HIV – NEWSSPACE

Collective efforts imperative to protect vulnerable members of the communities

**Dr Chidzewere Nzou, ZACH Programme Manager**

BY MUNYARADZI BLESSING DOMA

There is need for collective efforts in raising awareness, supporting survivors, and advocating for policy changes that protect the most vulnerable members of our communities, Zimbabwe Association of Church-Related Hospitals (ZACH), Programme Manager, Dr Chidzewere Nzou has said.

Dr Nzou revealed this during the Annual National Media Conference to publicise policy issues emerging from SASA (Start, Awareness, Support and Action) communities.

According to The HIV/AIDS Network; SASA is a methodology and approach designed by the Uganda-based organisation, Raising Voices, which works with women and children to explore the gender aspects of power and to address the link between violence against women (VAW) and HIV/AIDS.

“The SASA model’s success is rooted in its holistic approach to community engagement.

“By involving community leaders, activists, and institutions, we have created a movement against violent behaviour.

“Traditional leaders, including Chiefs and their spouses, have become vocal advocates for the SASA model, further amplifying our message and impact.

“This collective activism is crucial in creating environments that do not tolerate abuse and in fostering a culture of respect and equality,” said Dr Nzou.

He also revealed that the SASA initiative has shown “that change is possible when we work together, and we are confident that with your continued support, we can achieve even greater milestones.”

Dr Nzou further revealed that while the recent amendment of the Criminal Law Code which has now set the age of consent at 18 is a welcome move, more still needs to be done to protect adolescent girls and young women.

“We must continue to educate our communities about the benefits of these laws and work together to protect all members, especially the girl child.

“Let us raise our voices, break the silence, and ensure a safer future for everyone.

“Despite these legal advancements, there is a pressing need to educate minors and their guardians about the benefits of this law.

“Many adolescent girls continue to engage in sexual activities before turning 18, and some cultural beliefs still perpetuate the notion that sexually active girls must marry their perpetrators.

“To address this, it is crucial to raise awareness and aligning national laws with customary practices, ensuring comprehensive protection for all community members, in particular the girl child,” said Dr Nzou.

He also revealed that gender based violence remains a vice which needs collective efforts to eliminate.

Speaking at the same conference; Maxwell Hombiro said it was necessary to prioritise adolescent girls and young women (AGYW) for the SASA model because of their high vulnerability.

“AGYW are at a higher risk of HIV infection and gender-based violence due to biological, social, and economic factors.

”They often face intersecting challenges such as limited access to education, healthcare, and economic opportunities, which can exacerbate their vulnerability.

”Targeted programs can help prevent HIV and GBV by providing education, resources, and support, empowering AGYW to make informed decisions about their health and safety.

”Investing in the health and well-being of AGYW can have a long-term positive impact on communities, as healthier and empowered young women contribute to the social and economic development of their societies.

”By focusing on AGYW, we can address the root causes of their vulnerability and create a safer, healthier future for them and their communities,” said Hombiro.

Sokuluhle Dube also revealed that pregnant minors and adolescent mothers continue to face significant challenges, despite the existence of the Education Amendment Act of 2020, which gives a second chance to pregnant girls and adolescent mothers to continue their education.

“Communities believe the government should provide material support in such instances.

“Families may find it challenging to provide care for an additional child due to economic hardships, which may result in the adolescent mothers dropping out of school to fend for their child.

“Zimbabwe is a signatory to international and regional conventions like the UNCRC and ACRWC.

“These commitments validate the community’s perspective that the government should play a more active role in supporting pregnant girls and adolescent mothers, ensuring they have the resources needed to continue their education and secure a better future,” said Dube.

She also revealed that there was need for several policy recommendations in order to address some of the challenges which are currently being faced.

And amongst those issues which need to be addressed is review of age restrictions.

“Review of laws and policies that restrict access to Sexual Reproductive Health services (SRH) based on age.

“Ensure that adolescents can access these services without parental consent where appropriate

”Support Adolescent Mother: introduce social grants and programs specifically designed to support the well-being of adolescent mothers and their children.

”Integrate SGBV and HIV/AIDS Programs: enhance the collaboration between Sexual Gender-Based Violence (SGBV) and HIV/AIDS programs to provide holistic support to survivors.

“This should include joint training for healthcare providers and community workers on the intersection of SGBV and HIV/AIDS.

”Justice Sector Leadership in Awareness: key players in the justice services sector should lead efforts to raise awareness and educate communities about the consequences and effects of child sexual exploitation.

“They should also advise against promoting, aiding, or allowing child marriages,” added Dube.

“SASA changed my life”

BY MUNYARADZI BLESSING DOMA recently in Mbire

SASA; a programme designed by a Ugandan-based non-governmental organisation, Raising Voices, has proved its worth in Zimbabwe, as it had helped to reduce violence against women and HIV infections.

And to add it onto its benefit, the SASA (Start, Awareness, Support and Action) programme has also managed to change some people who revealed they used to be perpetrators of violence against their fellow community members.

These people revealed their appreciation of the SASA programme during a National AIDS Council Media Tour of Mashonaland Central.

According to The HIV/AIDS Network; SASA is a methodology and approach designed by the Uganda-based Raising Voices, which works with women and children to explore the gender aspects of power and to address the link between violence against women (VAW) and HIV/AIDS.

“SASA is a Kiswahili word for “now” and also serves as an acronym for the key components of the programme: Start, Awareness, Support and Action.

“The programme seeks to prevent VAW and HIV by changing the attitudes and behaviours that perpetuate power imbalances in relationships between men and women.”

