What’s driving Zim’s HIV/Aids prevalence rate?

One thing immediately struck us as we walked into the packed nightspot — the majority of the revellers were men.
In retrospect, I remembered that culturally Zimbabwean women hardly frequented nightclubs and those who do are labelled prostitutes.
I surveyed the dimly-lit room and noticed that at intervals of about five minutes or so several men took turns to chat with the women.
After a few drinks I decided to approach a female figure in a dark corner and we engaged in some idle talk.
Halfway through our discussion I asked how much she was charging for “services,” to which she replied “US$3 for a short stint”.
With or without protection, I inquired. “I don’t really mind,” she replied.
I became more inquisitive. “Are you not afraid of contracting Aids,” I  asked.
“We will all die some day,” she said. I excused myself to buy some drinks and never returned to the corner but instead collected my friend and left the club.
Zimbabwe exhibits a complex HIV and Aids paradox.
Seventy percent of the country’s estimated 1,3 million people infected with HIV are not aware of their status although nearly 100 percent of the population is aware of the grave dangers of the virus.
The country’s HIV and Aids prevalence rate is stabilising around 15,6 percent for the 15 to 49 age group but with so many “loose cannons” roaming the streets the fight against the pandemic remains a tough call.
Population Services International director for HIV services, Karin Hatzold, said people are still not keen to know their HIV status because of the stigma attached to the virus.
“But we are now focusing more on the benefits of knowing one’s status to fight the stigma. We are trying to send the message that even if you are HIV positive it’s not the end of the world and once you are aware of your status you have the chance of accessing drugs,” he said.
What is of major concern is the fact that “so many people are moving about with the disease because of fear of the unknown” said Douglas Gwatidzo, a Harare-based doctor.
Zimbabwe is still among the countries hardest hit by HIV and Aids and remains among nations with the worst HIV infection rates in sub-Saharan Africa.
According to Avert, an international Aids charity organisation, around one in seven adults are living with HIV and an estimated 565 adults and children become infected every day (roughly one person every three minutes).
The Zimbabwe National Aids Council said the principal mode of HIV transmission in the country is heterosexual contact, which accounts for an estimated 80-90 percent of all HIV infections.
The second mode of HIV transmission in Zimbabwe is prenatal transmission in which the mother passes HIV to the child during pregnancy, childbirth and breastfeeding.
A 2006 Zimbabwe Demographic Survey report pointed out that the future course of the country’s AIDS epidemic depends on a number of variables including levels of HIV and AIDS-related knowledge among the general population; social stigmatisation; risk behaviour modification; access to high-quality services for sexually transmitted infections; provision and uptake of HIV counseling and testing; and access to care and antiretroviral therapy, including prevention and treatment of opportunistic infections.
There is some consolation though.
Generally Zimbabweans are now aware of the dangers of HIV and Aids hence the interest in commercial sex workers is diminishing.
But some people living with HIV and Aids are concerned that prohibiting commercial sex in the country fuels the spread of the virus.
“We must call a spade a spade. There is a willing seller and willing buyer in this trade.
“The minute sex work is made legal the commercial sex workers are bound to go for HIV testing to protect themselves and their clients because sex work is economically driven in this country,” said Evelyn Mashamba who is living with HIV.
The country’s stringent policies on commercial sex work have fueled the development of the stigma against people living with HIV and this is greatly undermining health and creating barriers to safe sex, behavioural change and support.