Abstract
ZAMBIA’S nation-wide adult Human Immunodeficiency virus (HIV) prevalence stood at 13.3 percent in 2014. In Southern Province, 12.8 percent of adult men and women aged 15-49 years were HIV positive. The prevalence was higher in women than in men (15.1% compared to 11.3%). The most recent data also suggested that key populations were disproportionately infected with HIV compared to the general population. The Measure Know Your Response (KYR) study took place from September 2013 to July 2014 in the Southern Province of Zambia. The aim was to map and characterize the HIV response among both government (health and none health) and non-government organizations (NGOs). The purpose was to identify gaps in the response, in particular in terms of the geographical areas and the key populations attended to and those disproportionately missed. This paper focuses on the results from the mapping of NGOs involved in HIV and AIDS response. For this aspect of the mapping data were collected using the NGO Sector Questionnaire. Focus was interventions of NGOs and their services to target populations across all the 12 districts of the Southern Province. All program implementers working in a given district were asked questions to assess the extent to which their HIV-prevention activities in the district included strategies to address all key populations, including gender issues. Data from the quantitative questionnaires was analyzed using STATA version 12.0 and Microsoft Excel. The results of the pilot test revealed gaps in both geographic spread and content of programs in the NGOs run HIV-prevention response. For instance, hardly any NGOs worked in the new and smaller districts of Pemba, Siavonga, and Zimba. Similarly, certain services, such as mass media campaigns, interpersonal education and persuasion programs were being implemented across all the districts. Further, fewer than three of the 93 organizations surveyed targeted key populations, notably sex workers, incarcerated populations, men who have sex with men (MSM), transgender people and injective drug users. With respect to gender, about 25% of the organizations did not integrate gender issues into their HIV-prevention activities. From a methodological standpoint, the pilot test revealed the need to examine dimensions of program content, quality and intensity. In spite of these limitations, the study permits us to know which interventions are being implemented by the NGO sector, contributing to new knowledge in Zambia about geographic gaps in the availability of HIV-prevention interventions.
Highlights
Zambia’s HIV epidemic is characterized as mature and generalized, as opposed to being concentrated in specific populations [1]
The data come from a MEASURE Evaluation-supported pilot test of the Know Your Response (KYR) toolkit which was implemented from September to October 2013 in Southern Province, Zambia
At the time the list of registered non-government organizations (NGOs) was created, Pemba was under Choma District and Zimba was part of Kalomo and Kazungula districts
Summary
Zambia’s HIV epidemic is characterized as mature and generalized, as opposed to being concentrated in specific populations [1]. The spectrum estimates of the HIV prevalence in adults aged 15-49 years show that the HIV pandemic has been fairly stable over the last 15 years, after the initial peak prevalence of around 27% in the 1990s [1]. According to the Demographic and Health Survey (DHS), the adult HIV prevalence rate stood at 13.3 percent in 2014, with prevalence of 15.1% in women higher compared to 11.3% in men [2] In Southern Province where this study was conducted, 12.8 percent of adult men and women aged 15-49 years were HIV positive, making it the fourth highest among the 10 provinces of Zambia[1]. 15.7 percent of adults in the districts of Choma, Monze and Siavonga and 15.2 percent of those in Kalomo and Kazungula were HIV positive.
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