Zambia HIV Country Profile: 2016

WHO/HIV/2017.59 Zambia HIV Country Profile: 2016

Demographic and socioeconomic data 90-90-90 progress towards 2020 targets

Needles distributed per person who inject drugs per year ... 16.6 million 3 640 US$ 100% Total population (2016) $ GNI per capita, PPP (2015) 100%100%100% UNPOP World Bank 67% Percentage condom use among sex workers with most recent client 79% 224 5.0 % 22%52% 80% 80%80%80% Maternal mortality per Health expenditure, total 66% 65% HIV prevalence among men who have sex with men (%) ... 100 000 live births (2015) $ (% of GDP) (2014) World Health Stat., WHO 60% 58% World Bank Estimated ART coverage 60%60%60% HIV prevalence among sex workers (%) 56% 62 years 86 US$ children and adults Life expectancy at birth Health expenditure per 40% (2015-2020) $ capita (2014) 40%40%40% UNPOP World Bank 4.9 0.58 20%20%20%20% Total fertility rate (births Human Development 83% per woman) (2015-2020) Index Value (2015) UNPOP UNPOP 0%0%0%0% 3 279 PLHIVPLHIVPLHIVPLHIV PLHIVPLHIVPLHIVPLHIV PLHIVPLHIVPLHIVPLHIV Number of births (thou- Estimated % of pregnant women diagnoseddiagnoseddiagnosed receivingreceivingreceiving virallyvirallyvirally diagnosed receiving virally r 900 r sands) (2015-2020) 400 a living with HIV who received ARVs a ART suppressed e ARTART suppressedsuppressed e UNPOP y ART suppressed y for PMTCT r 800 r e

e 350 p

r p

n e

n 700 o p

Estimated number of people newly Estimated number of deaths due to o 300 r s n r s e o e

p 600 r s p

infected with HIV r

AIDS e r

250 e p e p

r p

500

100 000 100 000 e r s r s p a

l a 200 l l l r s

o 400 a o l d r l d

80 000 a S o 150 S e d 75 000 U 300

U y

S n i n

i U

100 e e n 60 000 c 200 i c

r i r i e p c

50 000 p

n r i 50 100 n a p i a

40 000 i d n d e a i e 0 0 M d M 25 000 e 2010 2011 2012 2013 2014 2015 2016 2010 2011 2012 2013 2014 2015 2016

20 000 M [ZDV+3TC+NVP] [150+200+300] [TDF+FTC+EFV] [600+200+300] [TDF+FTC]+[LPV/r] [ZDV+3TC]+[ATV/r] [TDF+3TC]+[ATV/r] 0 0 [TDF+3TC+EFV] [600+300+300] [ZDV+3TC]+[LPV/r] [TDF+3TC]+[LPV/r] 2000 2005 2010 2016 2000 2005 2010 2016 Trend since 2010 Trend since 2010 Elimination of mother-to-child Value Epidemiological HIV data Value [range] transmission (EMTCT) of HIV and syphilis [range] Year Estimated number of people living with HIV 1 200 000 [1 200 000 - 1 300 000] Antenatal care coverage - at least one visit (%) 96% 2013-2014 Estimated number of children aged 0 to 14 94 000 [84 000 - 100 000] Antenatal care coverage - at least four visits (%) 56% 2012 living with HIV % of pregnant women with known HIV Estimated number of women (15+) living with HIV 640 000 [600 000 - 680 000] … status Estimated adult (15-49) prevalence 12.4% [11.8% - 13.0%] Antenatal care attendees who were tested 82% 2016 Estimated number of deaths due to HIV 21 000 [17 000 - 28 000] for syphilis (%) Estimated number of children dying due to HIV 5 700 [4 700 - 6 800] Antenatal care attendees who tested posi- Estimated number of people newly infect- 4% 2016 59 000 [52 000 - 69 000] tive for syphilis (%) ed with HIV Estimated number of children newly infect- Antenatal care attendees who tested posi- 8 900 [7 000 - 11 000] 2016 ed with HIV tive for syphilis and who received benzathi- 100% ne penicillin IM (%) Estimated incidence rate per 1 000 unin- 4.08 [3.69 - 4.86] Reported number of pregnant women living fected population 68 700 2016 with HIV who received antiretrovirals for PMTCT Estimated % of pregnant women living with Antiretroviral therapy (ART) 83% [71% - 91%] 2016 HIV who received antiretrovirals for PMTCT*2 Reported number of people receiving ART 798 000 % of infants born to women living with Estimated ART coverage 65% [62% - 69%] HIV receiving a virological test within two 37% [33% - 43%] 2016 months of birth (EID)*1 Reported number of children receiving ART 49 500 Final mother-to-child transmission rate 1 10.7 Estimated ART coverage (children, 0-14)* 52% [47% - 58%] including breastfeeding period*3 2016 * Tracing indicators for elimination of mother-to-child transmission. A colour scheme (green, orange, red) is used to indicate if the country is on target to meet 2020 targets: ¹90% ²95% ³Less than 5 WHO/HIV/2017.59 WHO/HIV/2017.59 Zambia HIV Country Profile: 2016

