Avi J Hakim, Beth A Tippett Barr, Steven Kinchen, Godfrey Musuka, Julius Manjengwa, Shungu Munyati, Lovemore Gwanzura, Owen Mugurungi, Getrude Ncube, Suzue Saito, Bharat S Parekh, Hetal Patel, Yen T Duong, Elizabeth Gonese, Katrina Sleeman, Leala Ruangtragool, Jessica Justman, Amy Herman-Roloff, Elizabeth Radin.
Design: We conducted a cross-sectional household survey.
Methods: Consenting adults and children in the household were eligible to participate in ZIMPHIA (October 2015-August 2016). Participants completed face-to-face interviews and provided blood for HIV, CD4, viral load, and syphilis testing. VLS was defined as HIV RNA <1,000 copies/mL. HIV-positive specimens were tested for the presence of selected antiretroviral drugs. Data were weighted. Analysis was restricted to HIV-positive adults aged 15-64 years.
Results: We enrolled 11,098 men and 14,033 women aged 15-64 years. HIV prevalence was 14.1%. Of those living with HIV, 76.8% (95% confidence interval [CI]: 74.9-78.7) were aware of their HIV status or had detectable antiretroviral levels. Of these, 88.4% (95% CI: 87.1-89.7) were receiving ART, and of these people, 85.3% (95% CI: 83.4-87.1) had VLS. Male sex age 15-34 years and having one or more sexual partners were associated with being unaware of one’s HIV-positive status. Age <50 years and not taking cotrimoxazole were associated with being less likely to be being both aware and taking ART. Male sex, age <50 years, and taking cotrimoxazole were associated with being on ART but not having VLS.
Conclusions: Zimbabwe has made great strides toward epidemic control. Focusing resources on case finding, particularly among men, people aged<35 years, and sexually active individuals can help Zimbabwe attain 90-90-90 targets.