Towards UNAIDS Fast-Track goals: Targeting priority geographic areas for HIV prevention and care in Zimbabwe

Diego F Cuadros, J. Li, Zindoga Mukandavire, G. N. Musuka, A. J. Branscum, B. Sartorius, O. Mugurungi, F. Tanser

Research output: Contribution to journalArticle

6 Citations (Scopus)
30 Downloads (Pure)

Abstract

Zimbabwe has made substantial progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) targets of 90-90-90 by 2020, with 73% of people living with HIV diagnosed, 87% of those diagnosed on antiretroviral therapy (ART) and 86% of those on ART virally suppressed. Despite this exceptional response, more effort is needed to completely achieve the UNAIDS targets. Here, we conducted a detailed spatial analysis of the geographical structure of the HIV epidemic in Zimbabwe to include geographical prioritization as a key component of their overall HIV intervention strategy.Methods:Data were obtained from Zimbabwe Demographic and Health Survey (ZDHS) conducted in 2015 as well as estimations from the Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2016 report, and other published literature. Data were used to produce high-resolution maps of HIV prevalence. Using these maps combined with the population density maps, we mapped the HIV-infected population lacking ART coverage and viral suppression.Results:HIV maps for both sexes illustrated similar geographical variation of HIV prevalence within the country. HIV-infected populations lacking ART coverage and viral suppression were concentrated in the main cities and urban settlements such as Bulawayo, Harare, Ruwa and Chitungwiza.Conclusion:Our study showed extensive local variation in HIV disease burden across Zimbabwe for both women and men. The high-resolution maps generated here identified areas wherein high density of HIV-infected individuals are lacking ART coverage and viral suppression. These results suggest that there is need to tailor HIV programmes to address specific local needs to efficiently achieve epidemic control in Zimbabwe.

Original languageEnglish
Pages (from-to)305-314
Number of pages10
JournalAIDS
Volume33
Issue number2
Early online date13 Dec 2018
DOIs
Publication statusPublished - 1 Feb 2019

Bibliographical note

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Keywords

  • HIV mapping
  • UNAIDS 90-90-90 goals
  • antiretroviral therapy coverage
  • optimal resource allocation
  • spatial analysis
  • viral suppression

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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