In 2015, around 50,000 adults and 8,900 children became newly infected with HIV in Zambia.1 New infections are decreasing, especially in children - in 2010, 60,000 adults and 13,000 children acquired HIV.2 Contrastingly HIV prevalence in Zambia has made little progress in the last decade with records marking a 12.8% adult prevalence in 2007 compared to a 12.4% prevalence rate in 2016 according to UNAIDS.34 HIV prevalence in Zambia has declined, falling by 19% between 20.
Around 1.2 million people in Zambia are living with HIV.5 In 2015, life expectancy for men was 59 years and for women 65 years.6 This is a considerable increase from the 2012 life expectancy of 49.4 years, partly thanks to improved access to antiretroviral treatment.7 Unprotected heterosexual sex drives the Zambian HIV epidemic, with 90% of new infections recorded as a result of not using a condom.
However, prevalence among female sex workers ranged from 46% in Livingstone to 73% in Chirundu.15 Around 47% of female sex workers reported having had five or more different sex partners in the last seven days and nearly 9% reporting 10 to 14 sex partners over the same period.
Around 44% used a condom with a non-paying partner and 78% used a condom with a paying client.
Your relationship has to meet the needs of the two people involved.
Understand what your partner’s needs are so you can meet them.
The results showed that, of the men questioned, condom use was at 86% with sex workers, 77% with non-regular partners, 63% with a regular partner and just 7% with wives.
This suggests that respondents understood the benefits of condom use but wrongly thought it was not necessary with wives.19 Testing rates among this group were high with 84% of truck drivers having tested for HIV at least once and 87% of them testing within last 2 years and almost all (99%) receiving their HIV results.
Same sex intercourse is illegal in Zambia.12 What is currently known about this group is that men who have sex with men experience a heightened vulnerability to HIV for a multitude of reasons including alcohol abuse, low levels of education, being subjected to discrimination and low economic status.13 The Zambian government's own progress report alludes to one small-scale study in 2008, which puts HIV prevalence among this group at just 1%.
However, much higher HIV prevalence is reported elsewhere, such as 33% by the MSM Global Forum (MSMGF).14 The illegal status, stigma and discrimination that men who have sex with men experience makes them a population that is difficult to reach with HIV prevention messages.
The 2015 study of female sex workers and male long distance truck drivers mentioned above found around 33% had three or more female sexual partners in the last 12 months including wives.