Zim Digital Sunday Express
June 18, 2021

A review of Zimbabwe’s progress on HIV and Aids: Target 90-90-90

Zimbabwe implemented an integrated HIV Testing Services (HTS) model which deployed different testing approaches for different populations

By Mandy Nyama

*What is 90 – 90 -90*

 

It is a concept introduced by the United Nations programme on HIV/AIDS in 2013 as an idea that by 2020, 90 percent of people who are HIV infected will be diagnosed, 90 percent of people who are diagnosed will be on antiretroviral treatment and 90 percent of those who receive antiretrovirals will be virally suppressed.

So this means that in Zimbabwe 90% of PLWHIV (People Living With HIV) who are on ART therapy they have suppressed viral load ie the virus is undetectable. Because of ART their immune system is as good as one who is Living without the HIV Virus. Their TCells or white blood cells block the virus from multiplying.

According to the National AIDS Council of Zimbabwe (NACZ) the mortality has declined by almost 72 percent in the 10 years between 2010 and 2020.

*Strategies used to meet the MDG according to Dr Madzima*

Zimbabwe implemented an integrated HIV Testing Services (HTS) model which deployed different testing approaches for different populations.

1). The approaches included facility-based testing (provider-initiated and client-initiated testing and counseling). This is where one visits the clinic or hospital regularly for diseases that can be cured, but they won’t be responding to the treatment eg Coughs, diarrhoea, sore throat, So the hospital or clinic will advise you to be tested with your consent. Before testing they offer you Pre-test counseling and after testing they offer you Post-test Counseling.

2). Facility and community-based index testing. This is whereby the healthcare facility sent community Healthcare workers to go and do health promotions on HIV so as to encourage the community to be tested. To those who want to know their status and they want privacy, it can be done at their homes, by CHW also pre-test Counseling and Post-test Counseling will be offered.

3). HIV self-testing – This explains itself you get a self-test kit from the Pharmacy or Clinic. ( Without proper counseling you can end up being denial) this can prolong you in getting treatment

4). Targeted mobile outreach testing. This is whereby Healthcare workers visit places like the Rural areas where clinics and hospitals are far from the Community, erect a tent and do health promotions on HIV so as encourage the Community to know their status. Those willing to be tested they will get tested there, and their privacy will be respected. If positive they will be put on ART therapy.

 

Importance of testing

 

HTS is offered in several primary healthcare sites including tuberculosis, antenatal care, sexually transmitted infections, and maternal, newborn, and child health.

When one has TB it is advisable to be tested for HIV. HIV and TB is like brother and sister.

When one is pregnant it is a must to be tested for HIV this is done so as to Prevent Mother to Child Transmission (PMCT).

Those who have STIs because of its association with multiple sexual partners it is advised to get tested.

New born babies whose mother is positive they get tested as well.

Dr Madzima said the integration of other prevention services such as voluntary medical male circumcision, Pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) has helped Zim to achieve the target 90-90-90

Pre-exposure prophylaxis (PrEP)- tablets are taken by a negative partner when the other partner is positive, (discordant partners) before having sex.

Post Exposure Prophylaxis (PEP) tablets given when one is raped, or when one has unprotected sex with a person who is HIV+ you need to get the tablets within 72hrs. The procedure is the test you first and if negative they give you a month’s supply.

 

AIDS mortality rate in Zimbabwe had declined considerably, showing that people were now aware of the disease.

AIDS mortality significantly declined by 71.9 percent from 488 in 2010 to 137 in 2020 per 100 000. There was a 28.6 percent reduction of AIDS-related mortality from 2015 to 2020, which was a miss of Zimbabwe National HIV and AIDS Strategic Plan III ( objective of reducing HIV/AIDS-related mortality by 50 percent for both adults and children by 2020.

Zimbabwe is now is now working on the 95-95-95 Sustainable development Goal(SDG) target for 2025

Zimbabwe has done very well in HIV care. Tablets can be accessed in every government healthcare facility for free.

 

Conclusion

Do not default
Know your status
Say No to Stigma.
Have a positive attitude.
HIV is not a death sentence it can be managed.

 

Mandy Nyama is a professional healthcare worker. She holds a BTech in Health and Social care and Public Health. Feedback: mandynyama@gmail.com

 

 

 

 

The Health Column with Mandy: Tuberculosis remains the world’s deadliest infectious killer

 

 


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