Gladness Mwale, aged 23, from Mbire District in Ward 3 was full of praises for the SASA programme, as she was honest enough to reveal that she used to be violent.

“Ini SASA yakatondibatsira nekuti ndaitombovawo munhu wacho aitokonzeresa mhirizhonga.

“Ndaingoti kugumburiswa ndaibva ndatoita mhirizhonga. “Ndaingoti kungokanganiswa chete, ndaisazvitora zvakanaka, asi pavakanditora, vachindidzidzisa kuti unochinja; hunhu hwangu hwakabva hwachinja.

“Ndaiva munhu wekuti ndaiti ndikanzwa zvataurwa nezvangu ndainobvunza, asi pakubvunza ndipo paikonzereseka dzimwe nyaya dzaizonetsa. (SASA programme helped me personally because I used to be violent. Whenever I got angry, I would engage in violence but it took me to be trained that I saw that what I was doing was wrong.)

Mwale revealed that when she was introduced to the SASA programme she didn’t understand it before she got hooked, in a good way.

“As a member of this programme, we were taught that before you expect to change other people, you have to change first.

“So I’m happy I did that, I did self-introspection and knew what I had to change about my behaviour.

“We were taught about things to do with gender based violence and all its key drivers. So we started going to villages and spreading this word on SASA.

“I started in 2019 and this year in December I will be completing this programme. We go into villages teaching people so that they know all that is to know about GBV. Many people did not even know what SASA was all about, but it all changed and many people got to know about SASA and it impacted them positively.

“Many also got to be serious about getting tested for HIV and also to book pregnancies early and it also helped in many other aspects of maternal health,” said Mwale.

She added: “cases of GBV have lessened because SASA speaks against such issues, it really helped us. We also got to engage in many other income generating projects, this really helped us a lot.

“SASA also helped us especially as young women because we got to learn about many projects because we used to have issues with financial management.

“Before SASA, we really used to have issues in our marriages, like our husbands would just use all the money on things which they wanted not considering the family but we have been empowered also such that we now have our own income generating projects.

“We have goat projects which has really helped.”

She also revealed that as a result of SASA, women can now stand for their rights, they now understand that they can report either to the police or other women’s organisations.

Cases of young women who used to be abused and the perpetrators getting away with such crimes have also lessened said Mwale.

Holiday Banda, a 37-year-old man who is also helping to spread the SASA ‘gospel’ said the programme had also helped him in his marriage because they used to have numerous misunderstandings with his wife, but that had since changed.

Banda said at first he didn’t understand what this programme was all about till they were trained.

“There are groups and in each group there are 25 people and in a month we meet three times, first month we discuss about GBV.

“Then second month we discuss about power dynamics in the house, then lastly we talk about HIV and AIDS,” said Banda.

Chipo Jongoro, Katswe Sistahood Field Officer, revealed that the programme had four phases and along with NAC, they are implementing it in Mbire District five Wards 2, 3, 4, 11 and 12.

“In Ward 2 and 3, it is in the Action Phase, which is the last phase of the project where we are looking to say when the project is done, what shall happen, who will remain to see that the project continues.

“So we are working with several government departments, like Ministry of Youth, Ministry of Women Affairs, Ministry of Health and we are also working with traditional leaders, church leaders and youths and women who have influence in the community so that when the project they will continue to talk about GBV and HIV issues.

“Our main aim as SASA is we are looking at women and young women who are facing abuse, linking them to get health services or getting help when they want to get report issues,” said Jongoro.

Edgar Muzulu, Provincial Manager for NAC in Mashonaland Central, said GBV was one of our key drivers of HIV so they were making use of the SASA approach, which is a model meant to bring about transformation in terms of how people relate, how people view their own norms and values.

“So it is transformative in nature in terms of how people look at what is valuable and in terms of traditional practices.

“You will find out that traditionally in a setting like Shamva, there was actually valuing those traditions like chiramu, kugara nhaka and so forth, which were some of the causes how HIV spreads.

“So you will find that because of the education, it actually focuses on traditional leaders, influential leaders, religious leaders and the approach seeks to make people introspect and relook at how they are living and see which are the practices which are wrong, which are in the negative, which need to be addressed,” said Muzulu.

He added that with the SASA model, people are equipped with skills of trying to raise awareness amongst themselves and they are also given skills of how to respond, how to encourage each other to avoid such practices.

Muzulu further added that they had noticed some positive outcomes as a result of the SASA model which is currently being employed in Shamva, in Bindura District under the Global Fund and in Mbire District under a Social Contracting Arrangement.

And during the week long NAC Media Tour, journalists managed to see and hear how SASA had changed lives, testament that this Uganda borrowed initiative, can also work well in Zimbabwe.

Combination Prevention Approach proves effective in Mash Central

BY MUNYARADZI BLESSING DOMA in Mazowe

The Combination Prevention Approach being employed by the National AIDS Council (NAC) and other partners, has gone a long way in terms of reducing new HIV infections in Mashonaland Central Province.

The Province has a total burden of 111 000 people living with HIV, which translates to a 10,35 percent HIV prevalence and is currently on number five nationally.

It was also revealed that new infections used to be very high, but they have since reduced thanks to the Combination Prevention Approach.

According to the Pan American Health Organisation (PAHO), UNAIDS defines combination HIV prevention as rights-, evidence-, and community-based programs that promote a combination of biomedical, behavioural, and structural interventions designed to meet the HIV prevention needs of specific people and communities.

