Zimbabwe faces a public health challenge as young people manage relationships and prevention tools during an evolving HIV epidemic, balancing decades of clinical progress against shifting social perceptions.
Hard-Won Progress and Declining Infections
When Shaun Moyo started nursing at Parirenyatwa Hospital in Harare in the late 1990s, the human immunodeficiency virus epidemic filled hospital wards and made funerals a daily occurrence. UNAIDS data show that annual new HIV infections in the country fell from 79,000 in 2010 to 15,000 in 2023, according to Al Jazeera.
Antiretroviral treatment has transformed the lives of people living with HIV, while condoms, pre-exposure prophylaxis, and post-exposure prophylaxis provide multiple ways to prevent transmission. Yet public health advocates warn that these gains remain vulnerable. In September, Zimbabwean family physician Dr Misheck Ruwende warned in a public address on Twitter, followed online by Al Jazeera, that the country risked losing decades of progress despite having access to rapid testing and injectables.
Similar pressures persist across the region. South Africa, Zimbabwe’s neighbour, had an estimated 7.7 million people living with HIV in 2023, according to UNAIDS data cited by Al Jazeera. In Gauteng province, public health facilities treated 67,400 males for Male Urethritis Syndrome between April and December 2023 out of 167,109 total male attendees, with provincial data showing incidence rising from 12 percent in 2020 to 15 percent in 2023.
Shifting Perceptions Among Young People
Moyo, now a 48-year-old nurse working locum shifts at two major public hospitals in Harare, worries that some young people do not fully grasp the clinical risks because they did not witness the peak of the epidemic. She said that effective treatment has altered how some perceive the virus, removing the immediate fear it once carried.
Dr Linda-Gail Bekker, a South African HIV physician-scientist and co-author of a clinical trial examining the twice-yearly injectable prevention drug lenacapavir, argued that messaging must evolve beyond fear-based warnings. “Beating the old drum about the horrors of HIV, and shouting to youths about condoms is not necessarily going to cut it,” Bekker told Al Jazeera.
Funding pressures have added further operational hurdles. UNAIDS reported in March 2025 that disruptions to United States-funded HIV programmes in Zimbabwe impacted services for key populations, including testing, counselling, and pre-exposure prophylaxis access.
Decentralising Healthcare and Community Outreach
Health authorities are working to bring medical services directly to communities through decentralised screening, mobile healthcare trucks, and pop-up clinics. Dr Innocent Hove, Provincial Medical Officer for Harare Metropolitan Province, stated at an August meeting reported by Al Jazeera that addressing HIV among young people is an urgent priority, noting efforts to decentralize testing, treatment, and tuberculosis screening.
On the ground, peer educators are bridging the gap between formal health facilities and young populations. Angela Gutu, a 23-year-old peer educator working with local authorities and NGOs in Harare, organises pop-up health services at markets, transport hubs, and university campuses.
These initiatives allow young people to access self-testing kits and condoms without facing the stigma or intimidation sometimes encountered in traditional clinics. “It’s about speaking young people’s lingo, taking away the HIV stigma,” Gutu told Al Jazeera.
Medical Strategies Manage Viral Loads and Improve Access
- Prevention Options: Modern medical strategies include oral and injectable pre-exposure prophylaxis, post-exposure prophylaxis, and consistent barrier methods to block viral transmission.
- Managing Viral Load: Antiretroviral therapy suppresses the replication of the virus, turning a once-fatal condition into a manageable chronic disease while preventing onward transmission.
- Community Access: Mobile health clinics and self-testing kits reduce logistical barriers, making confidential screening more approachable for adolescents.
Clinical Trials and Regional Interventions
Recent clinical evaluations of long-acting antiretroviral agents have expanded pharmacological prevention options. In the trial’s primary analysis, none of the 2,134 women who received the active drug acquired HIV.
| Metric / Region | Historical Data (2010) | Recent Data (2023) |
|---|---|---|
| Annual New HIV Infections (Zimbabwe) | 79,000 | 15,000 |
| Infections, Ages 15–24 (Zimbabwe) | 27,000 | 4,400 |
| People Living with HIV (South Africa) | — | 7.7 million |
Youth Advocates Emphasize Using Prevention Tools
Bongani, who plans to volunteer as a peer educator through the health ministry’s programme in January, summarised the sentiment among youth advocates: “My generation was born with the best array of HIV prevention tools. It’ll be a tragedy if AIDS deaths make a dramatic comeback due to our reckless behaviours,” he said.
References
- UNAIDS.
- Al Jazeera. Zimbabwe’s HIV gains face a test among young people.
- Barbados Gazette. Zimbabwe’s HIV gains face a test among young people.
