Mothers on Art Means Viral Load Infants Harder to Detect

HIV and AIDS in Zimbabwe

Key POINTS

Republic of zimbabwe has a high HIV prevalence. Unprotected heterosexual sex continues to be the master manual route for new infections.

The illegal nature of sexual activity piece of work and homosexuality in Republic of zimbabwe presents huge barriers for sexual activity workers and men who have sex with men from accessing HIV services.

Well-nigh every meaning woman now has access to antiretroviral medicines thanks to the success of PMTCT services in Zimbabwe – as well contributing to a decline of new infections amongst infants.

Effectually ii-thirds of HIV expenditure in Zimbabwe comes from international donor sources.

Explore this page to ﬁnd out more about groups most aﬀected past HIV, testing and counselling, prevention programmes, antiretroviral treatment availability, civil lodge's role, HIV and tuberculosis, barriers to the HIV response, funding and the future of HIV in Republic of zimbabwe.

Republic of zimbabwe has one of the highest HIV prevalences in sub-Saharan Africa at 12.8%, with i.4 million people living with HIV in 2019.1

The HIV epidemic in Zimbabwe is generalised and is largely driven past unprotected heterosexual sex activity. Heterosexual people in stable unions account for around 55% of all new HIV infections.2 Women are unduly aﬀected, particularly adolescent girls and young women. Still, there are growing epidemics among key populations, such as sex workers and men who have sex with men, who are at higher adventure of HIV. Information on these populations is lacking as just a minimal corporeality of data is nerveless and reported in national documents.

In 2019, in that location were forty,000 new HIV infections, downward from 62,000 in 2010. Behaviour change

communication, high treatment coverage and prevention of female parent-to-child transmission are all thought to be responsible for this pass up. Deaths from AIDS-related illnesses proceed to fall – from 54,000 in 2010 to twenty,000 in 2019.iii

Republic of zimbabwe is making strong progress towards the UNAIDS 90-90-90 targets. As of 2019, ninety% of people living with HIV in the country were aware of their status, and 94% of those diagnosed were on treatment. Of the people diagnosed and on treatment, 86% are virally suppressed, meaning that they are probable to be in good health and wont to pass HIV on to anyone else. Overall, this equates to 85% of all people living with HIV in Zimbabwe being on treatment and 73% of all HIV positive people existence virally suppressed.4

Groups nearly aﬀected by HIV in Zimbabwe

The Zimbabwean HIV epidemic is largely driven by unprotected heterosexual sex. But in that location are now growing epidemics amongst sure population groups who are at higher risk of HIV (often referred to as 'key populations'). National information on these populations is thin. Merely a minimal amount of information is collected and reported in national documents.

Women

An estimated 730,000 women were living with HIV in Zimbabwe in 2018.5 In the same year, nineteen,000 women became HIV positive, compared to 14,000 men.6 Gender inequality is present inside relationships and marriages, and drives HIV infections. For example, only 69% of men believe a woman has the correct to refuse her husband sexual intercourse if she knows he has sexual activity with other women. Although in the minority, 23% of females believe women do not have the right to enquire their partner to use a safe if he has a sexually transmitted infection (STI).7

Around 20% of women who take been married have experienced physical or sexual violence from their partner in the past 12 months.viii Overall, xiv% of adult women reported experiencing sexual violence at least one time in their lifetime and 8% reported experiencing it in the terminal 12 months.ix This prevents many women from being able to negotiate using a condom and puts them at college biological chance of HIV.

In terms of broader reproductive health, Zimbabwe fares ameliorate. Zimbabwe has the lowest reported unmet need for family planning among married women in sub-Saharan Africa (15.2%).10

These factors help to create a situation in which women are disproportionately aﬀected by HIV compared to men. For case, the 2015/16 Population-Based HIV Bear upon Survey found HIV prevalence among adults who had intercourse before the age of 15 years was near 3 times as high for women (25%) than for men (9%). Amongst people reporting two or more than sexual partners in the 12 months earlier the survey, prevalence was more than twice as high amidst women (31%) every bit amid men (12%).11

Immature people

In 2018, around a tertiary of all new HIV infections in people in a higher place the age of 15 in Zimbabwe were amidst immature people (under the age of 24). At that place were 9,000 new infections among young women, more double the number of new infections amid young men (4,200).12

Effectually 59% of young people surveyed by the country'due south 2016 population-based HIV impact survey had tested for HIV, nonetheless, young men were less likely to test than young women (52% compared to 65%).thirteen Among young people living with HIV, lx% were aware of their condition, much lower than the proportion of adults enlightened of their status overall. The proportion of immature people on treatment and virally suppressed is also lower.xiv

Young people are more than likely to engage in risky sexual behaviours than older adults, making them vulnerable to HIV, nevertheless they accept less frequent contact with the healthcare organization in general, including HIV prevention and treatment services.

In 2015, 17% of young women (aged 15-19) in Zimbabwe reported having had sex with a human being 10 years older in the past 12 months. Intergenerational relationships (with older partners) are thought to be one of the master drivers of new HIV infections in young women. In these relationships, older partners are more than likely to decide condom use, and are likewise more likely to have HIV than women'south younger peers.15

In Zimbabwe, merely 42% of young women and 47% of young men accept comprehensive noesis near HIV, limiting their ability to take control of their sexual health.xvi

Sex workers

There are effectually 44,500 female sex workers Zimbabwe, around forty% of whom are living with HIV.17 18 This is concerning in an environment where sexual practice piece of work is illegal, condoms are beingness conﬁscated and gender inequality makes condom negotiation diﬃcult.