Speaking during a NAC media tour, Edgar Muzulu, Provincial Manager for NAC in Mashonaland Central said the province has eight districts, namely Mazowe, Bindura, Shamva, Mount Darwin, Rushinga, Muzarabani, Guruve and Mbire, where various responses to key drivers of HIV are being carried out.

Some of the key drivers in the province include gender based violence, traditional and religious practices, people with low risk perceptions about themselves and multi concurrent partnerships where there is low condom use.

“In response to these key drivers as a province; we have come up with interventions that are primarily preventative in nature, because our focus is more on prevention so we make use of what we call the Combination Prevention Approach.

“This is a cocktail of interventions or strategies that include Elimination of Mother to Child Transmission.

“Mother to child transmission is one of the major ways that transmission is taking place in our province because most women when they are pregnant, they miss out on getting on ART (anti-retroviral treatment) or in terms of taking the medication that prevents their unborn babies not to get infected.

“Then another intervention that we have when it comes to preventing these problems is the HIV Testing and Counselling Services; that is the entry point of everyone.

“Then we also have Behaviour Change Communication so that people are aware of risks and what ways they can use in terms of reducing risks in terms of new infections,” said Muzulu.

He added that another Combination Prevention Approach is the condom, which is a way of preventing new infections, a way of preventing of unwanted pregnancies and prevention of STIs.

“STIs are one of the major avenues through which people get HIV because if a person gets STIs, they have some wounds which become openings and become easier highways for HIV.

“Then as we do this Combination Prevention Approach; we make use of what we call models, these are community based interventions that are driven by what we call the peer led approach.

“Within each community, they identify each problem and come up with a model suitable to address those problems.

“For example we have gender based violence as one of our key drivers so you see that we make use of what we call the SASA (Start, Awareness, Support and Action) approach which is a model meant to bring about transformation in terms of how people relate, how people view their own norms and values.

“So it is transformative in nature in terms of how people look at what is valuable and in terms of traditional practices.

Muzulu further added that they had noticed some positive outcomes as result of the SASA model which is currently being employed in Shamva, in Bindura District under the Global Fund and in Mbire District under a Social Contracting Arrangement.

He also revealed that the Sista-2-Sista Model which is being implemented in Rushinga District under the Global Fund Grant and also from domestic resources, focuses on the adolescent girls and young women, mostly the 15 to 24 year olds.

“With the objective of equipping these young girls with skills of determination, with skills of resilience, skills of financial management, skills of knowing how to manage their own reproductive sexual health.

“In terms of other skills which will prevent them from getting pregnancies early in their lives and prolong getting married and empower them in terms of their livelihoods.

“So it’s a total package that empowers the young girls so that they are able to live and be able to avoid risk behaviours that can lead to them being infected.

“Then the DREAMS (Determined, Resilient, Empowered AIDS-free) Model, we learnt it from our partners, Zimbabwe Health Interventions (ZHI).

“This model also focuses on adolescent girls and young women to inculcate those virtues of determination, resilience, giving the girl child that confidence, so that they are able to realise their dreams. Determined, Resilient, Empowered, AIDS-free, mentored and safe girls.

“If they are mentored, if they are safe, if they are determined, if they are resilient, then they will realise their dreams.”

Muzulu further revealed that for all the models or strategies, they focus on people centeredness, which is why it is community rooted.

He also revealed that train selected volunteers who are known by their own peers so that they are given the skills and once they are given the skills through a trainer of trainers, they then come back to their communities and drive programmes.

Every year a cohort is recruited and they go through trainings from January to December and once they graduate they go back into the communities, while NAC then make follow ups to see if they are using the skills they would have acquired.

Some of the skills that we give them are economic generation programmes, which they are taught to be self-reliant, some do soap making, basket making, while some form groups and lend money to each other.

The Male Engagement is also another strategy whereby boys are engaged at an early stage so as to inculcate a sense of responsibility and a sense of working hard and sense of caring for others and a sense of not being reckless.

Asked why they carry out different interventions in different districts, Muzulu said: “the epidemic is not homogenous, what drives the epidemic in Mazowe is not what drives the epidemic in Muzarabani, so we do what we call problem identification together with stakeholders.

“And we do what we call ranking of problems and we do what we call prioritization. So when you come to Mazowe when they rank their problems, they can tell you that no, we want to focus on adolescents because this is our big problem.

“If you go to Mbire, they can tell you that focus on men because they are causing GBV (Gender Based Violence). So those are the issues now, so the epidemic is dynamic, it differs from one area to another accordingly.”

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Resilience in Action: Single Parents Living with HIV find empowerment through entrepreneurship

BY MUNYARADZI BLESSING DOMA

An organisation of single parents living with HIV is promoting self-reliance by engaging in several income generating activities for their wellbeing.

Not only that, the members also take care of some orphans by sending them to school and providing other needs.

Single Parent Movement for HIV and AIDS, co-founder Tariro Chigango, said they realised that self-reliance was their only hope as opposed to waiting for handouts.

Speaking at the ongoing Zimbabwe Agricultural Show, Chigango said though the journey hasn’t been easy since the organisation’s inception in 2008, they have remained resolute.

“We formed this organisation with Irene Kachinga and Hughs Masvosva in 2008. Our aim was to promote self-reliance to single parents who are living with HIV and AIDS.

“We realised that because of the numerous challenges facing single women and men living with HIV, we had to think of ways to make ends meet.

“We are into different contemporary work; some are into beads, some are into farming and as for me I’m into batik, I’m into printed batik.

“There are several income generating projects which our members are engaged in so that we earn a living for ourselves and children.

