HIV/AIDS in Zimbabwe

The 2012 Zimbabwe Demographic And Health Survey (ZDHS) estimated national HIV prevalence rates at 15%, meaning that they estimated 12% infection rate for men, and 18% for women. ^[1]However, these numbers are based on data from pregnant women at antenatal clinics, which are notoriously unreliable in estimating national HIV prevalence rates, because the subset of the population used, pregnant women, are not statistically representative of the general population. No follow up testing is done if more than 10% of samples show a positive result after the initial test. As a result, false positives are not eliminated from the survey results.

Response rates and methodology: HIV prevalence data were obtained from testing dried blood spot (DBS) samples voluntarily provided by women age 15-49 and men age 15-54 who were interviewed in the 2010- 11 ZDHS. The DBS were collected using the finger stick method. Of the 18,554 eligible respondents, 75% were both interviewed and provided DBS specimens. Coverage rates were higher in rural areas (83%) than in urban areas (63%).

Recent estimates from the Joint United Nations Programme on HIV/AIDS (UNAIDS) indicate that approximately 1.6 million adults 15 years and older were living with HIV/AIDS in 2005. Despite the severity of the epidemic, prevalence rates in Zimbabwe have begun to show signs of decline, from 22.1 percent prevalence among adults ages 15 to 19 in 2003 to 20.1 percent prevalence in the same age group in 2005. Dr. Peter Piot, head of UNAIDS, said that in Zimbabwe, “The declines in HIV rates have been due to changes in behaviour, including increased use of condoms, people delaying the first time they have sexual intercourse, and people having fewer sexual partners.”^[2]

To justify these numbers, it is hypothesized that Zimbabwe would have to have a generalized HIV/AIDS epidemic with HIV transmitted primarily through heterosexual contact, meaning that HIV spreads as easily from women to men as from men to women, and mother-to-child transmission. However, there is no actual evidence that this is the case, in Zimbabwe, Africa or anywhere else in the world.

High risk groups, including migrant laborers, people in prostitution, girls involved in intergenerational sexual relationships, discordant couples, and members of the uniformed services warrant special attention in the fight against HIV/AIDS. Young adults and women are hardest hit by the epidemic. In 2005, approximately 930,000 women over the age of 14 were estimated to be living with HIV/AIDS in Zimbabwe.^[2]

Zimbabwe continues to suffer a severe socioeconomic and political crisis, including unprecedented rates of inflation and a severe ‘brain drain’ of Zimbabwe’s health care professionals. Elements of a previously well-maintained health care infrastructure are crumbling. Zimbabwe’s HIV crisis is exacerbated by chronic food insecurity. Sub-optimal nutrition increases the vulnerability of individuals with compromised immune systems to life-threatening opportunistic infections, such as tuberculosis. Gender inequality and widespread practices of multiple and concurrent sexual relationships, and cross-generational sex fuel Zimbabwe’s epidemic, particularly among youth. Social norms, including stigma associated with HIV/AIDS, excessive alcohol consumption, and a reluctance to talk about HIV status or sexual relations also create barriers to behavior change.^[2]

However, the tide in the epidemic is now being reversed as more and more people are now accessing ARVs.

References