The Sunday Mail
Shamiso Yikoniko in Chipinge
At the peak of the HIV scourge in Zimbabwe, Chipinge was riddled with a high incidence of HIV and Aids, along with Victoria Falls and Beitbridge.
In 1993, a study found that HIV prevalence on commercial farms in Chipinge was between 13,7 and 36 percent while in 1996, research found that in Chiredzi in the Lowveld, the average prevalence rate for HIV infection was 47 percent.
At the onset of the epidemic, the most affected demographic was the educated and mobile elite. However, the demographics of those most at risk of infection have shifted to the poor, the young and women.
With interventions by Government and its partners, things are changing for the better and Chipinge is realising a decrease in HIV infections.
In 2009, Chipinge district recorded an HIV positivity rate of 22 percent that dropped to 8,4 percent in 2014.
Positivity rate refers to the number of individuals testing positive as a proportion of the number tested.
More so, sexually transmitted infection cases also realised a plunge. In 2009, the district recorded 6 669 cases, which fell to 5 419 the following year.
National Aids Council district Aids co-ordinator Mr London Makwanya said the Chipinge community now has a general understanding of HIV and how to manage it.
“The Government and several partners have worked tirelessly to realise the decline in the HIV prevalence in Chipinge. Several awareness campaigns have been held in the workplaces, schools and the community at large educating people about the pandemic,” he said.
“However, a milestone has been realised though there is still a fraction of people failing to accept their HIV statuses.”
For 2015, NAC decentralised funding to allow districts and provinces to cater for their specific needs.
Chipinge got between US$70 000 and US$80 000 to provide for prevention issues on the social side, while the Ministry of Health and Child Care takes care of the medical side of HIV.
Chipinge district administrator Mr Edgars Seenza said: “The HIV situation in the district has greatly improved due to the fact that most people are now aware of the signs and symptoms of the disease and how they can protect themselves from contracting.”
Colonisation, urbanisation and industrialisation have fundamentally transformed the dynamics of sexual relations in rural Zimbabwe over the past century.
These factors created a complex set of social conditions such as forced male migrant labour, land expropriation, rural poverty and structural inequalities in the market economy.
That in turn led to new patterns of sexual behaviour and family dynamics that subsequently increased vulnerability to the disease.
According to NAC and the Health Ministry, the key drivers that have contributed to the country’s explosive epidemic include poverty, low economic and social status of women, the prevalence of other sexually transmitted diseases and multiple sexual relationships.
Inconsistent use of condoms, the complexity of settlement patterns and mobility, forced migration and low levels of male circumcision are the other major drivers.
However, some traditional practices, stigma and lack of male involvement have been noted as holding back a major decline of HIV prevalence in the district.
“Strong traditional belief is a cross-cutting issue in the prevention, treatment and care of HIV making it difficult for programmers to break through the cultural barriers,” said Mr Makwanya.
“Male involvement has been literally absent due to some cultural aspects
and other reasons leaving women vulnerable with no support from their partners.
“Those at high risk of HIV aren’t accessing health services in the communities that they live in due to the high levels of stigma and discrimination.”
One common cultural belief in the district, which exposes women to HIV, is the use of intra-vaginal irritants that are said to enhance sexual experiences.
This practice, known as dry sex, is predicated on the cultural belief that vaginal fluids are dirty and disease-carrying, while a dry vagina is considered a clean environment and an essential part of female hygiene.
As a result, women traumatise their private parts with battery acid, bleach, salt water, tobacco or fertiliser to tighten their vaginal walls with scar tissue that increases friction.
Traditional Medical Practitioners’ Council of Zimbabwe Manicaland chair Mr James Gabaza said changing such mindsets was no walk in the park.
“Although there is debate about how common this practice is, what is evident is that changing this particular practice will not be an easy task because it challenges traditional gender roles and ethno-medical beliefs about personal hygiene,” he said.
“In addition, due to the fact people here strongly believe in witchcraft – even if one is diagnosed with HIV, they will always believe that somehow witchcraft has something to do with the ailing of their relative.”
Health Ministry’s director for Aids and TB Dr Owen Mugurungi said they are mandated to carry out awareness campaigns despite different communities’ beliefs.
“Our mandate as a ministry is to engage the communities and teach them about the key drivers of HIV. We can never prescribe to communities what to and not do,” he said.
Data suggests that the epidemic is significantly worse in rural communities, especially among women in commercial farming areas and around growth points.
“In Zimbabwe, farming communities have a higher prevalence rate of HIV than any other community and since Chipinge is largely a farming constituency, HIV positivity rate is generally high,” added Mr Makwanya.
Manicaland province – where Chipinge is located – has the highest provincial prevalence rate in Zimbabwe.
Zimbabwe is among 22 countries with the highest burden of HIV.
Government estimates that 1,3 million people are living with HIV, of which 600 000 are on the ART programme, 187 000 of them being children below 15-years-old.
Zimbabwe’s HIV prevalence is 15 percent.