Despite this, some progress is being made; just nether one-half (44%) of all sex workers were beingness reached with HIV prevention programmes in 2018. In 2017, 96% of sex workers reported using a condom with their about recent client. Around 93% of HIV positive sex workers were aware of their

status of whom 72% are on treatment.19

Sex workers' vulnerability to HIV is exacerbated past police intimidation, harassment and arrest. This creates fear that stops sex workers from accessing wellness services. In 2016, the Centre for Sexual Health, HIV and AIDS Research (CeSHHAR) found that 20% of female person sex workers in Zimbabwe had experienced violence from the police in the past twelvemonth.xx

The possession of condoms is often used as proof of sex work, and in the past many sexual activity workers have been arrested or had their condoms conﬁscated. This heightens their gamble of HIV, hampering their ability to negotiate safe use.21 All the same, in 2015, nine sexual activity workers' won a landmark case against them afterwards they were arrested without a customer existence present. This case was widely interpreted past the media to mean that the constabulary were no longer able to arrest sex workers for merely being on the street.22 In a survey of simply nether 3,000 female sexual practice workers, effectually l% reported existence stopped by the constabulary in 2013, but past 2016, but xxx% said they'd been stopped.23

We used to be rounded up in the streets even if we were caught but standing at that place, but now they can't practise that unless there is a customer there likewise. So cops are ﬁnding information technology hard to arrest us. I'grand sure it will also make them think and realise that we are also man beings.

– Female person sex activity worker in Republic of zimbabwe.24

Sex workers, and the organisations representing them, have minimal involvement in the Zimbabwean response to HIV. This marginalises them and prevents them from accessing services. Better inclusion of sex worker-led groups in HIV prevention initiatives would aid better the health of sex workers and the population as a whole.

Men who have sex with men (MSM)

Homosexual acts are illegal in Republic of zimbabwe for men who have sex with men (sometimes referred to as MSM), but legal for women who have sexual practice with women. As a outcome national statistics are rarely available for men who take sex with men.

Criminalising men who have sex activity with men drives this vulnerable group away from HIV services. As a upshot, many do not know their HIV status or admission treatment. From the information that is available, it's estimated that effectually a 3rd (31%) of men who have sexual practice with men are living with HIV.25

Zimbabwean organisations that support the rights of men who have sex with men and their access to HIV services practice exist, such every bit Gays and Lesbians Zimbabwe (GALZ), just many are routinely punished and shutdown or accept their members arrested.

In 2018, 50% of HIV positive men who have sex activity with men in Zimbabwe were estimated to be aware of their condition, of whom 77% were on treatment. In add-on, around 72% of men who accept sex with men take admission to HIV prevention programmes.26 Nevertheless, these ﬁndings are based on limited data so may non accurately represent the reality of the situation.

International donors such equally the Global Fund to Fight AIDS, Malaria and Tuberculosis and PEPFAR

have attempted to ensure some of their funding is directed towards men who have sex with men, but government restrictions hateful this has not materialised.

HIV testing and counselling (HTC) in Zimbabwe

It is estimated that xc% of people living with HIV in Republic of zimbabwe knew their condition in 2018.27 However, there is signiﬁcant discrepancy betwixt men and women, with 94% of women living with HIV aware of their status, compared to 86% of positive men.28

The number of HIV tests carried out in Republic of zimbabwe has increased from nineteen.iv million in 2011 to 28 million in 2017, however this ﬁgure is all the same below the government's target of 25.2 1000000.29 30

Findings from ZIMPHIA, a population-based survey carried out in 2015/16, suggest around 74% of all adults have tested for HIV and received their results; 66% of men and 81% of women. Around 36% of those questioned had tested for HIV and received their results in the past 12 months. ZIMPHIA conducts HIV testing as function of its research and effectually 9% of adults testing positive had non previously tested for HIV before.31

Young people are less likely than older age groups to test for HIV. For example, ﬁndings from ZIMPHIA suggest 3-quarters (75%) of 25 to 29-year-former men had been tested and received their results, compared to 44% of adolescent men (aged xv to 19). Similarly, around one-half (47%) of adolescent women (aged 15 to 19) had tested for HIV, compared to 90% of women aged 25 to 44.

Information technology is thought that masculinity norms in Zimbabwe inhibit men from getting tested and engaging in treatment.32 However, conducting testing in men'southward places of work can increase testing among men, with a 2013 trial reporting a 53% uptake when workplace testing was oﬀered.33

Scaling upward cocky testing in Republic of zimbabwe

Another way to increment testing, peculiarly among hard-to-reach groups, is self-testing. In 2015, Population Services International and UNITAID began HIV Cocky-Testing Africa (STAR), a four-year project to scale up cocky-testing in Zimbabwe, Malawi and Zambia.

