The DHS Program

March 27, 2009 
HIV prevalence remains high in Zambia; knowledge of prevention and HIV testing lagging

Lusaka, Zambia. One in seven Zambians age 15-49 is HIV-positive, according to the 2007 Zambia Demographic and Health Survey (ZDHS). Despite this high prevalence, many Zambians are not fully informed about HIV prevention, and the majority have not gone for HIV testing.

HIV prevalence has declined slightly from 15.6% in the 2001-02 ZDHS to 14.3% in the 2007 ZDHS. However, this decrease is not statistically significant and does not necessarily represent a large change in the number of people living with HIV between the two surveys. Currently, 16.1% of women and 12.3% of men are HIV-positive. HIV prevalence is twice as high in urban areas as in rural areas. Twenty-one percent of women and men living in Lusaka are HIV-positive, compared to 7% of women and men in Northern and North-Western provinces.

Knowledge of HIV prevention and transmission has shown little improvement since 2001-02. One in three Zambians does not know that HIV can be prevented by using condoms and limiting sex to one HIV-negative partner. One-quarter of men do not know that HIV can be transmitted through breastfeeding. About one-third of women and men believe that HIV can be transmitted by mosquito bites.

Most Zambian women and men are not taking action to know their HIV status. While almost nine in ten women and men know where to get an HIV test, only 35% of women and 20% of men have ever been tested and received the results. HIV testing is most common among wealthier and more educated Zambians, with 57% of women and 38% of men with secondary education or higher having ever been tested and received the results.

Youth are waiting longer to begin having sex. The percent of men age 15-19 who had sex before age 15 decreased from 27% in 2001-02 to 16% in 2007. Fifty-five percent of women age 18-19 have had sex by age 18, compared to 67% of women in 2001-02. These are encouraging trends as early initiation of sexual intercourse is a risk factor for HIV infection. Young women are also being tested to know their HIV status. Almost one-quarter of women age 15-24 were tested for HIV and received the results in the past year.

The 2007 ZDHS was implemented by the Central Statistical Office (CSO) in partnership with the Ministry of Health from April to October 2007. The Tropical Diseases Research Centre (TDRC) provided technical support and implementation of the syphilis and HIV testing. Macro International Inc. provided technical assistance to the survey through the MEASURE DHS programme, a USAID-funded project. Funding for the ZDHS was provided by the United States Agency for International Development (USAID), the Ministry of Health, the Ministry of Finance and National Planning, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Centers for Disease Control and Prevention (CDC), the Malaria Control and Evaluation Partnership in Africa (MACEPA), the European Union (EU), the World Bank through the Zambia National Response to HIV/AIDS (ZANARA) project, the United Nations Population Fund (UNFPA), the United Nations Development Program (UNDP), the Joint United Nations Programmes on HIV/AIDS (UNAIDS), the United Nations Children’s Fund (UNICEF), the Japan International Cooperation Agency (JICA), Swedish International Development Assistance (SIDA), United Kingdom Department for International Development (DFID), World Health Organisation (WHO), and Development Cooperation Ireland (DCI).This publication was made possible through support provided by the U.S. Agency for International Development.

Additional information about the 2007 ZDHS may be obtained from the Central Statistical Office, P. O. Box 31908, Lusaka, Zambia, Telephone: (260-211) 251377/85; Fax: (260-211) 1253468; E-mail: Info@zamstats.gov.zm; http://www.zamstats.gov.zm/