Men’s participation in HIV prevention: A matter of concern in Zimbabwe

Tafadzwa Mwanengureni

In 2018, Precious Marwa*(36) lost her husband to an HIV-related illness after he fell sick for less than a month.

Marwa, a mother of two, does not know if her husband defaulted on his Antiretroviral therapy (ARVs) or not, or whether he was on the treatment at all.

She believes her late husband tested HIV+ without her knowledge and failed to disclose his status, until he fell sick in January 2018.  Marwa accompanied him to a clinic where her husband of three years tested HIV positive.

“I suppose he knew his status when we started staying together in 2016. It seems like he used to take the treatment secretly because when he tested HIV+, it didn’t surprise him,” she said.

“Two weeks after testing HIV positive, he died.

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“I suspect, he defaulted, but l wonder why he stopped the treatment. Soon after l gave birth to my child, l went to stay in Bindura my maternal home and l was called less than a month before he died.”

According to Marwa, they were advised to come for post-test counselling, but her husband refused her company.

He went alone and was given some pills and review date. He however died before the review date.

In Zimbabwe, many men still chose not to be open about their status to their wives, after contracting HIV because of infidelity. Many also fail to comply ARV treatment schedules.

Men’s involvement in HIV prevention has been mainly affected by masculinity norms, which among other things encourages multiple sexual partners as a status symbol.

Marwa’s husband had a wife and some extra marital affairs with different women, prior to their union.

So, she suspects that he contracted HIV before they started living together since they didn’t get tested prior to their marriage.

But, she is grateful that she didn’t contract HIV. She is still negative.

In many settings men hardly seek healthcare services. In many cases women find out about their status first, which sometimes leads to them being blamed for bringing HIV into the marriage.

Women regularly visit health centres for antenatal care, where their status is checked.

Some men determine their HIV status based on their partner’s status, which is not encouraged because some couples are discordant.

Marwa shares almost the same story with Jasmine Chonzi* (42), who is in a discordant marriage since 2010.

Hers is a story of resilience.

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Her husband married another wife and after five years in polygamy, her husband and the co-wife were diagonised with HIV.

“I suspect he contracted the disease from his girlfriends because they were many.  Those days no women could pass by his sight. We tried to advise him but he would turn a deaf ear,” she said.

“First, it was the other wife who was diagnosed after a long illness. My husband was in denial and rejected medication but in 2014 he got sick and almost died. That’s when he went on medication,” said Jasmine.

In many cases men get tested for HIV or start to take medication when they get severely ill.

The history of HIV in Zimbabwe dates back to 1985, and in 2002 the country introduced ARVs.

 However, some men still live in denial while many others do not inform their partners of their status, exposing them to HIV without their knowledge.

Jasmine’s husband case correlates with the story of a Muslim pastor (Iman) Abdullah Chiponda (40) (pictured), who decided to take medication, seven years after being diagonised.

He tested HIV+ in 2007 and started taking ARVs in 2013 after he contracted tuberculosis.

“By then, l was living alone and l did not get a proper counselling since I was tested during an outreach drive. l think the staff was more concerned about how many clients they tested than how effective the post counselling was,” he said.

“So l found it hard to accept my status. l was also confused about how would start a new way of life, since I was HIV positive”.

“In 2013 I started my ARVs after l contracted tuberculosis and in 2021 l decided to come out to the public about my status. I had noticed that there was a low involvement of males in complimenting efforts to curb the new infections, re-infections and mortality rate in HIV related,” said Chiponda.

Zimbabwe introduced the use of condoms in 1990, but there are many people still indulging in unprotected sex.

Some of the main hotspots for HIV in Zimbabwe include mining areas and boarders among others.

Decent Moyo, a communications officer at AIDS Counselling Trust (ACT) said there is a need to address some gender norms in communities which limit men’s involvement in the prevention of HIV.

“Generally men do not show up to seek medical attention, not only for HIV but generally health seeking behavior is poor. In one of our sessions a man said gate rechipatara rinongoita kunge gate rejeri (a clinic is like a jail),” Moyo said.

“We have to try fight myths like the fact that most men believe that sweet rinodyirwa mubepa harinake these myths hinder the practice of safer sex, so there is greater need for awareness.”

Jerry Tozivaripi, chairperson for Zimbabwe National Men Living with HIV(ZNM+), a male oriented organisation which amplifies men voices in the HIV prevention said there is a need to come up with convincing strategies that can mobilise more men on board in the fight against the disease.

“Cultural beliefs hardened men to not easily hurry to take things and harden their hearts like bulls of wild animals,” Tozivaripi said.

 He called for more activities that can mobilise men to attend and participate in the prevention.

“I suggest that their plans should include tactics which can attract men for example visits even places favoured like beer halls or come up with something like the braai to draw their attention,” said Tozivaripi.

Moyo concurred with Tozivaripi’s suggestion saying that stakeholders should target areas where men gather most.

“Because men don’t like going to clinics but if the clinic go to them, it would go a long way”, said Moyo.

In an effort to mobilize more men, ACT has implemented a project called gender norms transformation.

“With that also, we have been promoting the provision of youth friendly services. These have helped young men and youth to feel confident and safe when seeking for help,” said Moyo.

In a National HIV and AIDS Strategic Plan (2021-2025), National AIDS Council (NAC) raised concerns that HIV and AIDS prevention and treatment interventions have mostly focused on women and girls because of their vulnerability. Men have received considerably less attention in the epidemic and receive less targeted HIV prevention and treatment programs.

 Zimbabwe is among the three countries that were recorded to have achieved the UNAIDS 95-95-95 target of ending HIV by 2030.

95-95-95 means 95% of the people who are living with HIV knowing their HIV status, 95% of the people who know that they are living with HIV being are on lifesaving antiretroviral treatment, and 95% of people who are on treatment being virally suppressed.

However, Chiponda believes that the country still has a long way to go to increase male involvement since stakeholders prioritise women in HIV programmes.

“We have a lot of men who have a torrid time in accepting their statuses, factors being unprofessional testing post counselling, stigma from society and work places, punitive sermons from pulpits regarding people living with HIV,” Chiponda said.

“For the past years, HIV awareness programs were mainly dominated by women living the bread half backed, so it’s high time male involvement should be appreciated and supporting male champions especially from the grassroots level (especially rural folks)”.

After his opening up in 2021, Chiponda said he has witnessed a number of men turning up to him for counselling which he offers freely since he believes that its a gift.

“From experience, l found out that by being open about my status and seeing me comfortable with it, having an undetectable viral load and sharing my journey with them does a half job of my counselling session. By the time we start talking it becomes easier for them to have self-acceptance,” Chiponda said.

“For the record, am not a trained (qualified) counsellor, but through passion and coming out l have managed to save many souls who were confused and at the verge of taking their lives.”

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