| Issue/Objective |
Zimbabwe's prevention of mother-to-child transmission of HIV
(PMTCT) programs have achieved notable progress, including 93% antiretroviral therapy (ART) coverage among HIV-positive pregnant and breastfeeding women in 2024 and notable reductions in mother-to-child transmission. For pregnant women living with HIV (PWLHIV), early engagement in antenatal care (ANC) and HIV care is critical for effective viral load management and improved child health outcomes. However, sustainability is challenged by late maternal HIV diagnosis, suboptimal ART adherence, and gaps in postpartum retention.
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| Methodology/Approach |
We analysed HIV treatment data from PWLHIV enrolled in ANC across
20 districts of Zimbabwe from November 2023 through July 2025. We
characterised HIV and ART status, gestational age at ANC booking, and viral
load (VL) management status at initial ANC contact. We explored how PWLHIV age and gestational age at ANC booking relate to VL results, and whether the primary care location of HIV care and ANC facility determines VL management outcomes.
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| Results |
Among 11,312 PWLHIV, the majority - 8,620 (76%) - were already living with HIV at the time of ANC booking. Among those established in HIV care at ANC booking, 6,039 (70%) were enrolled on ART at the ANC booking facility with VL sample collection according to guidelines. Only 1,549 (13%) initiated ANC at or before 13 weeks gestational age - the recommended timeframe - while 6,112 (54%) booked at 14-26 weeks and 3,217 (30%) booked late at more than 26 weeks. At booking, 5,065 (58%) had suppressed VL, 1,640 (19%) had pending VL, 1,666 (19%) had no VL collected, and 249 (3%) were not virally suppressed. |
| Discussion/Conclusion |
Despite high ART coverage among HIV-positive pregnant women in Zimbabwe, late ANC booking and gaps in viral load monitoring continue to
threaten PMTCT progress. Earlier ANC booking at 13 weeks or below and
integrated primary care support correlate with improved VL suppression.
Strengthening postpartum engagement, optimising facility-level VL management, and reinforcing HIV care and ANC coordination within PMTCT are essential to sustain gains and improve maternal and child health outcomes. |
| Presenters and Affiliations |
UWASE NKUSI DIANA Society for Family Health (SFH) |