Key populations

Needles distributed per person who inject drugs per year ...

Percentage condom use among sex workers with most recent client 79%

HIV prevalence among men who have sex with men (%) ...

HIV prevalence among sex workers (%) 56%

Median annual price of ARV drug regimens for adults

First line Second line

250 700

r 900 r year 400 a year a r e r e e y e y p 600 r

800 r e n n

e 350 p o 200

o r p s

s n r e r n

e 700 o p e

500 o p

300 p r s n

r r s r e o e e e

p 600 p r s p

150 r s e r s 400 e

2r 50 r p e a p a

l r p l

l 500 l e r s o o r s p a

d l d a

2 00

l l 300 S l r s S 100 o 400 a o U U

l d

r l d n n a S i o

150 i

e d U e 300

200 e U y c

c S i n i i n r

r i U

p e p 1 00

e 50 n c 200 n i c n

r i

a 100 a r i e i i p c

p d d

n r i 50 e

e 100 n a p i a

M M i d n 0

d 0 e a i e 0 2010 2011 2012 2013 2014 2015 2016 0 2010 2011 2012 2013 2014 2015 2016 M d M e 2010 2011 2012 2013 2014 2015 2016 2010 2011 2012 2013 2014 2015 2016

M [ZDV+3TC+NVP] [150+200+300]mg [TDF+FTC+EFV] [600+200+300]mg [TDF+FTC]+[LPV/r] [TDF+3TC]+[LPV/r] [ZDV+3TC]+[LPV/r] [ZD V[T+D3FT+3CT+CN+EVFPV]] [[610500+3+0200+030+03]m00g] [TDF+FTC+EFV] [600+200+300] [TD F [+TDFTFC+3]+T[CL]+P[VA/TrV]/r] [ Z [DZDVV++33TTCC]]+[ATVV//r]r] [TDF+3TC]+[ATV/r] [TDF+3TC+EFV] [600+300+300] [ZDV+3TC]+[LPV/r] [TDF+3TC]+[LPV/r]

National HIV policies and plans

2013-2014 Implementation of national policy on HIV self-testing (HIVST) Policy on HIVST implemented 2012 Treatment initiation threshold children Treat All regardless of age Treatment initiation threshold adults and adolescents Treat All regardless of CD4 count Implementation of Treat All adults and adolescents Implemented countrywide 2016 Dolutegravir (DTG) as part of 1st line ARVs for adults and adolescents DTG introduced in national guidelines (or confirmed plans for 2018) Implementation of lifelong ART to pregnant & breastfeeding women Implemented countrywide 2016 Implementation of national policy on viral load monitoring Fully implemented Completion of HIV services cascades Completed a national HIV cascade 2016 Adaptation of WHO Key Population guidelines in national plans Partially National M&E plan or strategy for HIV Yes, and updated in the past two years 2016 Method to de-duplicate key data (i.e. unique identifiers) Yes

2016 Nationally-representative quality assessment of facility-level ART data Yes

2016

2016 Sources: Global AIDS Monitoring (UNAIDS/WHO/UNICEF), Spectrum estimates (UNAIDS/WHO) and WHO HIV Country Intelligence Tool, 2017 * Tracing indicators for elimination of mother-to-child transmission. A colour scheme (green, orange, red) is used to indicate if the country is on target to meet 2020 targets: ¹90% ²95% ³Less than 5