The HIV epidemic in Zambia: Socio-demographic prevalence patterns and indications of trends among childbearing women

Objective: To examine socio-demographic HIV prevalence patterns and trends among childbearing women in Zambia. Design: Repeated cross-sectional surveys. Methods: Personal interviews and unlinked anonymous testing of blood samples of women attending antenatal care in selected areas. Results: The 1994 data includes information from 27 areas and a total of 11 517 women. The HIV prevalence among urban residents appeared with moderate variation at a very high level (range 25-32%, comparing provinces). The geographical variation was more prominent in rural populations (range 8-16%) and was approximately half the prevalence level of the urban populations. With the exception of the 15-19 years age-group, HIV infection was found to rise sharply with increasing educational attainment (odds ratio, 3.1; confidence interval, 2.6-3.8) when contrasting extreme educational levels. Although the assessment of trends is somewhat restricted, the available information indicates stable prevalence levels in most populations over the last 2-4 years. Conclusions: The data showed extremely high HIV prevalence levels among childbearing women. Longer time-intervals between surveys are needed, however, in order to verify the stability in prevalence identified by this study. The tendency to changing differentials by social status is suggested as a possible sign of an ongoing process of significant behavioural change.