Through STAR, close to 1 million self-testing kits will be distributed in Zimbabwe by 2020. Interim results published in 2017 propose STAR is working; twenty% of those using self-testing kits were ﬁrst time testers, 39% were anile between 16 and 24 and 35% were adult men. The ﬁndings besides suggest relatively practiced linkages to intendance for men, with eighty% of men testing positive via self-testing kits linked to handling.34

HIV prevention programmes in Zimbabwe

The number of people acquiring HIV each yr is falling in Zimbabwe, although levels are however relatively loftier. In 2018, there were 38,000 new infections (33,000 amidst adults and 4,800 among children). In comparison, 62,000 people became HIV positive in 2010 (47,000 adults and fifteen,000 children).35

Zimbabwe's National HIV and AIDS Strategic Program 2011-2015 saw the country adopt a Combination Prevention Strategy approach, which focuses on a number of areas to forbid new infections. This approach remains in identify and includes prevention of mother-to-child manual, voluntary medical male circumcision, behaviour change communication, safe programming and STI management.

In 2015, as the 2011-2015 strategic programme came to an stop, Republic of zimbabwe held a national consultation to explore how the country'south prevention responses tin be revitalised. As a effect, it adult a regional roadmap with S Africa and Kenya to increment HIV prevention services and investment.36 In 2017, the regime published the Extended Republic of zimbabwe National AIDS Strategic Plan 3 (ZNASP III), which will run to 2020. Some of its cardinal strategies are discussed below.37

Condom availability and employ

The availability and distribution of condoms in Zimbabwe is good, with 120 million male condoms and

1. million female condoms distributed in 2017.38 This equates to 33 male condoms per human being per year, making Republic of zimbabwe one of merely ﬁve countries to meet or exceed the Un Population Fund's regional benchmark of xxx male condoms per human per yr.39 Employ of condoms in multiple concurrent partnerships (when one or both partners have sexual relationships with other people) is thought to be low. Survey data from 2015 reported that, of respondents who had two or more sexual partners in the by 12 months, only 50% of women and 37% of men used a condom the final time they had sex.40

In a 2017 evaluation conducted past the Zimbabwe National AIDS Quango and partners, women and men indicated a dislike of the free condoms provided (a brand chosen Puma), reporting that they had an unpleasant odor and tended to intermission easily. The female condom was also disliked by both women and men.41

HIV pedagogy and arroyo to sex education

Findings from 2015 propose knowledge of HIV prevention is increasing in Republic of zimbabwe, peculiarly among men.

Knowledge of HIV is more often than not widespread, with 84% of women and 88% of men questioned enlightened that HIV may be prevented by using condoms during sex.42.

However, some misconceptions nearly HIV manual remain, with xvi% of women and men wrongly thinking that HIV can be transmitted by mosquito bites, 7% assertive a person tin become infected past sharing food with a person who has HIV, and 5% suggesting HIV can be transmitted by supernatural ways.43

Knowledge of HIV is poorer amid young people, despite their elevated HIV vulnerability. In 2015, less than half of 15 to 24-year-olds had comprehensive knowledge virtually how to prevent HIV.44 In terms of private questions, effectually nine out of x young people (87%) knew information technology was not possible to get HIV by sharing food with someone. Nonetheless, only 3 quarters (75%) knew that a person can protect themselves from HIV past using a condom correctly every time they had sex.45

Previously, a lack of lifeskills education and comprehensive social and behaviour change communication materials had been shown to preclude immature people from having the noesis they need to reduce their HIV vulnerability and prevent onward transmission.46

To accost this, the authorities has been rolling-out comprehensive sexuality education (CSE) in primary and secondary schools. Between 2015 and 2017, around 12,000 teachers were trained to deliver CSE and the topic is now included in national education curriculums, including a component on safe sex didactics.47 Other topics include sexuality, reproductive health, gender, rights, services and related lifeskills. A programme aimed at reaching out of school youth has also been adult, and will be delivered by community-based youth leaders and mentors.48

The Republic of zimbabwe National Behaviour Change Programme

In 2015, 2.4 meg people in Zimbabwe were reached with letters virtually HIV and 44% were referred for integrated HIV services.49

The programme targets sexually agile people and members of key aﬀected populations, and has scaled-up eﬀorts to accomplish schools, workplaces and customs-centred activities. In prisons for case, both staﬀ and inmates have been trained in the programme in order to pass on noesis to others.50

Every bit part of this, customs-based Behaviour Change Facilitators (BCFs) go door-to-door to speak to people about HIV and their take chances of acquiring the virus. All the same, this has been found to be ineﬀective at reaching men and young people. As the BCFs are community volunteers there has also been an result with their lack of capacity to address social and cultural factors that inﬂuence behaviour.51

Recent reductions in the number of new HIV infections in the country are idea to be due to a reduction in the number of people with multiple sexual partners. This shows a shift towards making witting behavioural changes in low-cal of a serious HIV epidemic. Despite this, men are even so fourteen times more likely to have multiple sexual partners than women.52

Prevention of mother-to-child transmission (PMTCT)

Since 2014 Republic of zimbabwe has been rolling out Choice B+, whereby HIV-positive mothers receive antiretroviral drugs for life in line with WHO treatment guidelines.53

