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Studies on HIV prevalence in Zimbabwe have found that communities that practice polygamy tend to have lower rates of HIV infection compared to other settings, reported <a href="https://healthtimes.co.zw/2024/07/03/polygamous-communities-have-lowest-hiv-burden-in-zimbabwe/">Health Times</a>.
Polygamy refers to the practice of one man being married to multiple women at the same time.
In Zimbabwe, the HIV response emphasizes the importance of individuals limiting themselves to one sexual partner, as having multiple concurrent partners significantly increases the risk of HIV infection.
While numerous studies conducted across Sub-Saharan Africa have found that the practice of polygamy is associated with an increased risk of new HIV infections, some research also suggests that certain cultural practices observed within polygamous settings may play a role in regulating sexual behaviour and potentially mitigating HIV transmission in these communities.
Mashonaland West Province, for example, is a high HIV burden province in Zimbabwe with an estimated population of 1,245,000 and an estimated 143,000 people living with HIV from its seven administrative districts.
Interestingly, Kariba District, which is known for having a higher prevalence of polygamous marriages, has the lowest HIV prevalence rates in the province.
Davison Mamombe, the National AIDS Council Programs Officer for Mashonaland West Province revealed that Kariba, despite being a polygamous community, has the lowest HIV and Sexually Transmitted Infections (STIs) burden in the province. He said:
<blockquote>
In terms of the highest disease burden, Mhondoro Ngezi has the highest HIV burden in the province at 14.3% followed by Chegutu at 13.7% then Zvimba, at 12.6%, Makonde at 12%, Hurungwe at 11.06% and Kariba has 9%.
Kariba becomes unique in the sense that we have people who have strong cultural roots and those people practice polygamy.
However for an outsider to penetrate their circles, it becomes a challenge so because of that, HIV prevalence in those communities is very low including sexually transmitted infections.
</blockquote>
In Matabeleland North province, Tsholotsho District has the highest HIV prevalence at 21.9% while Binga, also a highly polygamous community has the lowest HIV prevalence at 5.3%.
In a previous interview with the <a href="https://www.chronicle.co.zw/why-binga-has-low-hiv-prevalence/">Chronicle</a>, Amon Mpofu, the National AIDS Council’s (NAC) national director of monitoring and evaluation, highlighted that the Tonga people in Binga had valuable insights to share about how their cultural practices and beliefs have contributed to a lower HIV prevalence in their community compared to other regions in the country. He said:
<blockquote>
HIV is a sexually transmitted disease as we all know and this means Tonga values are strong and as a result, the transmission is low. They also have strong values when it comes to marriage. They avoid casual sex and value marriage, something which we should all emulate.
</blockquote>
However, National AIDS Council Chief Executive Officer, Dr Benard Madzima said polygamy was not the factor behind the low HIV prevalence in communities where polygamy is prevalent. He said:
<blockquote>
Maybe the protective factor is not necessarily polygamy. The prevalence might be low but to attribute it to polygamy that’s where my question is.
</blockquote>
More: <a href="https://www.pindula.co.zw/">Pindula News</a>

