The development of harmonized minimum standards for guidance on HIV testing and counselling and Prevention of Mother-to-Child Transmission of HIV in the SADC region: HTC country report: Zambia

Voluntary Counselling and Testing Services were established on a larger scale in Zambia in 1999. The programme was initiated in 21 pilot sites evenly distributed in each of the nine provinces of Zambia and the major funding in this pilot phase was provided by the Norwegian Government through NORAD. The Government of the Republic of Zambia provided the required human resources through the establishment of the Zambia Voluntary Counselling and Testing Service, which is housed in the Virology Laboratory at the University Teaching Hospital. A consolidation and expansion phase was undertaken with lessons and experiences learnt from the pilot. By January 2006, 485 HTC centres were established in all the 72 districts of Zambia. Zambia has a generalized heterosexual HIV-1 epidemic with a stabilizing seroprevalence trend. Estimates of HIV prevalence in 2007 for people aged 15 to 49 are 15.2% (UNICEF) and 14.3% (ZHDS). Estimates from sentinel surveillance data for 15-24 year olds are 6.5% (ZDHS, 2007) and 12.5% (SADC, 2008 ). Ninety-three percent of the population has access to antenatal care (UNICEF, 2008). As antiretroviral treatment programs and palliative care services are being scaled up in Zambia, the demand for counselling and testing is growing exponentially. The current HTC guidelines advocate universal access to HIV counselling and testing, which is to be achieved through the use of various counselling and testing models, involving both health workers and non-health workers in different settings.