As a upshot, in 2018, over 94% of significant women living with HIV in Republic of zimbabwe received antiretroviral handling to prevent mother-to-child manual.54 Testing rates among all pregnant women have remained steady in recent years at around 85%, meaning that a signiﬁcant proportion of women are however unaware of their condition and are not accessing treatment if needed.55

In 2015, mother-to-kid transmission was estimated to account for vi.39% of all new HIV infections in children aged 0-14 years.56 In 2017, this had risen slightly to 6.74%, however Zimbabwe still appears to be on track to achieve the global elimination target of less than five% by 2020.57 Equally a result of this success, new infections amongst 0-xiv year olds have fallen by two-thirds since 2010, from xv,000 to iv,800.58 Notwithstanding, despite the expansion of PMTCT services, only 63% of infants born to HIV-positive mothers received an HIV test within the ﬁrst two months of life.59

Voluntary medical male person circumcision (VMMC)

Republic of zimbabwe is ane of UNAIDS' priority countries for the scale upwardly of voluntary medical male circumcision (VMMC), and VMMC being listed in the country's current prevention strategy Zimbabwe.

By 2018, Zimbabwe aimed to reach i.3 million men with VMMC (80% of 13-29 yr olds)60 By 2017, 89% of this target had been reached, and in 2018 around 326,000 men underwent VMMC. This means that, although accelerated, the number of men undergoing VMMC is all the same below target.61 62

Access to VMMC is irregular between regions due to the limited number of wellness facilities oﬀering the intervention. People'southward awareness of the link between VMMC and HIV prevention is also relatively depression. As a effect, some areas are already at saturation level for VMMC among the main target age group (fifteen to 29-twelvemonth-olds), while others very unlikely to see programmatic goals. Overall, in 2017 VMMC coverage amidst men aged fifteen-29 was 33%, 16% amongst men in their thirties and 12% in men aged 40 and over.63

A written report on how to encourage uptake amidst adolescents recommended promoting VMMC as an intelligent lifestyle choice rather than a medical intervention. Various youth campaigns on radio, social media and in schools, including celebrity endorsements, accept run to this eﬀect.64

Using football game to appoint adolescent men has also proven successful. A study conducted at 26 schools in Bulawayo, Zimbabwe, found that a soccer programme called Brand-The-Cut-Plus, more than than doubled the odds of service uptake.65

Pre-exposure prophylaxis (PrEP)

Zimbabwe is currently implementing ongoing demonstration and research projects to investigate the uptake and impact of pre-exposure prophylaxis (PrEP). PrEP uses antiretroviral drugs to protect HIV- negative people from HIV.

Zimbabwe'south electric current HIV prevention strategy lists priority populations for PrEP equally beingness adolescent girls and young women, sexual practice workers, men who accept sex with men, prisoners, truck drivers, sero- discordant couples, transgender people and women in relationships with men of unknown status.66

In 2018, effectually 4,900 people in Zimbabwe were accessing PrEP.67 Initially, PrEP was oﬀered through the DREAMS partnership, pregnant immature women and girls accept been the main beneﬁciaries.68 The key challenges for implementing PrEP in Zimbabwe relate to funding, identifying and like-minded on target populations and areas, and navigating existing limitations within health systems in relation to HIV services. In addition, the criminalisation and social exclusion of men who have sex with men and sex workers makes it diﬃcult for programmes to reach them, despite them being named as priority populations.69

One study examined the extent to which female sex workers in Zimbabwe are enlightened of, and using, PrEP. Around 61% of HIV negative sexual practice workers participating in the study had heard of PrEP, around 29% had been oﬀered it, and 16% were taking it. Those on PrEP were more probable to be older and were less likely to drink booze.70

Antiretroviral treatment (Art) availability in Zimbabwe

Republic of zimbabwe is one of the sub-Saharan African countries with the greatest access to antiretroviral handling (ART), with 88% of all people living with HIV on treatment.71

In 2016, the land adopted a 'care for all' policy towards Art, meaning all people should be started on treatment immediately, regardless of their CD4 count.72 Since 2016, betwixt 120,000 and 150,000 adults have initiated ART each year.73 In 2018, it was estimated that 93% of all adult women living with HIV were on handling compared to 83% of men.74 In 2016, the well-nigh recent data bachelor, 67% of all women living with HIV were virally suppressed, compared to 67% of HIV positive men.75

Zimbabwe is currently scaling upward viral load testing. The expansion was made possible as a result of South African negotiations with Roche – a leading producer of viral load testing platforms. They managed to concord a maximum price of Us$ 9.40 per viral load test, making viral load tests more than aﬀordable for low and eye income countries.76

Notwithstanding, monetary issues, weak infrastructure and capacity challenges means viral load testing is far from routine, and existing facilities are mostly located in cities.77 In 2017, effectually 431,300 people received a viral load test 78, equivalent to around 40% of people on treatment that twelvemonth.79

In 2018, 76% of children (0-14 years) living with HIV had admission to ART.eighty Information technology is hoped the introduction of specialised ARV pellets for children being piloted by Zimbabwe will increase treatment coverage for this age grouping further.81

