Online Reporter
Theseus Shambare, Features Writer
STORIES of sex workers forced to improvise with baby socks in place of condoms recently made waves across the country. Whether fact or fiction, the tale captured the desperation of a community grappling with shortages of the most basic reproductive health supplies.
For Maria, a sex worker, those months were etched in fear.
“There were times when we did not have condoms or even the simplest of contraceptives. We were told to improvise. Some of us did. It was scary—you felt completely alone in protecting yourself,” she recalled.
Her experience reflects the human cost of contraceptive shortages. Sex workers remain disproportionately affected by HIV in Zimbabwe, with prevalence rates far higher than the national average of around 13 percent.
Studies by the National AIDS Council (NAC) and its partners have consistently shown that more than half of female sex workers in the country are living with HIV—past surveys put the figure at 56.4 percent overall, with more recent assessments in hotspot areas like Harare, Bulawayo, and Mazowe recording rates between 54 and 59 percent.
Age-specific data reveals a worrying trend: prevalence climbs from around 36 percent among young women aged 18 to 24, to over 77 percent among those above 40—underscoring how prolonged exposure and limited access to consistent protection compound their vulnerability.
But as International Contraception Day, marked on 26 September, approaches, Zimbabwe is turning the page—from desperation to hope. Government, civil society, and communities are beginning to restore both supplies and trust.
Supply restored, but questions remain
NAC has confirmed that Zimbabwe now has adequate stocks of condoms, dispelling fears of ongoing shortages that were worsened when USAID and other donors scaled down HIV prevention support.
“The country has sufficient stocks of condoms for now and into the foreseeable future. There were isolated reports of stock-outs early this year, but the situation is under control, with distribution to facilities well underway,” said NAC chief executive Dr Bernard Madzima.
The Ministry of Health and Child Care has since strengthened domestic procurement mechanisms. Non-Governmental Organisations (NGOs) like Springs of Life Zimbabwe (SLZ) continue to support last-mile distribution to sex workers and other marginalised populations.
“We are rolling out moonlight campaigns in various hotspots where sex workers frequent to ensure that they practise safe sex. To maintain our success in achieving the UNAIDS 95-95-95 targets, no one must be left behind.
“We act as a referral pathway—ensuring those living with HIV know their status, those diagnosed are on antiretroviral therapy (ART), and that pre-exposure prophylaxis is readily available for these marginalised groups at higher risk,” said Ms Precious Msindo, SLZ programmes director.
Experts warn that ensuring access to contraceptives is not simply a matter of stocking clinics. The deeper challenge lies in culture, religion, and gender norms that shape whether Zimbabweans actually use them.
Faith, culture and the contraception dilemma
Zimbabwe is overwhelmingly Christian, with apostolic sects commanding millions of followers. Religion is central to social life—and to decisions about fertility. In many apostolic churches, modern contraceptives are frowned upon. Fertility is seen as a blessing from God, and limiting births can be viewed as sinful. Some denominations promote abstinence or natural methods. Others encourage large families as proof of faith.
“Among Apostolic sects, women often face pressure to bear children without limits. This creates an environment where modern contraception is not just discouraged but actively resisted,” explained reproductive health specialist Dr Chiedza Nyathi.
In contrast, some mainstream churches and faith leaders are cautiously opening space for discussion. They acknowledge the health benefits of spacing births, preventing maternal deaths, and reducing adolescent pregnancies. Still, stigma remains a formidable barrier.
Gender and power: who decides?
Beyond religion, patriarchal norms often strip women of autonomy in reproductive choices. In many households, the decision to use contraceptives rests with men. Women may use them secretly, fearing accusations of infidelity or disrespect.
Research in rural Zimbabwe shows that women are sometimes expected to prove fertility immediately after marriage. Until the first child is born, contraceptives may be taboo.
“Without your husband’s approval, you can’t openly ask for family planning at the clinic. You may use it in secret, but if he finds out, there can be violence,” said Rudo, a 31-year-old mother from Chivi.
Such dynamics underline that access alone is not enough. Power and agency are equally important.
Adolescents: a silent crisis
Adolescents face the harshest barriers. Zimbabwe’s laws restrict access to reproductive health services for those under 16 without parental consent. In practice, this often leaves teenagers vulnerable—afraid to seek help from clinics and reliant on peers for misinformation.
The statistics are stark. Zimbabwe’s adolescent fertility rate is 90 births per 1,000 girls aged 15 to 19—among the highest in the region. Many of these pregnancies are unplanned, with life-altering consequences for education and economic prospects.
“Young girls fear being judged at clinics. Others believe myths—that contraceptives cause infertility or cancer. Until we address stigma and misinformation, contraceptives will remain underused, even when available,” said Dr Nyathi.
Myths and misconceptions
Common misconceptions continue to circulate. Some believe contraceptives reduce fertility permanently. Others argue that condoms encourage promiscuity. Family planning is sometimes viewed as only for married women. Such beliefs are reinforced by community gatekeepers—parents, elders, and sometimes even healthcare workers. NGOs and peer educators are working to correct these myths, but progress is uneven, especially in rural areas.
Zimbabwe’s reproductive health statistics paint a sobering picture. The contraceptive prevalence rate among women aged 15 to 49 stands at 62 percent, while the adolescent fertility rate is alarmingly high at 90 births per 1 000 girls aged 15 to 19. The maternal mortality rate remains a concern, with 462 deaths per 100 000 live births, according to the World Health
Organization (2022). Additionally, over 60 percent of sex workers rely on public distribution channels for access to condoms and contraceptives. These figures highlight the urgent need for consistent supply, comprehensive community education, and culturally sensitive engagement to ensure equitable access to reproductive health services.
A fragile balance
The withdrawal of donor support, particularly from USAID, exposed the fragility of Zimbabwe’s contraceptive programme. For years, free donor-supplied condoms underpinned HIV prevention. With declining external funding, the government now shoulders the burden of procurement.
“Donors are cutting back on HIV response support. As a result, individuals may need to start budgeting for condoms, moving away from reliance on free provisions,” said a NAC representative during a recent workshop with sex workers in Mazowe.
This shift raises equity concerns. Will the poorest—especially sex workers and adolescents—be left behind?
Signs of progress
Despite these challenges, there are encouraging signs. Stock-outs have declined. Peer education programmes have expanded. Youth-friendly clinics are reaching more adolescents. Ms Msindo emphasised that inclusion is key.
“Reproductive health is a right, not a privilege,” she said.
Maria herself has noticed a difference.
“I used to worry every night about protection. Now I feel safer. I can think about my future—not just surviving each day.”
Looking ahead
As Zimbabwe marks International Contraception Day, experts emphasise that the conversation must go beyond the availability of commodities.
“Contraception is about more than pills and condoms. It is about choice, dignity, and health. Every woman, every girl, every sex worker deserves that,” said Dr Nyathi.
For Maria, the day carries a message of hope.
“I want a life where I can decide when to have children. Where I can be safe every day. And where health services are there when I need them. That is what this day is about.”
*Name changed to protect identity.
