There is wide geographical variation in the Zambian epidemic, with important differences between urban areas (approximately 20-30% prevalence) and rural areas (approximately 5-14%) underscoring the socioeconomic drivers of the epidemic.

Table 1. Zambia HIV Data at A Glance

HIV Epidemic Trends

Prevalence estimates show adult prevalence peaked in the mid-1990s at about 16% and has stayed at the same hyperendemic level around 15% since then but has come down slightly in the most recent dat to 14% (2009). Crucially, prevention efforts may be having a positive impact on young women – the female to- male prevalence ration for those 15-24 years old dropped from 3.7 (more infections in young women) in 2001-02 to 1.6 in 2007 (fewer new infections in young women, more in young men). But women are still worse affected by the epidemic.

HIV Prevalence Zambia 1990 to 2007 (Epidemiological Fact Sheet on HIV and AIDS Core data on epidemiology and response Zambia, UNAIDS 2008)

Incidence in adults aged 15-49 years has halved since 1990 and is thought to be at a stable level at 1.6% in 2009 (2% in women, 1.2% in men). However, the absolute number of new infections remains high, continues to be higher in women and will still increase due to Zambia’s expanding population. Scale-up of prevention efforts to reduce incidence is urgently needed.