A study of around 300 HIV-positive children in Republic of zimbabwe found a tertiary were being prescribed incorrect doses of at to the lowest degree one component in their ART regimen due to the diversity of the children's body weights. However, those with admission to a ﬁxed-dose combination (FDC) antiretroviral (ARV) were less probable to accept been given an incorrect dose. This highlights the importance of monitoring children'due south weight during HIV care to ensure their treatment is eﬀective and their risk of developing drug resistant HIV is reduced. Information technology also suggests access to FDC ARVs should be improved for children.82

The proportion of people retained in intendance after 12 months is relatively good in Zimbabwe, standing at between 85% and 90% since 2011 (the 12 calendar month retention charge per unit was 87% in 2018).83 Both men and women have comparable HIV treatment retentiveness rates, however children, adolescents and young people are less likely to stay in care.84

Drug resistant HIV is an outcome in Republic of zimbabwe. In 2018, the Earth Health Arrangement found levels of pre-treatment HIV drug resistance to a higher place 10% among those initiating ﬁrst-line Art.85

CASE STUDY: Helping young positive adolescents in Zimbabwe stay in care

Zimbabwe has successfully introduced customs adolescent treatment supporters (CATS) to assist adolescents living with HIV stay in care. CATS are volunteer counsellors aged betwixt 18 and 24 who are HIV positive themselves. They provide a range of peer support to others to help them outset and stay in handling.

A 12-month trial was conducted in Gokwe South commune to assess the CATS' impact among 10 to xv-year-olds living with HIV. Around 100 teenagers were enrolled in the trial, one-half received standard HIV care and half received standard care plus CATS services.

Those in contact with CATS were found to be 3.9 times more likely to adhere to handling compared to the control group. The intervention group also reported a signiﬁcant increase in conﬁdence, self-esteem, self-worth and quality of life, compared with a decrease in the control grouping.86

"Seeing people I have helped, getting ameliorate, motivated me…through the preparation I received, I realised that one tin live a normal life and pursue dreams of selection just like anyone else." – Thabiso, 22, a CAT from Binga, Zimbabwe87

HELP US HELP OTHERS

Avert.org is helping to prevent the spread of HIV and meliorate sexual wellness by giving people trusted, upward-to date information.

We provide all this for Free, merely information technology takes time and money to keep Avert.org going. Can y'all support us and protect our future?

Every contribution helps, no matter how small.

Delight DONATE NOW

Civil society's part in Zimbabwe

In Zimbabwe, the long-standing ruling party Zanu-PF and civil society organisations (CSOs) in the state, peculiarly those working on human rights and governance issues, have had an adversarial human relationship, imbued with common mistrust.88

The government continues to constrain the eﬀorts of many CSOs. For instance, the government tin can restrict speciﬁc CSO activities if accounted contrary to 'national security', has criminalised activities relating to the promotion of LGBT rights, and limits the type of activities not-local CSOs can engage in if they receive foreign funding. Such hostile regulations mean many 'controversial', rights-based organisations cease to be, rebrand, or switch to less sensitive work.89

The ousting of President Mugabe by military coup in November 2017 has seen civil society farther at threat. The elections in 2018, which returned the ruling Zanu-PF party, did little to resolve this. In 2019, CIVICUS described the country's attack on civil social club every bit "systematic", reporting that CSOs beyond the land were facing an increase in surveillance, abductions, arbitrary arrests and detention. Nether the Public Gild and Security Act, the work of many CSOs that back up and protect

vulnerable groups are now criminalised. Republic of zimbabwe'southward state-controlled media has also spread anti-CSO letters and a number of ceremonious society activists have been arrested, some of whom take been charged with oﬀences designed to criminalise homo rights piece of work.90 91

HIV and tuberculosis (TB) in Zimbabwe

Tuberculosis (TB) remains a major issue for people living with HIV in Zimbabwe, with the country ranked in the summit thirty loftier brunt TB countries by the World Health Arrangement.92 In 2017, 63% of people in TB intendance were HIV positive. Although the incidence of TB in Republic of zimbabwe has increased dramatically in recent years, TB remains the most mutual crusade of decease for people living with HIV.93 In 2017, vi,300 people with HIV died of a TB-related illness, although this is an improvement from 2010 when 11,000 TB-related deaths amongst HIV positive people occurred.94 In 2017, 23,000 people living with HIV adult active TB, although coinfection rates are falling. 95 In 2014, around 15% of people newly enrolled in HIV intendance had active TB, compared to 0.5% in 2018. Simply 11% of people living with HIV began TB preventative therapy in 2017.96

Barriers to the HIV response in Zimbabwe

Social and cultural barriers

The prolonged economic crisis facing Zimbabwe has seen resulted in many people being unemployed or working informally. Effectually half dozen million are estimated to work in Zimbabwe's informal sector, including roadside stallholders, miners and sex activity workers. Their line of work means they are unable to claim social welfare or qualify for wellness insurance schemes, making treatment access diﬃcult. Many are too unable to visit health clinics equally they cannot aﬀord time oﬀ work.97

Gender-based violence (GBV) persists in Zimbabwe. Survey results from 2015 found 39% of women and 33% of men thought a married man was justiﬁed in beating his wife for at least one of the following reasons: burning the food, leaving the firm without telling him, arguing with him, neglecting the children or refusing sex with him. 98 GBV is closely linked to inability to negotiate prophylactic use, and greater vulnerability to HIV. In 2015, around one in ﬁve women who had ever been married or partnered (aged 15–49 years) had experienced physical or sexual violence from a male intimate partner in the past 12 months.99

Polygamous relationships are commonplace in Zimbabwe. According to 2011 data, twenty% of those in such a human relationship were living with HIV, compared to sixteen% of those in a monogamous human relationship.100 Even so, a new national survey in 2015 did not include data on this.

