Online Reporter
Sukulwenkosi Dube-Matutu
MS NOBUHLE Moyo* from Mangwe District, Matabeleland South Province, was diagnosed with HIV in 2023 and for two years she had to take her antiretroviral therapy (ART) treatment in secret out of fear of being victimised by her live-in lover.
She kept her status a secret and had to surreptitiously take her medication at her sister’s homestead so that her partner would not find out. This caused her to default on her medication on several occasions.
A resident Community Art Refill Group (CARG) leader working with staff from her local health facility had to continuously engage her to ensure that she adhered to her medication.
Moyo said she was only able to take her medication freely late last year after breaking up with her lover.
She feared that if she had disclosed her status to him he would have assaulted her or even chased her out of their home as he is a violent man.
Several programmes have been successfully rolled out by the Government and development partners to intensify the fight against HIV. Some of the initiatives have seen community members acting as ambassadors and cadres, playing a crucial role in influencing behaviour change.
This has helped to cascade HIV prevention programmes to grassroots level. Despite all these efforts, gender-based violence (GBV) has, however, remained a hindrance, causing setbacks in the implementation of such programmes.
Some HIV-positive women are defaulting on their antiretroviral therapy out of fear of being victimised by their husbands or lovers. Others have not disclosed their status to their partners out of fear. Some women also fear approaching their partners to suggest undergoing HIV tests, which puts both partners at risk of infection and reinfection.
Studies have shown that due to gender-based violence, some women have no say in sexual and reproductive health issues and prevention methods, such as using condoms, exposing themselves to HIV infection.
“In my HIV-positive journey, I had to hide my status from my partner because of fear. I feared that if he found out, he would beat me up or even chase me out of the house as he is violent. I didn’t know his status, and was afraid to ask him or suggest we go for testing,” Ms Moyo said.
“We at times used protection during intercourse, but sometimes he would refuse. I had to go to my sister’s homestead to take my medication because I feared that if I kept it at home he would see it and all hell would break loose,” she added. “I once suggested that we go for HIV testing and he went berserk. He demanded to know what I had done for me to suggest that.”
Moyo said her boyfriend made it clear that he would not be tested for HIV, especially after she told him. This made it difficult for her to adhere to treatment. Health staff and community cadres would check on her whenever she stopped taking her medication.
They always encouraged her to disclose her status to her partner or bring him to the health facility for testing but she could not do so because of fear.
Ms Samukeliso Nkomo, a Community Art Refill Group (CARG) leader attached to Ingwizi Clinic in Mangwe District, Matabeleland South, said she has come across several cases where women hide their status from their spouses out of fear.
“As a CARG leader, my duty is to work with the community to ensure that people adhere to their ART treatment. One challenge I have faced is that of women who take their treatment without their partner’s knowledge as they fear to disclose their status,” she said.
Ms Nkomo added that she had to follow up on Ms Moyo several times after she defaulted on her medication.
“It might come as a relief now that she is adhering to her treatment since she has separated with her partner but a gap still remains. Her partner needs to get tested so that he knows his status,” she said.
Ms Nkomo said their community has a number of married men living in either Botswana or South Africa while their partners have remained back home.
She said after spending almost a year apart, some of the men refuse to go for HIV testing or to use protection, thereby putting their wives at risk.
Ms Duduzile Ndlovu, a community health worker from Ntanye Village in Gwanda District said she recently had two cases where women fell critically ill after defaulting on their ART treatment. Both women kept their status a secret.
Ms Ndlovu pointed out that it becomes difficult to properly take medication if one is hiding their status.
“Some women whom I work with are hiding their status. The challenge is that when they have to take medication at a certain time, and the partner is at home, they end up deferring, which compromises their immune system,” she said.
Matabeleland South National Aids Council (NAC) manager, Mr Mgcini Sibanda, said after realising the gaps caused by gender-based violence in HIV prevention programmes, they incorporated communities.
Mr Sibanda said gender-based violence is not only affecting couples but young boys and girls as well, who are being victimised and violated sexually putting them at risk of HIV infection.
He said young girls were being victimised by their boyfriends, older men, strangers and even relatives.
Other key populations at risk are sex workers. Mr Sibanda said sometimes sex workers are victimised by clients who demand to have unprotected sex in order to get value for their money.
He said systems have been put in place to protect these key populations and to educate them on their rights.
“Gender-based violence is a factor when it comes to HIV prevention, especially when it comes to married couples. There are issues to do with cultural and social norms, where women are not expected to use condoms or any other prevention methods without the permission of their husbands.
“This exposes women because of fear of being assaulted by their husbands. That is why we have come with initiatives to involve traditional leaders to generate a narrative which says: no to gender-based violence. With a highly sensitised community, through involvement of traditional leaders, the issue of GBV can be addressed,” he said.
Mr Sibanda said addressing gender-based violence is crucial in the HIV prevention drive.
Zimbabwe has made remarkable progress in the fight against HIV, achieving and surpassing the global UNAids 95-95-95 targets. This means over 95 percent of people with HIV know their status, more than 95 percent of those diagnosed are on treatment and over 95 percent of those on treatment have achieved viral suppression.
This is a critical milestone towards ending Aids as a public health threat by 2030. New HIV infections have dropped by an estimated 80 percent between 2010 and 2025, and Aids-related deaths decreased by 78 percent in the same period.
Approximately 1,2 million people are on life-saving ART, with 97 percent of those on treatment achieving viral suppression, making the virus virtually untransmittable.
The Government’s institutionalisation of the National Aids Fund, financed by the Aids Levy (a three percent tax on income and corporate profits, has been instrumental in funding the national response and plugging gaps left by donor fluctuations. —@DubeMatutu
Bongani Ndlovu