“We have so many members and we have since lost count because when there was Covid-19, we had some of our people move to other areas around the country.

“You will find out that we have some in Mount Darwin, some in Guruve, some here in Harare and other places. We have members in many provinces,” said Chigango.

She added that apart from selling various products, the organisation is also involved in training women and school children in various income generating skills.

“They (those who wish to be trained) come to our offices in Harare at the National Art Gallery and there is also an option to be trained at home or anywhere where they feel comfortable with.

“We are doing all this because we want to remain empowered, we do not want to be a charity case,” she added.

Chigango however revealed that it hasn’t been easy, as they have faced numerous challenges, which have threatened their operations.

“It has been difficult for us, especially when it comes to funding, that has been really difficult for us.

“We could do more but unfortunately funding has been the major challenge. Lack of funding has also been a major challenge because others who wanted to get into such projects have also failed to do so.

“We are also facing a challenge of having our own working place so that we can work freely from there and we can do more.”

Despite the challenges they face, Chigango said they have remained hopeful as they have managed to make big strides in other people’s lives.

They have managed to send some orphaned children to school, something which gives them a cheer and the resolve to do more.

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Getting an HIV vaccine remains necessary

BY MUNYARADZI BLESSING DOMA

While other biomedical prevention methods have been found to be effective, an HIV vaccine remains necessary as it offers long lasting protection and eliminates the stigma associated with treatment, among other benefits, a recent media science café has heard.

During the media science café organised by the Health Communicators Forum of Zimbabwe, Dr Muchaneta Bhondai-Mhuri, Investigator of Record at the University of Zimbabwe Clinical Trials Research Centre (UZ-CTRC), said while past trials have seen an HIV vaccine remain elusive, every study has provided new information necessary for this endeavor.

According to the National Institute of Health, “a preventative HIV vaccine is given to people who do not have HIV, with the goal of preventing HIV infection in the future.”

Dr Bhondai-Mhuri revealed that the first HIV vaccine trials in Zimbabwe were conducted in 2016 and currently the country is on its fifth trial and several lessons have been learned as the search continues for an efficacious vaccine.

“We know that more than 24 percent of people in the world who have HIV experience problems with accessing HIV treatment. We also know that all HIV prevention modalities have their own challenges that include adherence and just access.

“We know that a vaccine itself can stay in someone’s immune system for a very long time so it entails long term prevention.

“With every HIV vaccine study that is being done, we are learning something new, even if the vaccine does not show us that it is efficacious, we learn something new.

“For example, whilst the HVTN 705 study did not help us to have an efficacious vaccine, it showed us that the vaccine candidate was able to elicit an immune response which means it is possible to have a vaccine that works.

“So that is new information that will lead to the development of a better vaccine, what it means is that what one candidate needs to go back to the lab and to be tweaked for it to improve the effectiveness but we have already learnt something new,” said Dr Bhondai-Mhuri.

She added that though five HIV vaccine studies have been conducted without an effective one, they (trials) are not losses.

“So every study is not a loss, each study that we do teaches us something new and it will help us, yes the road is going to be long but we will get there,” she said.

Dr Bhondai-Mhuri also revealed that currently the country was on the HIV Vaccine Trials Network 140 (HVTN 140) which has 15 participants, showing that these are strides being taken to find a vaccine.

“We have a couple of HIV prevention modalities which have been approved by four authorities and this already includes the long-acting injectable cabotegravir (CAB LA) which has reached advanced clinical trials stages and is already in implementation trials and then we also have the dapivirine vaginal ring which has been proven to be effective and which also has been approved and we now have the Pre-Exposure Prophylaxis (PrEP), the daily oral prevention pill which is broadly available and it’s available whether you go to our council clinic, or you go to your local doctor, you go to your private practitioner, they will be able to offer this prevention method,” she said.

Dr Bhondai-Mhuri added; “however an HIV vaccine is still necessary in the fight against HIV because it eliminates the stigma that is associated with going looking for an HIV prevention tool from your clinic, no one really wants to be seen going to your local clinic daily to look for an HIV prevention pill.

“An HIV vaccine is going to last in your body for longer than the pills, is going to be longer than cab injection and also an HIV vaccine is likely to be one of the best tools in the prevention of HIV compared to any other method.

“It’s likely in the long run to be more effective and more cost effective than most prevention tools because one doesn’t have to visit their clinic often, you don’t have too frequent dossing so yes as a country we will need a method that is cost effective in the prevention of HIV and in safeguarding the health of our people.”

She added that the major challenge in all these years of HIV prevention vaccine trials is that we have not yet found a vaccine that is efficacious is preventing HIV, but it (challenge) was not only unique to Zimbabwe, hence a lot of work will continue to be put to make this dream a reality.

It is estimated that a total of 1,3 million people are living with HIV in Zimbabwe.

Shortcomings in Pandemic Agreement need to be addressed

**Dr Enerst Chikwati flanked by Dr Sandra Bote (left) and Clever Taderera**

BY MUNYARADZI BLESSING DOMA

The World Health Organisation (WHO) Pandemic Agreement lacks the capacity to protect people from poor countries, such that if another major health issue strikes, millions will die; AIDS Healthcare Foundation Zimbabwe, Country Program Manager, Dr Enerst Chikwati, has said.

Dr Chikwati reiterated that if the finalisation of the agreement-which is set for this May- goes without addressing the gaps, there will be catastrophe.

He said: “If this thing goes through, next pandemic we might all die.”

Dr Chikwati was speaking during a Pandemic Agreement Sensitization Meeting with journalists last Friday.