Pindula News

Polygamous Communities In Zimbabwe Have Lower HIV Infection Rates

The Government is set to withdraw a clause in the Criminal Laws Amendment (Protection of Children and Young Persons) Bill that lists wilful HIV/AIDS transmission to a partner as a criminal offence.
The Bill, which is currently before Parliament, listed HIV/AIDS as one of the sexually transmitted infections (STIs), whose deliberate transmission to a partner is a criminal offence. Others include syphilis, gonorrhoea and herpes, reported <a href="https://www.herald.co.zw/govt-withdraws-wilful-hiv-transmission-from-bill/">The Herald</a>.
The Criminal Laws Amendment Bill also sets out to raise the minimum age of sexual consent from 16 to 18.
The Bill sought to re-criminalise deliberate HIV/AIDS transmission even though the Marriages Act had decriminalised wilful HIV/AIDS transmission.
Justice, Legal and Parliamentary Affairs Minister, Ziyambi Ziyambi, said that prosecution under the Criminal Laws Amendment (Protection of Children and Young Persons) Bill should only apply when deliberate transmission of HIV/AIDS is done in aggravating circumstances such as rape and other sexual offences involving young persons.
Ziyambi made the remarks while contributing to a debate on the Bill in the National Assembly last week. He said:
<blockquote>
The way it is couched in the Bill is not correct. The policy direction from the Executive was, that if you sleep with a young person and you have been convicted, it becomes an aggravating factor if you have wilfully transmitted an STI to that particular young person.
The assumption that we are coming from is, that young persons are not sexually active and it is not very difficult to prove once you have been convicted.
Medical reports are there to prove that the young person contracted HIV and STIs and it should be an aggravating factor in sentencing.
We are going to change this so that it does not appear like we have generally reintroduced the clause that we repealed the last time when we brought the Marriages Act.
It is very difficult to prove and worldwide studies have shown that criminalising does not reduce transmission levels.
</blockquote>
He added that several discordant couples can stay for years, “the other one not seroconverting”. Said Ziyambi:
<blockquote>
So, if we say we are criminalising, we are saying, perchance, if you manage to contract, you are a criminal, but that one who has not contracted and nothing has happened, we say ‘they are okay’; there is discrimination, scientifically it does not mean that if people sleep together, automatically they will have HIV.
So I want to take it to agree that it is a law that is very difficult to implement, hence the reason why the Executive, the last time when we had the Marriages Act, agreed with the submissions from those within the Ministry of Health and Child Care that we need to repeal it.
We now have an assumption that we have a case where somebody has been arrested for sleeping with a young person and medical reports are there that there has been an infection.
Those reports will indicate whether that particular young person was sexually active or not, and there we are saying it becomes an aggravating factor if you have infected that particular young person with STIs and HIV.
Therefore, that particular clause will be amended accordingly and hence we will be bringing those amendments.
</blockquote>
The chairperson of the health and childcare portfolio committee, Daniel Molokele, who is also Hwange Central MP (CCC), said:
<blockquote>
This bad law was repealed because it is not possible socially and legally to prove who, in a particular relationship, was infected first with HIV.
Over the years, many countries have repealed this bad law and Zimbabwe was one of the last countries to repeal this law.
Women are the ones who have been prosecuted under this law and it has been difficult to prove that they committed a criminal offence because we all know that in this country, women are the ones who have health-seeking behaviour; they are the ones who are willing to do HIV tests.
Most men in this country are scared to do an HIV test. They are less scared of lions and other wild animals than having an HIV test.
I can dare a man in this Parliament to have an HIV test in public and you see the reaction. Most of them will look for the nearest exit door.
</blockquote>
More: <a href="https://www.pindula.co.zw/">Pindula News</a>

