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Door-to-door HIV testing a game changer

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THE second phase of the Zimbabwe Population-based HIV Impact Assessment (Zimphia) has recorded an overwhelming response from the target population drawn from several parts of the country.

BY PHYLLIS MBANJE

THE second phase of the Zimbabwe Population-based HIV Impact Assessment (Zimphia) has recorded an overwhelming response from the target population drawn from several parts of the country.

Launched in Harare in November last year, the project seeks to give accurate measures of HIV prevalence, incidence, and viral load suppression. Such information will be critical in coming up with strategies that will help stem further spread and enhance treatment regime.

According to Zimphia 2020 director Munyaradzi Mapingure, Zimbabwe has made significant progress in bringing down the HIV prevalence which at one stage was at 29% but now has stabilised at around 14,1% among the adult population. Remarkably, the number of new HIV infections has also slowed down.

Speaking during a sensitisation meeting in Ruwa last month, Mapingure said the survey would provide critical data that was key in mitigatory strategies.

He also applauded Zimbabwe for continuing to record a decline in HIV infections.

“We are almost achieving our set targets,” he said.

Part of the survey includes HIV testing which has been dubbed the Front door to the Joint United Nations Programme on HIV/AIDS (UNAids) 90-90-90 targets. The 90–90–90 targets aim was to diagnose 90% of all HIV-positive persons, provide anti-retroviral therapy (ART) for 90% of those diagnosed, and achieve viral suppression for 90% of those treated by 2020.

Door-to-door testing of HIV has provided communities with the opportunity to have access to health services right at their door step.

“The community has responded well to this programme. It has been awesome. The selected families have welcomed us and allowed the teams to do their work,” said Kudzanayi Moyo, one of the southern region survey co-ordinators.

Moyo said the programme had offered an opportunity for many to know their status and also be able to receive comprehensive information on HIV and Aids.

However, she said while the rural folk and those who lived in the high-density areas were more embracing, it was not the same with those living in the leafy suburbs.

“It could be the security issues where people in such places will not just open their gates easily with some even asking to fill the questionnaire electronically,” she said.

According to World Health Organisation (WHO), research has shown that anti-retroviral medicines reduce Aids-related deaths and prevent HIV transmission. However, these benefits are only likely to occur if individuals know their HIV status and start treatment early.

Early HIV diagnosis through different HIV-testing approaches has become an important strategy for HIV prevention and control in the 21st century and people diagnosed with HIV should be linked to care and start treatment as early as possible to harness the benefits of anti-retroviral treatment.

Laboratory advisor for Zimphia Rex Chikara said besides the actual HIV tests, there is also an opportunity for other related tests like viral load and CD4 count.

Ordinarily many people struggle to get these done at their local clinics while some dread the long trips to health centres The survey, which is being led by the Health ministry in collaboration with the Zimbabwe National Statistics Agency, National Aids Council and ICAP at Columbia University, is the second population-based survey to be conducted in Zimbabwe. Besides providing key data, the survey will give some critical insights on guiding policy and funding priorities.

The current phase will take three months to complete the survey. There are 36 teams, 24 covering the northern region and 12 teams covering the southern region. Results of the same survey are expected to be out by December 1.

With support from the US President’s Emergency Plan for Aids Relief through the Centre for Disease Control and Prevention, the latest survey is targeting a representative sample of 22 886 adults between the ages of 15 and 65 years.

The first study was carried out in 2015 and Zimbabwe became the first country in Africa to roll out such a survey.

According to the Zimphia 2015-2016 survey results, 77% of people living with HIV in Zimbabwe knew their status, 88% were on treatment, and 85% were virally suppressed. Zimphia 2015-2016 showed significant progress towards reaching the UNAids 90-90-90 targets by year 2020 and the global target to end Aids by 2030.

Zimphia 2020 targets 22 886 eligible individuals aged 15 and above from 12 000 households.

National Aids Council monitoring and evaluation director, Amon Mpofu said his organisation was fully behind the survey which would also be instrumental in assessing the coverage and impact of HIV services at the population level and measuring the HIV-related risk behaviours using a national representative sample.

Mpofu said the new data from the current survey would assist the country in improving HIV response.