The Pandemic Agreement was created by WHO’s Intergovernmental Negotiating Body (INB), to address gaps which were seen following the Covid-19 pandemic which is estimated to have killed almost 18 million people globally.

It is reported that the Covid-19 pandemic exposed major shortcomings in the global health security architecture, and to address those (shortcomings), INB came up with the Pandemic Agreement on April 16 this year.

While the some of the aims of the Pandemic Agreement include, “to protect all people, in all countries, no matter how rich or poor, from harm”, AHF which has 47 member states, noted there are some gaps which need to be addressed before the final agreement is launched this May.

“This is our position on why changes are needed before the document is finalized in May 2024.

“So our number one concern is about the agreement itself, as AHF we are worried by the WHO Pandemic Agreement which has now become weaker, Dr Bote (AHF Zimbabwe, National Medical Director) has said it’s now watered down and it lacks accountability.

“Second issue is of the current text, the latest version of the agreement is filled with empty promises and lacks the power needed to make sure everyone has access to health, health resources during pandemic, you have already heard about equity.

“By definition it means equal distribution of resources among the people in considering their needs. This is not what is happening and this is what happened during the Covid-19 pandemic in terms of access to vaccines. Most developing countries struggled to get vaccines, whilst developed countries hoarded vaccines more than they needed so we need to talk more of equity in the future pandemics.

“The third point is focused on pharmaceutical interest; developing countries are protecting drug companies; instead of making sure that everyone has got access to healthcare during pandemics, drug companies are putting profits over lives of people,” said Dr Chikwati.

He added that the Pandemic Agreement “lacks health product guarantees, like Dr Bote has already mentioned, WHO will only access only 20 percent of all the commodities, of all the resources, maybe drugs and vaccines. 20 percent is not enough definitely, it won’t be enough to cover the third world countries, or developing countries.

“The 80 percent will be at the mercy of these big pharmas, they have money and they want to make more money, so we really plead with WHO, INB board to reconsider this 20 percent.

“There is also need for accountability and enforcement, we need strong rules to make sure countries follow the agreement, we need commitments from Heads of State and also for the Heads of State to be involved in the signing of this agreement. That will ensure accountability, that will ensure in country has commitment for each country.

“Then the sixth one is call for independent oversight, there is no independent body from WHO, we urge WHO to consider appointing an independent body, independent from WHO, independent from donors of WHO, to head and oversee the Pandemic Agreement.

“We also urge WHO to reconsider the CSOs (Civil Society Organisations), to be more involved, their voices need to be heard, they need to hear them, their finalizing, but let them get input from the civic society. AHF is therefore mobilizing support across the board to roll-out action to pressure Intergovernmental Negotiating Body to revisit the agreement and address critical gaps that I have highlighted.”

Similar sentiments on the Pandemic Agreement were also echoed by Dr Sandra Bote, who said “this latest iteration of the text, which has been significantly watered down through the negotiation process, is filled with platitudes, anemic in obligations, and devoid of any accountability.”

She added, “the word equity appears nine times in the October negotiating text, including as a guiding principle of the whole treaty. But in reality, Article 12 stipulates that WHO would have access to only 20 percent of “pandemic-related products for distribution based on public health risks and needs”.

”The other 80 percent— whether vaccines, treatments, or diagnostics—would be prey to the international scramble seen in COVID-19 that saw vital health technologies sold to the highest bidder.

”Most of the world’s population live in countries that might not be able to afford these products, but 20 percent seems to be all that high-income countries were willing to agree to.

”It appears like the developed nations have vehemently defended the private interest of pharmaceutical companies over the collective common interest of achieving global health security in a sustainable and equitable manner.”

AHF was established in 1987 with the main purpose of providing quality and affordable health services to people living with HIV and the organisation is currently in 47 countries.

Bluetoothing floods the ghetto

**Tendai Phillip Daka, Mubatirapamwe Programmes Manager**

BY MUNYARADZI BLESSING DOMA recently in Chinhoyi

While the country has been praised for successful HIV interventions, a scourge is threatening to derail such efforts as people looking for a quick way to get intoxicated, have resorted to injecting themselves with blood from other drug users.

Known as bluetoothing or flash-blooding, the dangerous practice which according to the National Center for Biotechnology Information is when “blood is withdrawn from one individual who has recently injected a drug and directly injected intravenously unto another person.”

While this practice was said to have been more common in neighbouring South Africa, a recent media workshop organised by the National Aids Council (NAC) heard that our own people have joined the bandwagon, with the trend now in most ghettos.

Speaking on the sidelines of the workshop, Tendai Phillip Daka, Programmes Manager at Mubatirapamwe, revealed that it was sad that while the country was striving towards epidemic control, practices like bluetoothing are hampering efforts being made.

“Now we have a practice of drug use which is common in South Africa and it is characterized by the use of nyaope drug which is a mixture of heroin, marijuana, ARVs (anti retrovirals) and rat poison.

“So this bluetoothing came about because some people will be facing difficulties to buy drugs so from our understanding, they draw blood from someone who would have injected themselves with drugs.

“It can even be from someone who would have taken crystal meth, so they draw blood from that person so as to also get intoxicated.

“Sadly some people are now seeing it as a business avenue because when they inject the drugs, they then withdraw their blood and package into small plastics or sachets and sell,” revealed Daka.

He revealed that several parents have revealed to them that they are finding sachets of blood in their children’s rooms.

“What we are really not sure yet about is how they (drug users) preserve the blood, but many parents have been revealing seeing this.

“Some parents reveal finding sachets with strong smells and even syringes in their children’s rooms.