Govt Withdraws Wilful HIV Transmission Clause From Bill

Zimbabwe has introduced Cabotegravir long-acting (CAB-LA), an injectable pre-exposure prophylaxis drug, to add to the HIV prevention regime in the country.
The drug is an antiretroviral (ARV) designed to suppress any infection as it occurs. It is administered to HIV-negative people who have a high risk of becoming infected with the virus.
CAB-LA is the third pre-exposure prophylaxis (PrEP) product to be introduced in demonstration sites under a study for catalysing access to new prevention products to stop HIV (CATALYST). The other two are the dapivirine ring and oral PrEP as HIV prevention choices for women.
<a href="https://www.herald.co.zw/zimbabwe-introduces-injectable-hiv-drug/">The Herald</a> reported the HIV prevention clinical officer in the Ministry of Health and Child Care’s AIDS and TB Programme, Dr Idah Moyo, as saying Zimbabweans could now access the injectable PrEP at the 15 demonstration sites.
She was speaking at a health communicators forum in Harare on Wednesday, 10 April. Said Moyo:
<blockquote>
CAB-LA is a long-term injection for pre-exposure prophylaxis that is meant to prevent the acquisition of HIV for people who are HIV-negative and are at substantial risk of acquiring HIV.
Since it is meant to prevent HIV in people who are at substantial risk, this intervention will be implemented in the demonstration sites which means we will get learning insights from those sites and that will inform the country in the rollout of the CAB-LA in the whole country.
</blockquote>
Moyo emphasized that healthcare providers should empower clients visiting the sites with knowledge.
This knowledge enables them to make informed choices from the available PrEP products.
Clients are encouraged to select a relevant and appropriate method based on their individual needs, preferences, and lifestyles.
The Medicines Control Authority of Zimbabwe (MCAZ) approved the use of the dapivirine ring in 2021.
Then in 2022, MCAZ approved CAB-LA, making Zimbabwe the first country in Sub-Saharan Africa to approve the product.
Moyo asserted that CAB-LA will be used together with other prevention methods like condoms as it does not protect anyone from contracting STIs and getting pregnant. She said:
<blockquote>
CAB-LA is an ARV which reduces the ability of HIV to replicate itself. Whilst research findings are there, the country still wants to learn more through the demonstration projects, so the learning will inform the rollout.
The healthcare providers in these 15 selected sites have been capacitated on CAB-LA so that after the implementation and demonstration projects, we learn from those to facilitate the rollout in the country. The injection is only administered by clinicians.
</blockquote>
Eligible individuals to access PrEP serodiscordant couples (where one partner is HIV negative), adolescent girls and young women, and pregnant and lactating women in relationships with men whose status is unknown, are HIV positive or have an unsuppressed viral load.
PrEP is also available for people who use and inject drugs, key populations like sex workers, high-risk men, and the transgender among others.
More: <a href="https://www.pindula.co.zw/">Pindula News</a>

Zimbabwe Introduces Injectable ARV For HIV-negative People

The fishing camps dotted around Lake Kariba and have become hotspots for fish for sex which involves sex workers trading sex for fish.
This was said by National Aids Council (NAC) chief executive Bernard Madzima on Monday.
<a href="https://www.newsday.co.zw/local-news/article/200010025/kariba-fishermen-in-sex-for-fish-trade">NewsDay</a> reported Madzima as saying the sex for fish trade was hampering efforts to reduce the prevalence of HIV and AIDS in Zimbabwe.
Madzima noted that prostitution in fishing camps was leading to a new wave of HIV infections as well as sexually-transmitted infections. He said:
<blockquote>
In Kariba, fisheries have been identified as hotspots where there is rampant trade of fish for sex.
There is a new phenomenon where sex workers now cohabit with male fishermen in exchange for fish.
As an organisation, we have trained 10 female peer sex workers and 10 male peer fishermen to conduct HIV and AIDS peer education and condom distribution in Kariba where this issue is rampant.
</blockquote>
Some of the fishing camps affected by the sex-for-fish practice include Gatshe Gatshe, Ndomo, Musamba, Muchenga in Kariba and Kalulwe, Simatelele and Chibuyu in Binga.
Last year, Zimbabwe became the first African country to approve injectable pre-exposure prophylaxis (PrEP) medicine to help reduce the rate of new infections.
PrEP is for people who don’t have HIV and are at risk of getting HIV from sex or injection drug use.
According to CDC, injectable PrEP with CAB is highly effective at protecting patients from HIV and is for adults and adolescents who weigh at least 35 kg and are at risk of getting HIV through sex.
The US Embassy in Zimbabwe said that in 2020, 1.23 million adults in Zimbabwe were living with HIV. This constituted 12.9 percent of the adult population.
More: <a href="https://zero.pindula.co.zw/">Pindula News</a>

