Just 45% of young women in East and Southern Africa are virally suppressed

25 January 2018

PEPFAR-funded Population-based HIV Impact Assessment (PHIA) surveys reveal a lack of knowledge of HIV status as a major barrier to achieving global HIV targets.  

Women in Africa

New figures reveal that less than half (46.3%) of all adolescent and young girls (15-24) across seven East and Southern African countries are aware of their status, meaning far fewer young women in the region are accessing effective HIV treatment to save their lives.

Just 45% of all young women living with HIV in the region are virally suppressed, according to samples collected as part of the Population-based HIV Impact Assessment (PHIA) surveys conducted in Lesotho, Malawi, Swaziland, Uganda, Tanzania, Zambia and Zimbabwe – an initiative funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and conducted with the respective countries’ Ministries of Health, the US Centres for Diseases Control (CDC), and ICAP at Colombia University in the USA.

The surveys also reveal that of those aware of their status, 85.5% self-report being on ART, and 81.8% are virally suppressed. Using 90-90-90 estimates gives a viral load suppression prevalence of 32.4%, far lower than the 45% indicated from sampling, meaning there could be underreporting in the measurement of the first two targets.

The stats are a concern, as they are well off UNAIDS targets of getting 73% of all people living with HIV virally suppressed by 2020.

Awareness of status ranged between countries – with 70.2% of young women in Swaziland aware of their status, compared to just 40.6% in Zambia. This means that in Zambia, around a third of all women living with HIV were on effective treatment to save their lives.

Generally, HIV prevalence among adolescent girls and young women was found to be 3.6%, more than double (1.6%) the prevalence for males in same age group. Specifically, HIV prevalence ranged from 2.1% in Tanzania and 3.4% in Malawi, to 11% in Lesotho and 13.9% in Swaziland.

The authors state: “There is a need to design, implement, and evaluate strategies aimed at ensuring HIV-positive adolescent girls and young women know their HIV status and are on ART treatment to improve their immunity status and reduce transmission to others.”

The PHIAs are made up of household-based national surveys that aim to measure the status of the national HIV response across a number of PEPFAR priority countries.

The study was published in last week’s CDC Morbidity and Mortality Weekly Report.

Photo credit:
©Avert/Corrie Wingate. Photos are used for illustrative purposes. They do not imply any health status or behaviour on the part of the people in the photo

Written by Caitlin Mahon

Content Specialist - HIV & Sexual Health