Progress Toward the 90-90-90 HIV Targets in Zimbabwe and Identifying Those Left Behind
Year: 2021
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: We present findings from the nationally representative Zimbabwe Population-based HIV Impact Assessment that characterize Zimbabwe's progress toward the Joint United Nations Programme on HIV/AIDS 90-90-90 targets. DESIGN: We conducted a cross-sectional household survey. METHODS: Consenting adults and children in the household were eligible to participate in Zimbabwe Population-based HIV Impact Assessment (October 2015-August 2016). Participants completed face-to-face interviews and provided blood for HIV, CD4, viral load, and syphilis testing. Viral load suppression (VLS) was defined as HIV RNA <1000 copies/mL. HIV-positive specimens were tested for the presence of selected antiretroviral drugs. Data were weighted. Analysis was restricted to HIV-positive adults aged 15-64 years. RESULTS: We enrolled 11,098 men and 14,033 women aged 15-64 years. HIV prevalence was 14.1%. Of those living with HIV, 76.8% (95% confidence interval [CI]: 74.9 to 78.7) were aware of their HIV status or had detectable antiretroviral levels. Of these, 88.4% (95% CI: 87.1 to 89.7) were receiving antiretroviral therapy (ART), and of these people, 85.3% (95% CI: 83.4 to 87.1) had VLS. Male sex age 15-34 years and having 1 or more sexual partners were associated with being unaware of one's HIV-positive status. Age <50 years and not taking cotrimoxazole were associated with being less likely to be being both aware and taking ART. Male sex, age <50 years, and taking cotrimoxazole were associated with being on ART but not having VLS. CONCLUSIONS: Zimbabwe has made great strides toward epidemic control. Focusing resources on case finding, particularly among men, people aged <35 years, and sexually active individuals can help Zimbabwe attain 90-90-90 targets.
Authors: Avi J. Hakim, Beth A. Tippett Barr, Steven Kinchen, Godfrey Musuka, Julius Manjengwa, Shungu Munyati, Lovemore Gwanzura, Owen Mugurungi, Getrude Ncube, Suzue Saito, Bharat S. Parekh, Hetal Patel, Yen T. Duong, Elizabeth Gonese, Katrina Sleeman, Leala Ruangtragool, Jessica Justman, Amy Herman-Roloff, Elizabeth Radin
Institutions: Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, ICAP Global Health, Columbia University, Biomedical Research and Training Institute, University of Zimbabwe, Ministry of Health and Child Welfare, Association of Schools and Programs of Public Health
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3186947623
