HIV Epidemic Heterogeneity in Zimbabwe: Evidence from successive Demographic Health Surveys

The HIV epidemic, which started with a handful of cases in the early 80s, very quickly became a worldwide epidemic. It has since then killed millions; devastating lives and destroying economies. Zimbabwe has one of the worst HIV epidemics in the world with within country variations. This study investigates successive 2005 and 2010-11 Demographic and Health Surveys (ZDHS) from Zimbabwe. a random representative sample of 30,000 men aged 15-59 and women aged 15 to 49 was selected in both surveys. HIV prevalence are mapped in a flexible, coherent regression framework using a geo-additive semi-parametric mixed model and produce HIV indicators (prevalence maps) at the sub-national regional level, an administrative level relevant for policy design, planning and decisions. It was found that there is substantial regional variation, not only in the burden of HIV, but also in the risk factors. This therefore requires varying responses/policies at the regional level to ensure that the often diverse needs of populations across a country are met and incorporated into planning the HIV response. The use of geographically referenced data in the successive ZDHS provides crucial new insights into the spatial characteristics of the HIV epidemic in Zimbabwe. It especially highlights the HIV heterogeneity across Zimbabwe. There is substantial regional variation, not only in the burden of HIV, but also in the risk factors.