Legal and data drove barriers

The illegal nature of sex piece of work and homosexuality presents huge barriers for these populations in accessing HIV services to have care of their wellness. It also means that the country is unaware of the demographics of people living with HIV, pregnant targeted prevention, testing and treatment services are impossible. If people who are living with HIV cannot access handling to prevent onwards transmission, this allows HIV to continue as a public health effect.

Stigma and discrimination

Stigma and bigotry towards people living with HIV in Zimbabwe remains rife – with one study ﬁnding that 65% of people living with HIV had experienced some form of discrimination due to their HIV status.101

Survey information from 2015 plant 22% of women and 20% of men who were aware of HIV had discriminatory attitudes towards people living with HIV. Around half dozen% of women and 9% of men did not call up children living with HIV should be allowed to attend school with children who are HIV negative. Additionally, xix% of women and 16% of men would non purchase fresh vegetables from a shopkeeper with HIV.102

The eﬀects of stigma are far reaching. Around 40% of sex workers questioned said they avert healthcare due to stigma and bigotry.103 Around 6% of people living with HIV study being denied some form of healthcare due to their positive status.104

All the same the most current information

Funding for the HIV response in Republic of zimbabwe

The Zimbabwean government collects an AIDS levy, made upward of 3% payee and corporate tax, which contributes to Zimbabwe's domestic share of funding for the HIV response.105

Even so, in 2017, roughly two-thirds of Zimbabwe's HIV response was however funded by international donors. Domestic funds contributed effectually The states$127 meg compared to US$289 million from international contributions, totalling United states$417 million. The biggest funder of the country's HIV response is the Global Fund to Fight AIDS, Tuberculosis and Malaria, followed by PEPFAR.106

The future of HIV in Republic of zimbabwe

Prevention of mother-to-child transmission (PMTCT) services are proving successful, and this eﬀort must exist maintained in order to terminate child infections.

Without information on HIV among key population groups, such as men who have sex with men, there is petty bear witness to inform prevention interventions or how to encourage people to use HIV services.

The fact that in that location is no statutory requirement to enforce data reporting past all sectors too hampers monitoring and evaluation107, as does continued, persistent bigotry and criminalisation of men who have sexual activity with men and others from the LGBT community.

Although improving, HIV education and knowledge is still lacking, specially for immature people. This is peculiarly important where patriarchy, gender inequality, polygamous relationships and intergenerational relationships persist.

The diminishing international funding for the HIV response too poses a threat to Zimbabwe's progress on HIV, particularly in relation to HIV prevention.

- 1. UNAIDS 'AIDSinfo' (accessed October 2019)
  2. Zimbabwe National AIDS Council (2017) 'Zimbabwe HIV and AIDS Strategy for the Informal Economy 2017-2020', p.15.[pdf]
  3. UNAIDS 'AIDSinfo' (accessed October 2019)
  4. UNAIDS 'AIDSinfo' (accessed Oct 2019)
  5. UNAIDS 'AIDSinfo' (accessed October 2019)
  6. Ibid.
  7. Republic of zimbabwe National Statistics Agency (2016) 'Zimbabwe Demographic and Wellness Survey 2015' [pdf]
  8. Zimbabwe National Statistics Agency (2016) 'Zimbabwe Demographic and Wellness Survey 2015' [pdf]
  9. Republic of zimbabwe National Statistics Bureau (2016) 'Zimbabwe Demographic and Health Survey 2015'[pdf]

10. UNAIDS (2019) 'UNAIDS Data 2019', 72-73. [pdf]

Ministry of Health and Child Intendance Zimbabwe (2019) 'Zimbabwe Population-Based HIV Bear on Assessment (ZIMPHIA) 2015-2016', p.97. [pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
Ministry of Wellness and Child Intendance Zimbabwe (2019) 'Zimbabwe Population-Based HIV Touch on Assessment (ZIMPHIA) 2015-2016', p.91. [pdf]
Ibid.
Zimbabwe National Statistics Bureau (2016) 'Zimbabwe Demographic and Health Survey 2015' [pdf]

xvi. UNAIDS (2019) 'UNAIDS Information 2019', 72-73. [pdf]

