Accessibility to PrEP Changing Lives in Zambia

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September 23, 2022
Lead Paragraph/Summary

Adolescent girls and young women in Zambia remain vulnerable to HIV infection. In fact, they are twice as likely as their male peers to contract HIV. Limited knowledge and education about the risks of HIV, high levels of risk behaviors such as intergenerational and transactional relationships, and low risk perception are all contributing factors.  

“I am happy today to be HIV negative because I use PrEP consistently. As a young girl, at substantial risk of contracting HIV, taking PrEP has been part of my daily routine for over a year” – Deborah (18) 

Deborah (18) and Gloria (17) remain HIV negative, thanks largely to supportive families and the great work of the Liyoyelo Dreams Center. Deborah, who is the mother of a two-year-old child, is lucky to have a mother who encourages and supports her decision to take PrEP.

However, it is not easy for the clinic or the girls. According to the Zambia Demographic Health Survey (ZDHS) report of 2018, adult HIV prevalence (15-49 years) was found to be at 11.1%. The report also showed that women (14.2%) remain disproportionately affected compared to men (7.5%).

Site Coordinator Priscilla Makasa and Gloria discuss challenges during a community PrEP refill event.
Site Coordinator Priscilla Makasa and Gloria discuss challenges during a community PrEP refill event.

Deborah and Gloria are fortunate to benefit from their participation in programs run by the Liyoyelo Urban Clinic. This clinic, supported the University of Maryland’s CIHEB Zambia, has been key in responding to the challenges facing adolescent girls and young women by empowering them to make better health decisions, and by mobilizing communities and families to recognize the risks and support these decisions. The clinic also offers young women access to pre-exposure prophylaxis or PrEP, a proven effective way to substantially reduce the risk of HIV infection among populations who are at substantial risk of HIV infection.  

Guaranteeing adequate supplies of PrEP throughout the country is not easy, but the USAID Global Health Supply Chain Program – Procurement and Supply Management (GHSC-PSM) has been a key supply chain partner in the PrEP program. More than 2.1 million bottles of PrEP (August 2022) have been delivered to Zambia, making it accessible to adolescent girls and young women at health facilities countrywide. The project has also procured antiretrovirals, rapid test kits and laboratory commodities so that people can continue to live healthy lives.  

 The PrEP program began in 2018, thanks to the Zambian Ministry of Health and the PEPFAR-supported DREAMS (Determined, Resilient, Empowered AIDS-free, Mentored, and Safe) initiative, helping to keep adolescent girls and young women safe. Through the provincial field office in Western Province, GHSC-PSM has been key in strengthening the supply chain system by working with provincial and district health office leadership, the Ministry of Health, and the Zambia Medicines and Medical Supplies Agency (ZAMMSA) to ensure uninterrupted availability of PrEP drugs.  

Through accurate data collection and reporting of consumption data. This is critical information for the Ministry and supply chain partners to use in decision-making to ensure medicine is available where and when it is most needed.   


“I decided to start taking PrEP last year at the age of 16 because I was at risk of acquiring HIV. The drugs together with other services provided at the center have greatly helped me to continue being HIV negative till this day” – Gloria (17)