Zimbabwe gains world recognition for reducing HIV prevalence

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Zimbabwe has been praised globally for achievements in dramatically reducing both the HIV prevalence and incidence over the years.

Zimbabwe has been praised globally for achievements in dramatically reducing both the HIV prevalence and incidence over the years.

Staff Reporters

Dance performers expressing a heartfelt thank you to PSI stakeholders
Dance performers expressing a heartfelt thank you to PSI stakeholders

The HIV prevalence was above 27% towards the end of the 1990s. Due to a combination of robust HIV prevention programmes that included social marketing, massive community mobilisation and awareness campaigns combined with HIV-counselling and testing, condom promotion and distribution, prevention of mother to child transmission and others, Zimbabwe has become a global example in HIV prevention.

The scale up of treatment services also played a major part in lowering both the HIV prevalence and incidence.

results of two key surveys that were conducted to get the latest picture on the HIV and Aids situation across the country and under the Demographic Health Survey of 2015/16 and the Zimbabwe Population-based HIV Impact Assessment (Zimphia) were released recently.

The final results of the 2015 Zimbabwe Demographic and Health Survey show that the HIV prevalence rate in the country declined from 18% to 14% over the past 10 years

The results of the survey, which were presented at a meeting organised by Zimbabwe National Statistics and the United Nations Population Fund recently, showed that HIV prevalence among both men and women aged between 15 and 49 had decreased.

“However, there is a higher prevalence rate among women at 17% than men at 11%,” the report said.

The survey also shows that the prevalence increased with age. Among women, peak HIV occurs in the 40-44 age group, while among men prevalence is highest in the 50-54 age group.

Provincially, prevalence ranges from the lowest rate of 11% in Manicaland to the highest of 22% in Matabeleland South.

Matabeleland South was followed by Matabeleland North with 20,1% while Bulawayo stood at 18. Mashonaland West had the second lowest prevalence with 12, 9% followed by Mashonaland Central at 13, with 6%.

Mashonaland East and Midlands had the same rate at 14%, while Masvingo province had 14,9%.

Harare province held sixth position with a prevalence rate of 14, 2%.

The survey said there has been a 50% increase in testing within the last year for both women and men.

Increased protective behaviours as seen in condom use among young men with multiple partners increased by a third.

Some of the key results of the Zimphia indicate that the annual incidence of HIV among adults aged 15 to 64 years stood at 0,45%. Prevalence of HIV among adults ages 15 to 64 years is now at 14,6 % from 15%.

The health ministry recently developed an HIV Prevention Revitalisation Roadmap to guide implementation of high impact HIV prevention interventions, particularly targeting hotspots and key populations. Zimbabwe has identified sex workers, youth, long distance truck drivers, artisanal miners and prisoners as key affected populations that need more and better targeting with HIV prevention interventions.

“We therefore must continue intensifying innovative efforts to these target groups and the entire population” said health minister David Parirenyatwa.

While revitalisation of HIV prevention is central to country’s current efforts, there has been calls not negate the people living with HIV, who need various forms of care and treatment. Currently over 930 000 people are now receiving treatment, representing 66% progress towards the fast track target, where-in 90% of all HIV-positive people should be on treatment by 2020.

While this is commendable, there is need for expansion of HIV testing services to ensure that the remaining 470, 000 people are tested and placed on treatment.

“The Government of Zimbabwe remains focused and committed to achieving the 90.90.90. targets and ending AIDS by 2030. The 90.90.90. targets speak to 90% of people living with HIV knowing their status; 90% of people who know their status are on treatment; 90% of those on ART have sustainable viral suppression” said Parirenyatwa.

The health minister also highlighted that achieving this goal required adequate investment in policies, systems and programs that reduce new HIV infections and ensure provision and access to quality treatment services in line with the fast track targets.

As part of efforts to ensure quality services are provided to people living with HIV, the health ministry has recently adapted the national consolidated HIV guidelines in line with the recently released 2015 World Health Organization (WHO) guidelines. These new guidelines have seen the removal of eligibility criteria for commencing Anti – Retroviral Treatment meaning that HIV infected people once confirmed to be HIV positive no longer need to wait to be eligible for treatment but once assessed by health workers and deemed to be well prepared can start immediately on treatment.

This will see a considerable number of people accessing treatment early, leading to better survival of HIV infected people. In addition, the guidelines also emphasize provision of client centered HIV services through provision of services that are responsive to clients’ expectations and needs. For people to benefit from these new guidelines they need to know their HIV status, hence it is important that people get tested early.

The newly introduced HIV self-testing will enable scale up of testing to also increase the number of people that know their HIV status as well as target those who would normally not get tested easily such as men. Pre-Exposure prophylaxis for those people who are at high risk of contracting HIV has also been introduced with these guidelines. This means that people who see themselves as having a high risk of acquiring HIV such as those in discordant relationships (different HIV status) will take some Anti-Retroviral medications to prevent themselves from getting infected with HIV. The introduction of Pre-Exposure prophylaxis will also contribute to closing the tap of new HIV infections.

While revitalisation of HIV prevention is central to the country’s current efforts, there has been calls not to neglect people living with HIV who need various forms of care and treatment. over 930 000 people are now receiving treatment, representing 66% progress towards the fast track target, where 90% of all HIV-positive people should be on treatment by 2020.

While this is commendable, there is need for expansion of HIV testing services to ensure that the remaining 470 000 people are tested and placed on treatment.

“The government of Zimbabwe remains focused and committed to achieving the 90.90.90. targets and ending Aids by 2030. The 90.90.90. targets speak to 90% of people living with HIV knowing their status; 90% of people who know their status are getting treatment; 90% of those on ART have sustainable viral suppression,” said Parirenyatwa.

The minister also highlighted that achieving this goal required adequate investment in policies, systems and programmes that reduce new HIV infections and ensure provision and access to quality treatment services in line with the fast-track targets. As part of efforts to ensure quality services are provided to people living with HIV, the health ministry recently adapted the national consolidated HIV guidelines in line with the recently released 2015 World Health Organisation guidelines. These new guidelines have seen the removal of eligibility criteria for commencing anti-retroviral treatment, meaning that HIV- infected people once confirmed to be HIV-positive, no longer need to wait to be eligible for treatment but once assessed by health workers and deemed to be well-prepared can start immediately on treatment.

This will see a considerable number of people accessing treatment early, leading to better survival of HIV-infected people. In addition, the guidelines also emphasise provision of client-centred HIV services through provision of services that are responsive to clients’ expectations and needs. For people to benefit from these new guidelines they need to know their HIV status, hence it is important that people get tested early.

The newly-introduced HIV self-testing will enable the scaling up of testing to also increase the number of people that know their HIV status, as well as target those who would normally not get tested easily, such as men. Pre-exposure prophylaxis for those people who are at high risk of contracting HIV has also been introduced with these guidelines. This means that people who see themselves as having a high risk of acquiring HIV, such as those in discordant relationships (different HIV status) will take some anti-retroviral medications to minimise the risk of getting infected. The introduction of Pre-exposure prophylaxis will also contribute to closing the tap of new HIV infections.