UNAIDS 'AIDSinfo' (accessed Oct 2019)
Ministry of Health and Child Care Republic of zimbabwe (2018) 'Global AIDS Response Progress Report 2018', p.fifteen. [pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
Busza, J et al. (2017) 'Expert news for sex activity workers in Zimbabwe: how a courtroom social club improved safety in the absence of decriminalization', Journal of the International AIDS Society, Volume twenty, Issue one, 21860.
Maseko, S, and Ndlovo, South, (2012) 'Condoms every bit evidence: police force, sex workers and condom conﬁscation in Zimbabwe'
Busza, J et al. (2017) 'Good news for sexual practice workers in Zimbabwe: how a court order improved safety in the absence of decriminalization', Journal of the International AIDS Society, Volume 20, Issue 1, 21860.
Busza, J et al. (2017) 'Good news for sex activity workers in Zimbabwe: how a court order improved safety in the absence of decriminalization', Journal of the International AIDS Guild, Volume 20, Issue 1, 21860.
Ibid.
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS 'AIDSinfo' (accessed October 2019)
Ibid.
Republic of zimbabwe Ministry of Health (2016) 'GARPR Republic of zimbabwe Land Progress Written report 2016'[pdf]
Ministry of Health and Kid Intendance Zimbabwe (2019) 'Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2015-2016', p.9. [pdf]
Ministry of Wellness and Kid Care Zimbabwe (2019) 'Zimbabwe Population-Based HIV Touch on Assessment (ZIMPHIA) 2015-2016', p.48. [pdf]
UNAIDS (2017) 'Addressing a bullheaded spot in the response to HIV — Reaching out to men and boys' [pdf]
Hensen B, Taoka S, Lewis JJ, Weiss HA, Hargreaves J. (2014) 'Systematic review of strategies to increase men's HIV-testing in sub-Saharan Africa' AIDS, Volume 28, Effect 14, p.2133–45.
PSI (2017) 'HIV Self-Testing Africa STAR Initiative' [pdf]
UNAIDS 'AIDSinfo' (accessed Oct 2019)
Zimbabwe Ministry of Health (2016) 'GARPR Zimbabwe Country Progress Report 2016' [pdf]
Government of Zimbabwe (2017) 'Extended Zimbabwe National HIV and AIDS Strategic Plan (ZNASP) 2015-2020' [pdf]
Zimbabwe Ministry of Health (2016) 'GARPR Zimbabwe Country Progress Report 2016'[pdf]
Ministry of Wellness and Child Intendance Republic of zimbabwe (2018) 'Global AIDS Response Progress Report 2018', p.14. [pdf]
Republic of zimbabwe National Statistics Agency (2015) 'Zimbabwe Demographic and Health Survey 2015: Central Indicators' [pdf]
Zimbabwe National AIDS Council (2017) 'Zimbabwe HIV and AIDS Strategy for the Breezy Economic system 2017-2020', p.18. [pdf]
Zimbabwe National Statistics Agency (2015) 'Republic of zimbabwe Demographic and Wellness Survey 2015: Key Indicators' [pdf]
Zimbabwe National Statistics Agency (2015) 'Zimbabwe Demographic and Health Survey 2015: Key Indicators' [pdf]

44. UNAIDS (2019) 'UNAIDS Data 2019', 72-73. [pdf]

Ministry of Health and Child Intendance Zimbabwe (2019) 'Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2015-2016', p.88. [pdf]
Muchabaiwa L, Mbonigaba J (2019) 'Touch of the adolescent and youth sexual and reproductive wellness strategy on service utilisation and health outcomes in Zimbabwe', PLoS One, Volume 14, Issue 6, e0218588.
Ministry of Health, Zimbabwe (2017) 'Comprehensive Sexuality Education and Life Skills: Zimbabwe's Experiences [presentation slides]'
Zimbabwe Ministry of Health and Child Care (201) 'Comprehensive Sexuality Education (CSE) For Out of School Young People in Zimbabwe' [pdf]
Republic of zimbabwe Ministry of Wellness (2016) 'GARPR Zimbabwe Country Progress Report 2016' [pdf]
Republic of zimbabwe Ministry building of Health (2014) 'GARPR Zimbabwe Country Progress Report 2014' [pdf]
Regime of Zimbabwe (2017) 'Extended Zimbabwe National HIV and AIDS Strategic Plan (ZNASP) 2015-2020', p. 14. [pdf]
Republic of zimbabwe National Statistics Agency (2015) 'Republic of zimbabwe Demographic and Health Survey

2015: Central Indicators' [pdf]

Zimbabwe Ministry building of Wellness (2016) 'GARPR Zimbabwe Country Progress Report 2016' [pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS 'AIDSinfo' (accessed Oct 2019)
Zimbabwe Ministry of Wellness (2016) 'GARPR Zimbabwe Country Progress Report 2016
Ministry of Health and Child Care Zimbabwe (2018) 'Global AIDS Response Progress Report 2018', p.12.[pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS 'AIDSinfo' (accessed October 2019)
Government of Zimbabwe (2017) 'Extended Zimbabwe National HIV and AIDS Strategic Plan (ZNASP) 2015-2020', p. 36. [pdf]
Ministry of Health and Child Intendance Republic of zimbabwe (2018) 'Global AIDS Response Progress Report 2018', p.14. [pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
Government of Republic of zimbabwe (2017) 'Extended Zimbabwe National HIV and AIDS Strategic Plan (ZNASP) 2015-2020', p. 36. [pdf]
Hatzold, K et al (2014) 'Barriers and motivators to voluntary medical male person circumcision uptake among diﬀerent age groups of men in Republic of zimbabwe: Results from a mixed methods report', PLOS ONE, Volume nine, Consequence 5, e85051.
Kaufman ZA, DeCelles J, Bhauti K, Hershow BB, Weiss HA, Chaibva C et al. (2016) 'A sport- based intervention to increase uptake of voluntary medical male circumcision amongst adolescent male students: results from the MCUTS 2 cluster-randomized trial in Bulawayo, Zimbabwe.', Book 72 Result 4, S292-viii.
Government of Zimbabwe (2017) 'Extended Zimbabwe National HIV and AIDS Strategic Programme (ZNASP) 2015-2020', p. 38. [pdf]

