OBJECTIVE:
To
estimate the adult prevalence of HIV among the adult population in Zambia and
determine whether demographic characteristics were associated with being HIV
positive.
METHODS:
A cross
sectional population based survey to asses HIV status among participants aged
15 years and above in a national tuberculosis prevalence survey.
Counselling was offered to participants who tested for HIV. The prevalence was
estimated using a logistic regression model. Univariate and multivariate
associations of social demographic characteristics with HIV were determined.
RESULTS:
Of the
46,099 individuals who were eligible to participate in the survey, 44,761
(97.1 %) underwent pre-test counselling for HIV; out of which 30,605
(68.4 %) consented to be tested and 30, 584 (99.9 %) were tested. HIV
prevalence was estimated to be 6.6 %; with females
having a higher prevalence than males 7.7 % versus
5.2 %. HIV prevalence was higher among urban than rural residents. The risk of HIV was double among urban dwellers than among their
rural counterparts. Being divorced or widowed was associated with a threefold
higher risk of being HIV positive than being never married. The risk of being
HIV positive was four times higher among those with tuberculosis than those
without tuberculosis.
CONCLUSIONS:
HIV
prevalence was lower than previously estimated in the country. The burden of
HIV showed sociodemographic disparities signifying a need to target key
populations or epidemic drivers. Mobile testing for HIV on a national scale in
the context of TB prevalence surveys could be explored further in other
settings.
Below: Estimated HIV prevalence by age and sex with uncertainty bounds
Below: Estimated HIV prevalence by wealth quintile for urban and rural areas with uncertainty bounds
- 1Department of Disease Surveillance, Control and Research, Ministry of Health, Lusaka, Zambia ; Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.
- 2Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands ; Department of Epidemiology and Disease Control, Ministry of Community Development, Mother and Child Health, Lusaka, Zambia.
- 3KNCV Tuberculosis Foundation, The Hague, Netherlands ; Department of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
- 4Department of Disease Surveillance, Control and Research, Ministry of Health, Lusaka, Zambia.
- 5World Health Organisation, Lusaka, Zambia.
- 6Virology Laboratory, University Teaching Hospital, Lusaka, Zambia.
- 7Department of Economics, University of Zambia, Lusaka, Zambia.
- AIDS Res Ther. 2016 Jan 19;13:4. doi: 10.1186/s12981-015-0088-1. eCollection 2016.
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