753 32,452 15,855 103,202 35,208 665,935200079,902 265,518 76,213 46,293 155,729 56,050 25,735 117,477 54,123 877,040200386,654 270,590 81,509 48,988 159,409 62,430 27,418 120,425 57,844 915,267200183,080 270,781 78,511 47,465 158,506 58,683 26,517 120,188 55,919 899,650200285,490 270,945 80,157 48,426 160,240 60,802 27,045 120,347 57,252 910,704200487,435 270,525 81,785 49,462 157,997 63,812 27,587 120,768 58,347 917,718200587,144 268,790 81,680 49,798 155,687 65,020 27,676 120,672 58,224 914,691200686,734 266,706 81,504 50,127 153,187 65,385 27,738 120,309 58,015 909,705200786,238 264,358 81,228 50,435 150,408 65,567 27,772 119,829 57,673 903,508200885,637 261,807 80,938 50,685 147,584 65,749 27,769 119,200 57,298 896,667200984,993 259,111 80,560 50,959 144,640 65,772 27,795 118,417 56,861 889,108201084,321 256,374 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 Estimated killed in AIDS Central Copperbelt Eastern Luapula Lusaka Northern North-Western Southern Western Grand Total1985028 107 012 006 024 010 004 635 019 8451990410 4,664 384 198 640 207 087 3,690 314 10,59419952,306 17,485 2,688 1,478 4,786 1,476 655 8,397 1,684 40,95520005,833 26,801 6,721 3,682 12,188 4,166 1,848 11,379 4,097 76,71520037,877 27,704 8,818 4,761 15,597 5,712 2,522 12,143 5,438 90,57220016,648 27,549 7,597 4,141 13,658 4,727 2,119 12,075 4,641 83,15520027,311 27,798 8,316 4,486 14,758 5,247 2,336 12,331 5,076 87,65920048,399 27,609 9,319 4,995 16,274 6,103 2,684 12,524 5,763 93,67020058,747 27,553 9,614 5,131 16,569 6,418 2,792 12,578 5,971 95,37320068,978 27,477 9,730 5,204 16,617 6,657 2,856 12,586 6,097 96,20220079,098 27,405 9,719 5,232 16,468 6,807 2,887 12,574 6,150 96,34020089,133 27,275 9,627 5,234 16,211 6,901 2,892 12,541 6,150 95,96420099,097 27,094 9,481 5,224 15,849 6,949 2,880 12,485 6,109 95,16820109,016 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. Risk for the disease is higher for people with sensory, intellectual, physical and psychosocial disabilities, despite the 2012 Persons with Disabilities Act. 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. 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.

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.Kapungwe 2009, p. 9

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.

HIV/AIDS in Zambia

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