Thirty years on with an HIV epidemic in Zimbabwe (1985-2015)

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• 作者：Walter Chingwaru^a ; ^b ; ^c ; ^{wchingwaru@yahoo.co.uk" class="auth_mail" title="E-mail the corresponding author} ; Jerneja Vidmar^a ; ^b
• 关键词：HIV ; Antiretroviral therapy ; Epidemiology ; Zimbabwe
• 刊名：HIV & AIDS Review
• 出版年：2016
• 出版时间：2016
• 年：2016
• 卷：15
• 期：1
• 页码：26-32
• 全文大小：636 K

文摘

Zimbabwe, like many of her neighbours, is going through an HIV epidemic since 1985. It is imperative to assess progress with epidemic over the past three decades. We conducted a systematic review of reports in Pubmed/ScienceDirect, and a number of sentinel surveillance reports published by local and international organisations that have dealt with HIV/AIDS in the country, including the National AIDS Council of Zimbabwe, Ministry of Health and Child Welfare of Zimbabwe, UNAIDS and World Health Organisation. Thirty-five original research articles and 16 review articles, 4 surveillance reports and 2 conference reports met our inclusion criteria. The first 5 years of the epidemic were characterised by an exponential increase in prevalence (65-fold) and incidence (up to 13-fold) which were fuelled by high risk sexual behaviour. Comprehensive AIDS programmes that were launched between mid-1990s and 2015 and high mortality over the same period are thought to have played a role in slowing down the epidemic since the mid-2000s. Increased uptake of antiretroviral therapy (ART) and prevention-of-mother-to-child-transmission (PMTCT) (95%) prophylaxis accounted for a 70% drop in HIV-related mortality between 2003 and 2013. However, the epidemic has been characterised by a low paediatric ART coverage (35% in 2011 to 46.12% in 2013) and a recent increase in adolescent HIV prevalence. The epidemic has been driven by a number of social factors that include the local traditional beliefs and customs. A more holistic approach which deals with the epidemic in its socio-political context is required to effectively lower the country's HIV burden.