67. UNAIDS (2019) 'UNAIDS Data 2019', 72-73. [pdf]

Ibid.
Government of Zimbabwe (2017) 'Extended Zimbabwe National HIV and AIDS Strategic Plan (ZNASP) 2015-2020', p. 38. [pdf]
E, Fearon et al. (2019) 'How Tin can Programs Meliorate Support Female Sex Workers to Avoid HIV Infection in Zimbabwe? A Prevention Cascade Assay', Periodical of Acquired Immune Deﬁciency Syndrome, Volume 81, Consequence ane, p.24-35.
UNAIDS 'AIDSinfo' (accessed October 2019)
Ministry of Health and Child Care (2016) 'Guidelines for Antiretroviral Therapy for the Prevention and Treatment of HIV in Zimbabwe' [pdf]
UNAIDS 'AIDSinfo' (accessed Oct 2019)
UNAIDS 'AIDSinfo' (accessed October 2019)
Ibid.
UNAIDS (2017) 'Ending AIDS: Progress towards the xc–xc–xc targets' [pdf]
Roberts T, Cohn J, Bonner G et al. (2016) 'Scale-up of routine viral load testing in resource- poor settings: electric current and hereafter implementation challenges', Clinical Infectious Diseases, Volume 62, p.1043–48.
Ministry building of Health and Kid Care Republic of zimbabwe (2018) 'Global AIDS Response Progress Written report 2018', p.10.[pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS (2017) 'Catastrophe AIDS: Progress towards the xc–90–xc targets' [pdf]
Dakshina, Due south et al. (2019) 'Evaluation of weight-based prescription of antiretroviral therapy in children', HIV Medication, Volume 20, Upshot 3, p.248-253.
UNAIDS 'AIDSinfo' (accessed October 2019)
Regime of Zimbabwe (2017) 'Extended Republic of zimbabwe National HIV and AIDS Strategic Programme (ZNASP) 2015-2020', p. 47/48. [pdf]
WHO (2019) 'HIV drug resistance report 2019', p.ii.
Willis, N et al. (2019) 'Eﬀectiveness of community adolescent treatment supporters (CATS) interventions in improving linkage and retention in care, adherence to ART and psychosocial well-existence: a randomised trial among adolescents living with HIV in rural Republic of zimbabwe.', BMC Public Health, Volume 19, Result 1, p117.
UNICEF (23 January, 2019) 'Young people transforming the lives of adolescents living with HIV in Zimbabwe' (accessed October 2019)
Grace Chikoto-Schultz, M. and Uzochukwu, K. (2016) 'Governing Civil Guild in Nigeria and Zimbabwe: A Question of Policy Process and Non-State Actors' Involvement', Nonproﬁt Policy Forum, Volume 2, Result 2.
ibid
CIVCUS (25 June 2019) 'Borough space and fundamental freedoms in Zimbabwe' (accessed October 2019)
CIVCUS (6 Baronial 2018) 'SADC should urge respect of the rule of law in Zimbabwe'south post- elections crisis' (accessed October 2019)
WHO (2018) 'Global Tuberculosis Control Report 2018' [pdf]
WHO (2018) 'Global Tuberculosis Control Report 2018', p.230 [pdf]
UNAIDS 'AIDSinfo' (accessed October 2019)
UNAIDS 'AIDSinfo' (accessed Oct 2019)
UNAIDS 'AIDSinfo' (accessed Oct 2019)
Zimbabwe National AIDS Council (2017) 'Zimbabwe HIV and AIDS Strategy for the Informal Economy 2017-2020', p.viii. [pdf]
Republic of zimbabwe National Statistics Agency (2016) 'Republic of zimbabwe Demographic and Health Survey 2015' [pdf]

99. UNAIDS (2019) 'UNAIDS Data 2019', 72-73. [pdf]

Republic of zimbabwe National Statistics Agency (2012) 'Republic of zimbabwe Demographic and Health Survey 2010-11'[pdf]
Republic of zimbabwe National Network of People Living with HIV (2014) 'Zimbabwe Stigma Index Research Report' [pdf]
Zimbabwe National Statistics Bureau (2016) 'Republic of zimbabwe Demographic and Health Survey 2015' [pdf]

103. UNAIDS (2019) 'UNAIDS Data 2019', 72-73. [pdf]

Ibid.
Zimbabwe Ministry of Health (2014) 'GARPR Zimbabwe Country Progress Written report 2014'[pdf]

106. UNAIDS (2019) 'UNAIDS Data 2019', 72-73. [pdf]

107. Zimbabwe Ministry building of Health (2016) 'GARPR Zimbabwe Land Progress Report 2016'[pdf]

Last full review: 31 March 2020 Next full review: 31 March 2023

Source Credit: Avoid

weaverwittlaspis.blogspot.com

Source: https://www.zach.org.zw/hiv-aids-in-zimbabwe/