Zambia has made substantial progress in providing access to HIV testing services. The availability of
HIV testing services has expanded across the country. By 2012, Zambia had an estimated 1800 HIV
testing and counselling sites available, up from 56 in 2001. The number of health facilities
dispensing anti-retroviral treatment (ART) (564) was higher than the target of 500 set for 2015. As
such, the country has made significant improvements in increasing access to lifesaving ART.
Despite advancements in providing access to HIV testing services, approximately 40% of Zambians
have never tested for HIV. As a consequence, a high proportion of individuals are unaware of their
HIV positive status and many people living with HIV access treatment at later stages of infection.
There remain a number of barriers to accessing currently available HIV testing services, including
structural barriers, such as the direct and opportunity costs associated with seeking HIV testing
services at a health facility, and individual-level barriers, including fear of confidentiality of testing
and a low perceived risk of HIV infection.
Self-testing for HIV (HIVST) has the potential to address these barriers and therefore reach HIVpositive
individuals who remain undiagnosed, link these individuals into treatment and care
services at earlier stages of infection, and reduce the risk of onward transmission of HIV infection.
In light of this potential, Zambia is considering adopting HIVST as a strategy to deliver HIV testing
services, alongside existing methods, to reach individuals underserved by currently available
strategies.