“Also known as hotspoting, this practice is increasing the spread of diseases through these transfusions, leading to the transmission of diseases like hepatitis B, C as well as HIV.

“So while efforts are being made to fight HIV, we need to have other interventions to help with the scourge of drug use, failure of which, will lead to losing the HIV fight,” added Daka.

In a separate interview with this reporter, a drug activist who preferred anonymity said sadly bluetoothing has led to increasing cases of new HIV infections and hepatitis B, because of the sharing of needles.

“The first person to inject themselves could be HIV negative but then from the time the syringe gets to be used by the last person, who knows. Maybe someone in between could be HIV positive.

“The worst scenario is if the first person who injects themselves with drugs is HIV positive, then all the other users get the blood from him or her.

“In Zimbabwe it seems the measures to contain this are really difficult because the only thing that people can do is go for an HIV test or if you say someone should take PrEP (pre-exposure prophylaxis), but then it (PrEP) will only block HIV, it doesn’t stop other infections or complications.

“So now there is something called Harm Reduction which has a programme called Needle and Syringe Programme (NSP), but from last I checked, that programme has not yet started here in Zimbabwe.

“This is a programme whereby people who inject drugs will be coming in to get clean equipment to use, like needles, syringes, alcohol swabs and other items, so there is a whole bunch of things provided in NSP,” added the source.

The source further added, “then there are also needle disposal sites so that people don’t just get rid of their needles or syringes willy nilly.”

While a total of 1,3 million people are living with HIV in Zimbabwe, it was revealed that the country is recording a decline in the prevalence and incidence owing to several interventions.

However one hopes that the emergence of practices like bluetoothing, will not hamper the successes which the country is registering in fighting HIV.

When grace locates you

…the story of Kensington Marufu

BY MUNYARADZI BLESSING DOMA

“I want you to believe that God exists, I want you to appreciate life from an angle of grace; that there is a certain thing called grace.”

The above were the words of 34-year-old Kensington Marufu, who was diagnosed with HIV when he was just aged 10 and the doctor who attended to his family said they only had five years to live.

Despite facing huge setbacks, including losing family members to the HIV virus, stigma, discrimination, missing out on precious school time and working at various farms to earn a living, Marufu triumphed to become a legal practitioner and author.

Marufu was one of the key speakers at a recent media workshop organised by the National AIDS Council (NAC) in Chinhoyi.

And his presentation titled, “Testimony-Positively HIV positive,” touched many attendees, including the Minister of Information, Publicity and Broadcasting Services, Dr Jenfan Muswere, who said Marufu’s testimony was “proof that living with HIV is not the end of life.”

Marufu revealed that along with his parents and brother, they tested HIV positive in the year 2000 and the doctor said they would all not live beyond five years.

“When we got tested on the 23^rd of March 2000, the doctor who attended to us estimated that we were not likely to live more than five years.

“It meant that I had about five years to live. Those days there was no medication, there were no ARVs (anti retrovirals), we were just taking cotrimoxazole and when I was in Grade 5, I knew most of those pills.

“So stereotypes unfortunately got affirmed, my brother passed on in 2003, my mother passed on in 2004 but my dad went beyond five years, actually he passed on in 2006,” revealed Marufu.

For some time, Marufu went into hiding, because of the labeling that was common during that time.

“I then realized that I was actually hiding from myself and it took me years to appreciate that there are certain things in life that we can never change and we will not go forward in life until we appreciate who we are.”

He revealed that he was called names such as “Go Slow”, and when he sat for his O-Level exams, he only managed to pass one subject, English with a B; and it meant that he had to go stay with his grandmother in Shackleton, Chinhoyi.

And there life was tough; as people were judged by how they could perform hard labour.

“So we were working in farms, not that I had the strength but I had no choice, I had friends who would assist me, those were the days when I also had a tattoo, a mohawk and I was smoking marijuana because I wanted to fit in.

“I had lost faith in life, I stopped believing in myself, I stopped believing in life, I stopped believing in a lot of things, you know losing parents who loved you and appreciated you and then growing up in an environment where you are unfairly judged really affected me, so I started taking some drugs,” narrated Marufu.

He further revealed that how the HIV messages were packaged in those days also affected him as some of the phrases in use included, “AIDS kills”, “mukondombera” and “chakatikuuya chiya”, as this brought fear.

“When I was in Shackleton, things were really tough and I did not expect to live until now, but God was with me throughout the time.

“When I’m telling my story, I want you to believe that God exists, I want you to appreciate life from an angle of grace; that there is a certain thing called grace,” he said.

Kensington also revealed that in 2010 when he was now 20 years-old; he went to his late father’s bank and he was notified that he (father) had left US$1000 in his account.

He revealed that when all due processes were done, he wanted to use the money to buy a Mazda 323; but he was warned against and was advised that going back to school was the best option.

And he went back to school and rewrote his O-Levels but that also had its own challenges because of his advanced age as the name calling started again.

“Because I was very old, I was called many names like kadhara, but one thing that my mum told me before she died was that when people laugh at you, laugh with them, they will feel embarrassed.

“So when people called me kadhara, I would correct them to say no, call me mudhara because I was actually the eldest at the school.

“Then I rewrote my O-Levels in 2011 and passed eight subjects, I had 4As, 3Bs and a C,” revealed Marufu.

While he thought he would easily get a job maybe as a cop or soldier, it was not to be; as “some of the things that hindered me had something to do with my health, my age, there were a lot of things involved.”

Despite passing his O-Levels; in 2012 he was just at home, the same with 2013 and at one time he was herding some old lady’s cattle.

