Online Reporter
Robin Muchetu, [email protected]
FOR 12-year-old Ayanda Dube from Magwegwe suburb in Bulawayo, access to life-saving HIV medication depends on her elderly grandmother. At 72, and unaware of the child’s HIV status, she is unable to ensure that Ayanda takes her antiretroviral drugs (ARVs).
This situation reflects a growing concern in the city, where many children who depend on caregivers for treatment are failing to get the support they need. As a result, progress in paediatric antiretroviral therapy (ART) is being affected.
Recent figures show that only 91 percent of children living with HIV in Bulawayo know their status, 97 percent are on treatment, and just 90 percent have achieved viral suppression. These numbers fall short of the global targets set by UNAIDS, which aim for at least 95 percent in all three categories in the fight to end AIDS by 2030.
In response, the National Aids Council (NAC) is stepping up efforts to improve outcomes for children.
Primrose Dube, monitoring and evaluation officer for NAC in Bulawayo province, said several strategies are being introduced to address the challenges.
“As NAC we have set aside a budget specifically for paediatric ART where we are bringing in all partners that are implementing and working with paediatrics to map a way forward to come up with other strategies and other interventions that might help us.
“We also have treatment interest programmes that we are implementing within our six districts in the province. Initially these focused on PLWHIV in the adult age group. But now we have deliberate focus to say we bring in the adolescence and talk about issues that are affecting them,” she said.
NAC has also carried out research to better understand the challenges affecting children and adolescents on treatment. The findings will help guide future programmes and interventions.
“We are not doing so well in paediatrics, our children aged 0-14 years of age. We are all aware that these ones rely on their parents and their care givers (for access to medication).
“In the province only 91 percent know their status, of those with a status that is known, only 97 percent have been initiated on ART and ideally since they are relying on their parents and caregivers for their medication and their sustenance, we expect their viral suppression to be a bit high, but we are not doing so well where we have only 90 percent of them having a viral load that is suppressed,” she said.
“We see that there is need for us to continue with our efforts of ensuring that outcomes for paediatrics, our children living with HIV in the province and they receive HIV services and they are supported in adhering to their medication.”
Health experts say one of the major challenges is the type of medication available for children. Some paediatric ART formulations have an unpleasant taste, making it difficult for children to take them consistently. Others struggle because there are limited options for those who cannot swallow tablets.
Dube also highlighted concerns about new infections among young people, particularly adolescent girls and young women aged between 15 and 24, who are more at risk compared to their male counterparts.
“For our under 25 age group a total of 10 957 were tested and 256 tested positive with an overall positivity rate of approximately 2,8 percent. In the under 25 age group the highest positivity rate was in the 10 to 14 years.”
The council has also pointed to relationships between young women and older men as a possible driver of new infections.
“We have some tertiary institutions around the city, and when we spoke to adult men, they highlighted that they now have disposable income and they can now date younger women and we believe there is a relationship there, which leads to infections. But we are trying to talk to the girls and the men too so that they practice safer sex and always negotiate for safer sex always in these intergenerational sexual relationships,” said Dube.
Despite the challenges, Bulawayo still has the lowest HIV population in the country. As of February 2026, an estimated 80 320 people living with HIV are on treatment.
Of these, 78 533 are aged 15 and above, while 1 787 are children aged between zero and 14.
Most patients — 94 percent — are on first-line treatment, which is the most effective and affordable. About 5,6 percent are on second-line treatment, while 0,4 percent are on third-line treatment, which is more complex and costly.
For children like Ayanda, however, the statistics reflect a deeper human challenge — one that goes beyond numbers and requires stronger family support, awareness and care.
