2 weeks Ago By Staff Reporter
A micro planning pioneering programme by the National AIDS Council (NAC) in Mashonaland Central Province, in Zimbabwe is yielding remarkable results in lowering the rate of new HIV infections The model’s initiative focuses on sex workers with the aim of closing the new HIV infections tap. It also places importance on treatment adherence for those living with HIV. Mercy Mudhombo, the District AIDS Coordinator, (DAC) emphasized the importance of leaving no community behind.
“By scaling up initiatives, integrating economic empowerment, and strengthening partnerships and community-led programmes, we are seeing a significant decrease in new HIV infections. The National AIDS Council’s strategic plans and collaborations with government ministries and international partners are crucial in this fight,” said Mudhombo. “By focusing on sex workers, we have achieved a notable decline in HIV prevalence from 18% in 2017 to 11.
9% in Mazoe District in 2023. This success is attributed to enhanced awareness, prevention, and empowerment of sex workers to demand condom use. The national prevalence estimate is at 10,3%, while Bindura District is at 12.
54% and Shamva District at 12.17 prevalence. “Our district is mineral rich.
The Great Dyke runs through our province. It has all the minerals. Many districts in the province receive good rainfall and has vibrant farming activities,” said Mudhombo.
“Three-quarters of the district are farmers. We have diverse cultures from Malawi, Zambia, Mozambique and from various other countries. “With diverse cultures, for example, Chinamwari, a right of passage sees young girls as young as nine to 10 years initiated into womanhood.
A minor is taught how to please the man in bed. So, with many not going to school, the next stage is sexual activity. “Here in Mvurwi, Rosa, Glendale, Shamva, Mbire, Mazoe, and Concession, we have 15 micro-planning groups.
It is a peer-led programme. We train lead sisters who, in turn, go on to form a group of 25 at-risk women. The aim is for the HIV-negative to maintain their status.
“Centre for Sexual Health and HIV/AIDS Research (CeSSHAR) did the sampling and found 500 sex workers in Mvurwi. With the decentralized tobacco auction floors, the visiting sex workers see numbers fluctuate with the season,” said Mudhombo. “A micro planner educates her group for a full year.
She teaches them about HIV prevention, STIs, and unplanned pregnancies. For those who are HIV positive treatment adherence and protection from STIs. is pivotal.
“We do not work in silos. We work with partners. With DREAMS, a PEPFAR-funded project, we have young women selling sex.
Safety of key populations, (KP) condom distribution, HIV counselling, and screening is a shared responsibility. “We are seeing a reduction of sexual partners among KPs. For example, PANGEA comes in with PrEP exposure prophylaxis (PrEP) to prevent new HIV infections.
When we have condom stockouts, Population Services Health comes in. So our work is a collaborative effort. With new infections, known as incidence in 2023, estimated at 0,14% from 0,21% in 2018, the initiative is yielding good results.
HIV is a gender epidemic with more women than men infected,” said Mudhombo. The DAC said cultural norms were a barrier, too. “We are identifying men who have sex with men.
Currently, we have 54. But being conservative, they don’t come out. “Chief Makope is now the focal point person after we engaged him.
He is supportive, although it conflicts with some cultural aspects. He can not go back and say we have men having sex with men. The numbers are noticed when they fall sick and need Services.
No one is denied any health service due to sexual orientation,” she said. Underage girls can get STIs. They have no power to negotiate fpr safer sex.
“As NAC, we refer to social welfare. Sadly, the young girls’ numbers are overwhelming as the demand for rehabilitation outweighs the supply. We have STI hotspots like Suoguru.
It is a mapped hotspot. Mvurwi’s population sees an influx around March to July when the auction floors are open and shows high mobility. “The highly mobile females can come in the evening and leave by bus in the morning.
So we don’t initiate the moonlight clients as they are bound to be hard to follow up. We have challenges with artisanal miners. They are highly mobile.
They give false names. Asking for an ID is not helpful. The majority don’t have,” said Mudhombo.
Mudhombo called for understanding to shift the Chinamwari age group focus to girls above 16 or more “We engage the parents, and we are urging them to start the programme with girls aged 16 or above. Some of these cultures are very secretive so we can’t have evidence. At times the parents agree yet in principle, they continue,” said Mudhombo.
Mudhombo urged the sex workers to plan for the future. “Sex work has a time frame. We encourage them to buy and sell.
We encourage them to boil eggs and take to the bar to sell. Some have been married and stopped,” said Mudhombo. A micro planner for Rubber Stone Compound appreciated the training she got from the NAC programme.
“I have 24 members in my group. I identify those at high risk. I engage and educate, with the aim of reducing HIV infections.
After capacitating 25, they too will make a change in those they meet. Sex work keeps getting clients, so the following year, we get new clients into the cohort,” said the planner. “I no longer use paper trail, I now have a tablet given by NAC, I enter my data, and it is accessible to NAC.
This is making a positive change. “Our girls are empowered now. They know their rights.
They demand condom use, and no men can still do as they please. Our clients request that it is not automatic that I can be willing to give sex. I have a right to say no,” she said.
“A sex worker can be raped. We report such cases. It’s sad that some people think a sex worker can’t be raped,” she said.
Another senior sex worker who spoke on the condition of anonymity said she plans on retiring. “I am getting old. Young and fresh girls are now on the market.
I am investing in a livelihood project. I am willing to get settled. If you know one, I am ready to settle on a rural home,” she said.
With young girls under 16 engaging in sex work, the HIV estimates show the face of young woman getting more infections as compared to their male counterparts. ● Underage girls in sex work is a pressing concern that requires attention. ● Highly mobile populations.
Artisanal miners pose challenges due to their mobility. ● Cultural Practices. Initiation rituals like Chinamwari promote early sexual debut.
MOVING FORWARD To build on this success, there is a need to expand successful programmes and replicate effective initiatives. Address Cultural Practices by engaging with communities to change harmful practices. There is a need to increase rehabilitation services to support underage girls.
For the artisanal miners, there is a need to bridge the gap by bringing HIV prevention services to their workstations. The continued strengthening of collaborative partnerships will achieve more by covering more districts. This innovative approach demonstrates the power of community-led initiatives in combating HIV/AIDS.
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