“The old lady would brag that her herd boy had passed Mathematics and English.

“I didn’t have any problems with that because I had passed the two subjects and I was also a herd boy; that’s life.

“In 2014, a certain guy called Kuda approached me to say if I assist you to go for A-Level, would you take the opportunity.

“I was now 24; but then there is a verse in the Bible that says; I know the plans I have for you, so because I was desperate, I accepted.

“And I started my Form 5 at St Pauls Musami; and as always, teachers would ask for our ages and then people would know.

“You would get nicknames and being at a boarding school I would share hostels, so I had my medication but then I didn’t want people to know, but it was really difficult,” he narrated.

He went on to reveal to NAC that taking medication is one of the challenges for children living with HIV who learn at boarding schools because they get to share hostels.

Despite the challenges he faced, Marufu revealed that it didn’t affect him academically as he went on to ace, first becoming a class monitor, then Deputy Headboy, before later scoring 15 point when he sat for his A-Level exams in 2015.

Marufu then enrolled into Law School and today he is a Legal Officer at a company in the capital.

**Minister Jenfan Muswere receives the novel titled “Touched by Grace”, from author and lawyer, Kensington Marufu**

He then wrote a book titled “Touched by Grace”, which is about his life with HIV.

He said of the book; “because I understand that there is another Kensington out there, I’m not alone like what I’m saying, there is another Kensington going through similar challenges but that Kensington does not have role models.

“Because most of the people like Kensington are in hiding, they will never expose themselves, they will hide, they will succeed but in hiding. “So that Kensington is just where he is and he doesn’t know if there is anything in life.

“So I have written a book, maybe one day that Kensington will read the story of Kensington and appreciate life; that life can change, God can make things possible.

“The title of the book is called Touched by Grace; because grace touched me. I would not have achieved this without God, because the life was actually too complicated,” he added.

And Marufu took the opportunity to hand over his book to Minister Muswere, describing it as a special moment for him, considering his journey to success.

Journalists play critical role in ensuring a healthy nation-Minister Muswere

BY MUNYARADZI BLESSING DOMA recently in CHINHOYI

Minister of Information, Publicity and Broadcasting Services, Dr Jenfan Muswere has said journalists play a critical role in ensuring a healthy nation as they disseminate the much needed information to combat the spread of diseases.
Minister Muswere said the media’s role on the dissemination of information on diseases like HIV and AIDS, cholera and Covid-19 can never underestimated.
He was speaking at a media workshop organised by the National AIDS Council (NAC) in Chinhoyi last week.
The workshop was meant to update the media on the response to HIV and related conditions and also to discuss how the media can contribute towards ending AIDS by 2030.
“Journalists have a role to play in national development, journalists have a role to play in health matters and in nation building because the health of the population defines the past, defines the current circumstances, the challenges, opportunities and the resilience, the dedication and commitment of Zimbabweans.
“The health of the nation also defines the future of our country and journalists have a role to play as we journey towards an upper middle income society by the year 2030,” he said.
He added that he was advised that the country had done extremely well to reduce the HIV prevalence and NAC attributes part of that success to the role of the media in raising awareness, in educating the population of Zimbabwe, in informing the nation of Zimbabwe.
“The role of the journalists, the media in articulating critical issues whether its transmission of HIV and AIDS, or the most important aspect in terms of stigmatization and the same time the role of the media in ensuring that drug provision, in ensuring that we leave no one behind, that all the people in the four corners of our country are knowledgeable on the issues of HIV and AIDS.
“Knowledge is power and education is the key and education is being supported through a deliberate segmented approach in English and other important local languages.
“The media is in a position to articulate with ease the challenges, the behaviours that are expected, the health solutions that are available in our country for us to be able to achieve the success story in terms of the HIV prevalence in our country and Zimbabwe has managed and achieved and score significant gains as we combat epidemics and pandemics in our country.
“All successes stories are attributed to the role of the media, the role of the media teams who have worked with the members of the Fourth Estate,” added Minister Muswere.
Similar sentiments were also echoed by NAC Chief Executive Officer, Dr Bernard Madzima in a speech read on his behalf by Amon Mpofu, Monitoring Evaluation Director, who said creating mutual partnerships with the media was important in telling the HIV and AIDS story.
“In convening this workshop, we are convinced that the proper flow of information on HIV and AIDS requires a mutual partnership between the media and ourselves,” he said.
He added that the partnership has led to the sharing of information, accurate and responsible reporting which in-turn contributes to the development agenda as enshrined in the National Development Strategy 1 (NDS1).
“Our strong belief in the role of the role of the media which already has been instrumental in improving our response.
“Workshops such as this one compliments our other efforts which include media tours, media awards and our regular dissemination of our diaries to the media,” added Dr Madzima.
NAC Board Member, Tatenda Chipungudzanye, added that journalists can contribute effectively to the national efforts to tame the HIV pandemic through their work.

Collective efforts needed to fight HIV stigma and discrimination

BY MUNYARADZI BLESSING DOMA

Ending HIV related stigma is not only morally crucial but it is also vital for the public health and socio-economic development of the country, it has been revealed.

During a workshop on the Zimbabwe HIV Stigma Index Action Plan, it was also noted that stigma had to be eradicated if the country is to attain its targets in HIV management.

This is comes at a time when the country’s 2022 HIV stigma index stands at 69,7 percent, up from 2014’s figure of 65,5 percent.

According to UNAIDS, HIV stigma index is the standardized tool to gather evidence on how stigma and discrimination impacts the lives of people living with HIV.