Lake Kariba A Hotspot For Fish For Sex Trade - NAC

A new HIV drug, <a href="https://www.pindula.co.zw/Sunlenca">Sunlenca</a> (Lenacapavir), is now available, but awaiting approval by the Government.
The drug is taken twice a year by people with multi-drug-resistant HIV Type One.
It is administered through injections once every six months and has recently been approved in the United States.
The Director of Aids and Tuberculosis in the Ministry of Health and Child Care, Dr. Owen Mugurungi said they welcomed the development. He said:
<blockquote>
We welcome such developments as they greatly improve adherence to treatment.
You will find out that daily intake of ARVs or any other drugs is associated with defaulting as pill fatigue grows for some people.
There are also cases of people missing doses so the development of drugs that are taken a few times will greatly improve adherence.
</blockquote>
In November 2022, the <a href="https://www.pindula.co.zw/Medicines_Control_Authority_of_Zimbabwe">Medicines Control Authority of Zimbabwe</a> (MCAZ) approved the use of a long-acting injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis for HIV prevention.
However, last week, MCAZ warned against the use and sale of Gammora, a drug from abroad as a treatment for HIV saying they have not approved its use in Zimbabwe.
It was initially claimed that clinical trials performed had shown that Gammora could eliminate 99 percent of HIV within the first four weeks of treatment. | <a href="https://www.sundaynews.co.zw/twice-a-year-hiv-drug-on-the-cards/">The Sunday News</a>

New HIV Drug, Sunlenca, Awaits Govt Approval

Nearly 5 000 babies were infected with HIV in 2021 due to the mothers’ unwillingness to get antiretroviral therapy during pregnancy and breastfeeding.
Addressing journalists at a National Aids Council media training workshop in Chinhoyi on Friday, Ministry of Health and Child Care (MoHCC) Deputy PMTCT and Paediatric HIV Care and Treatment Coordinator, Dr Precious Andifasi said 4 750 babies got infected during pregnancy and breastfeeding last year alone. She said:
<blockquote>
As a program, we collect some data every year just to try and see where the new infections are coming from. So, for 2021, we had about 4 785 new infections. So, these are babies that had HIV transmitted from their mothers.
</blockquote>
Fundira said during pregnancy, 1 345 women did not receive Antiretroviral therapy, and 445 during pregnancy and this resulted in babies getting infected.
She said stigma, discrimination and denial are some of the barriers to accessing PMTCT services. She said:
<blockquote>
Another one of our interventions is to keep the women who are negative, negative. If we look at the barriers to accessing PMTCT services, we can see that stigma, discrimination and denial are significant barriers.
Stigma around people still thinking that HIV only infects those who are immoral or sexually deviant. That they must not be doing something right.
Denial. Not accepting the risk of contracting HIV applies to them. And also shunning those who are infected or perceived to be at risk.
</blockquote>
Fundira added that as part of their initiatives to prevent the transmission of HIV from mothers to their children, they are testing every six months if the mother is seroconverted.
She also said 46 percent of those who tested positive in Ante Natal Clinics were adolescent girls and young women under 30. | <a href="https://healthtimes.co.zw/2022/11/02/5-000-zimbabwean-babies-infected-with-hiv-in-2021-as-mothers-shun-pmtct/">Health Times</a>

5 000 Zimbabwean Babies Infected With HIV In 2021

Zimbabwe has become the first African country to approve the use of long-acting injectable, Cabotegravir (CAB-LA), a pre-exposure prophylaxis (Prep) dose for HIV prevention.
The Medicines Control Authority of Zimbabwe (MCAZ) on Monday announced the approval of the use of the drug.
According to the World Health Organisation (WHO), “CAB-LA may be offered to people at substantial risk of HIV acquisition as part of comprehensive HIV prevention approaches”.
CAB-LA injections are to be taken every two months and studies have shown that they are highly effective in reducing the risk of HIV acquisition among homosexual men, transgender, and cisgender women.
Community Working Group on Health (CWGH) executive director Itai Rusike applauded the move to approve the use of the drug in Zimbabwe. He said:
<blockquote>
Prep dramatically reduces the risk of HIV acquisition for women as well as men.
We are aware that for more than a decade, WHO has recommended that pregnant and breastfeeding women at risk of HIV should be offered Prep.
The people of Zimbabwe should embrace this new development in order to reduce the risk of HIV infection.
</blockquote>
Development Agenda for Girls and Women in Africa Network representative Nyasha Sithole said “this will contribute to our basket of HIV prevention tools that work for us as girls and women in Zimbabwe”. | <a href="https://www.newsday.co.zw/local-news/article/200002248/zim-pilots-new-hiv-drug">NewsDay</a>

