Projection of HIV Incidence Trends in Zimbabwe Using Incremental Mixture Importance Sampling

Abstract

HIV prevalence has remained high in Zimbabwe due to continued use of Antiretroviral therapy (ART). Incidence is now a better measure of the programmatic efforts in response to the epidemic. Mathematical modeling remains the main tool for assessing incidence trends. Secondary data transmembrane (TM) one, that is [TM1] analysis, was conducted using incremental mixture sampling (IMIS). Absolute neutrophil count (ANC) [TM2] prevalence data were used for modeling incidence in the general population. The force of infection in 6 of the 10 provinces in Zimbabwe is projected to fall below 1%. ART has significantly helped in reducing the force of infection in the country. With continued use of ART coupled with other programmatic interventions, HIV incidence can be reduced to very low levels in many parts of the country. HIV incidence in Zimbabwe varies by geographical location. Matabeleland South province has the highest cumulative incidence in the country, while Harare province has the lowest. There is a difference in the force of infection between rural and urban areas. The force of infection remains high in the Matabeleland South, Midlands, Bulawayo, and Mashonaland East provinces. An increase in the use of ART reduces HIV incidence. Scaling up HIV counselling and testing activities in provinces or districts with high force of infection will help reduce the force of infection in these areas a the number of people on ART will increase, consequently reducing the infectiousness of infected people. Intervention programmes should address cultural differences.