Tatenda Makoni, Executive Director at ZNNP+ said as a country, it was worrisome that while the stigma index was supposed to be going down, it was actually on the rise.

Abisha Jonga, Senior Programmes Manager at Zim-TTECH, said as a clinical partner, they notice that stigma is a major barrier to various efforts to ensure that we attain not only the 95-95-95 targets but actually the 100-100-100 targets.

“But what is critical is that for us to reach those high targets, stigma and discrimination needs to be addressed at all costs, not only today but as of yesterday, if not last year, if not five years ago.

“The reason being, due to stigma and discrimination, people are not open enough to disclose their status which actually is a starting point towards prevention and then again because of lack of disclosure, people are not going to find it easy to adhere to their medication.

“Then they will have to hide each time they need to take their medication. We have realized that due to the issues around failure to adhere to medication, we are then having a situation where viral suppression is getting highly compromised because people are not taking their medication as expected, every day, same time, same time every day; they can’t achieve that if they experience stigma and discrimination.

“What we have also noted in our work with stigma, it varies across different sub population, where even parents are afraid of disclosing their own status to the children or the children’s status to the children themselves,” revealed Jonga.

He also emphasized that people should work together so as to ensure there is a full program to address stigma and discrimination.

It was also revealed during the workshop that another issue of concern is internalized stigma or self-stigma.

Winnet Manyadza, Clinic and Further Education Manager at CONNECT Zimbabwe Institute Systemic Therapy, said internalized stigma was also a stumbling block to all the efforts being put in the HIV fight.

“We are committed to work together so that we strengthen those strategies, so that people living with HIV will live lives which are free of internalized stigma, we would want to see people living lives free from negative thoughts of their HIV status,” said Manyadza.

Shamiso Yikoniko, Technical Advisor-Advocacy Communication and Social Mobilization at Zimbabwe Association for Church Related Hospitals, also revealed that stigma and discrimination surrounding various aspects of society including health conditions such as HIV and AIDS can hinder progress and perpetuate inequality. “It is our collective responsibility to champion a society that embraces compassion, empathy and inclusivity. To address this issue, we must first recognize that stigma and discrimination are rooted in ignorance, fear and misconceptions.

“Ending stigma and discrimination is not solely the responsibility of a selected few, it is an obligation that each one of us must embrace, let’s examine our own biases, examine attitudes and promote empathy and understanding within our circle of influence,” said Yikoniko.

Belinda Chindove, Senior Strategic Information and Evaluation Officer at Zimbabwe Health Interventions said

HIV related stigma remains a significant challenge in the country, hindering access to vital HIV prevention, treatment and care services.

She added that it is essential that we confront this issue head on and work collectively so as to create a more compassionate and informed society.

“Let us acknowledge the few key points, understanding stigma, it is not just a word, it’s a real world consequence.

“People living with HIV face many issues, denial of employment, housing and education.

“They may even experience violence; by addressing stigma, we can address the lives of those affected by HIV, let us break the silence.

“HIV related discrimination is a violation of human rights, everyone deserves respect,” she added.

Isheunesu Nhiringi, Technical Advisor Community Support at OPHID, revealed that the increase in stigma was worrisome and is not supposed to be taken lightly.

“The increase in stigma and discrimination from 65,5 percent in 2014 to 69,7 percent in 2022 is a wakeup call and testament to gaps in our current system.

“In Zimbabwe, combating HIV and AIDS is not just about medical treatment, it is about confronting a deeply engraved stigma and discrimination that exacerbates the epidemic.

“Our collective efforts to end stigma is not only morally imperative but also vital for the country’s public health and socio-economic development,” revealed Nhiringi.

He added that the stigma and discrimination surrounding HIV and AIDS did not only marginalize those living with the virus but also hinder prevention and access to treatment.

“Fear of discrimination prevents individuals from getting tested, seeking treatment and disclosing their status, perpetuating the spread of the virus.

“Furthermore, stigma leads to social exclusion, loss of employment opportunities and undermines the overall wellbeing of the affected individual and the community. “Addressing stigma and discrimination requires multifaceted approaches including education, advocacy and policy change. We must challenge myths and misconceptions about HIV and AIDS through community outreaches and awareness campaigns.

“Empowering individuals with accurate information can dispel fear and encourage acceptance. Moreover, legal and policy frameworks must be strengthened to protect the rights of people living with HIV and AIDS and prevent discrimination in healthcare settings, workplaces and society at large,” added Nhiringi.

He also revealed that ensuring equal access to health care and opportunities for all regardless of HIV status, is not just a moral obligation but a strategy imperative for sustainable development.

And he added that by fostering a culture of compassion, understanding and inclusivity, an environment can be created “where individuals feel safe to seek support, access treatment and live fulfilling lives without fear of judgment or discrimination.”

Similar sentiments were also echoed by Imelda Mahaka, Executive Director at Pangea Zimbabwe who revealed that while significant strides had been made in preventing HIV infections, stigma and discrimination was threatening to derail such progress.

“We have come a long way and made sterling progress in preventing HIV infections and putting people living with HIV on optimized regiments, the biggest threat to the gains in the HIV response and to sustain epidemic control is stigma and discrimination.

“We need to appreciate the complexity in the various forms of stigma at individual and community systems levels.

“More importantly, we need to appreciate the intersectionality of stigma for example as Pangea Zimbabwe, we serve communities and individuals who experience stigma either because they are on PrEP or living with HIV but also because, the same individual is a member of the KP (key population) community experiencing gender based violence or has mental health issues or is probably using drugs,” revealed Mahaka.