Zimbabwe Becomes First African Country To Approve Use Of New HIV Drug

Lupane men believe traditional sex enhancement supplements are fuelling new HIV infections as they make men hyperactive, at the same inhibiting their reasoning capacity.
The came out during a National Aids Council (NAC) brother-to-brother session at Ndamuleni village in Lupane.
NAC embarked on the brother-to-brother programme to engage men on HIV related issues.
Speaking during the session, Ndamuleni headman Philani Ncube said imbiza/isgubhu (traditional sex enhancement supplements) increases men’s libido, causing them to desire intimacy “all the time”. He said:
<blockquote>
Isgubhu makes a man visible in the bedroom, it actually gives them existence all the time.
Men of today do not understand that isgubhu was used by our forefathers because they had many wives whom they had to satisfy.
They just drink it while they have one wife, resulting in them sleeping around because women cannot stand the roughness that comes with it. Therefore, the spread of HIV is more likely.
</blockquote>
Another participant, Mdibhisi Dube said some men use isgubhu to cover up for cheating so that their partners don’t become suspicious. He said:
<blockquote>
When I go out with my side women and I do not want my wife to find out, I will drink isgubhu.
Once I drink it, I will still have the usual or more energy even if I’ve used some on someone.
With isgubhu, a condom will surely break, it comes with too much energy and roughness, thus leading to the spread of HIV.
</blockquote>
Ignitious Sibanda said isgubhu tends to make men reckless and may not use protection under its influence. Said Sibanda:
<blockquote>
These things tend to make hormones overcome someone’s thinking capacity and the chances of one thinking about protection are very slim.
Isgubhu pushes them to do whatever satisfies the body at that moment. The assumption is that the supplements actually boost a man’s confidence and help them earn respect.
It has killed the nation because a man who uses imbiza is not safe from HIV.
</blockquote>
Village head Siqalekiso Sibanda said the traditional sex enhancement supplements should be banned or at least men should be made aware of the side effects.
<h4>More: <a href="https://www.chronicle.co.zw/sex-enhancement-supplements-fueling-hiv/">Chronicle</a></h4>

Traditional Sex Enhancement Supplements Fuelling HIV

A United Nations Report claimed that 740 000 young women in Zimbabwe are living with HIV, the third highest figure in the SADC region.
This was revealed in a UNAIDS HIV and Women report released this week. The report further said that South Africa tops the list with 4.4 million followed by Mozambique at 1.3 million.
Young women are those whose ages fall between the ages of 15-24.
The report attributed the high numbers to the existence of high levels of transactional sex and age-disparity sexual relationships that are blamed for the HIV vulnerability of young women. The report says in part:
<blockquote>An estimated 740,000 women were living with HIV in Zimbabwe in 2017.
Gender inequality is present within relationships and marriages and drives HIV infections.
Although knowledge among young people is improving, only 37% of young women and 41% of young men have comprehensive and correct knowledge of HIV prevention.
Only 46% of young women and 47% of young men have comprehensive knowledge about HIV, limiting their ability to take control of their sexual health.
… In addition, only 29% of adolescent women (aged 15-19), at high risk of HIV infection used a condom the last time they had sex, compared to 44% of their male counterparts.</blockquote>
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<h4>More: <a href="https://www.newzimbabwe.com/close-to-a-million-young-women-living-with-hiv-in-zimbabwe/">NewZimbabwe.com</a></h4>

740 000 Young Zim Women Are HIV-positive - UN Report

Latest statistics from the National Aids Council have revealed that <a href="http://www.pindula.co.zw/Kwekwe">Kwekwe</a> district had the highest number of HIV-positive people in the <a href="http://www.pindula.co.zw/Midlands_Province">Midlands province</a> during the first quarter of this year.
Of the 9 482 people tested positive during a voluntary HIV testing programme in the province, Kwekwe had 2 115 people, followed by Gweru with 1 732, Gokwe South (1 582), Zvishavane (1 204), while Mberengwa, Shurugwi, Gokwe North and Chirumanzu had 980, 745, 646 and 478, respectively.
The figures also showed that 1 429 out of 23 014 pregnant women tested HIV positive.
More: <a href="https://www.newsday.co.zw/2016/10/20/kwekwe-recorded-highest-hiv-positive-people-midlands/">NewsDay</a>

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