BULAWAYO HIV prevention efforts are facing mixed outcomes, with declining uptake of voluntary medical male circumcision (VMMC) and persistent repeat sexually transmitted infections (STIs), despite large-scale condom distribution and expanded school-based prevention programmes.
Provincial National Aids Council (NAC) programmes officer Douglas Moyo said VMMC, once the cornerstone of Zimbabwe’s HIV prevention strategy, was no longer attracting the same number of men as in previous years.
“VMMC was brought to the country as one of the pillars of HIV combination prevention strategy,” said Moyo while providing a programmes update to the media recently.
“Along the way, we have seen the number of men circumcised declining.”
Moyo explained that changes in policy had also altered how VMMC services are delivered, including the removal of compulsory HIV testing for men seeking circumcision.
“Now for VMMC, it’s not everyone who is asked for an HIV test if they want to circumcise,” he said.
According to data presented during the briefing, uptake among the key age group of 15 to 19-year-olds stood at 45%.
Of these, 41% tested HIV negative, while 55% were not tested.
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Despite the decline, Moyo said there was encouragement in reaching younger adolescents, who were assumed to be less sexually active.
“One thing that is encouraging is that we still have those children, those adolescents, who we assume have not yet started engaging in sexual activity, whom we assume are still HIV negative, so that VMMC would really offer that protection that we want,” he said, referring to evidence that circumcision reduces female-to-male HIV transmission by about 60%.
The update revealed condom distribution figures, with a total of 2 090 611 condoms distributed in first three quarters of this year in Bulawayo.
Male condoms accounted for 96% of distribution, while female condoms made up just 4%.
Moyo said the imbalance pointed to ongoing challenges in female condom uptake, calling for targeted education and promotion.
However, he cautioned against interpreting distribution figures as proof of safe sexual behaviour.
“The condoms, this is just a proxy indicator,” Moyo said.
“There is no way we can measure whether each condom was successfully or properly used in a sexual encounter.
“Whether all of these condoms were actually used, we cannot tell.”
He added that condom distribution was accompanied by education, but rising repeat STI cases suggested gaps remain.
“We distribute them hoping that the person who has taken the initiative to take the condoms will use them,” Moyo said.
“But when you relate this to STIs, especially repeat STIs, you will see that we have a big challenge.”
To address long-term prevention, NAC continues to prioritise HIV education among school-going children.
“For the youth in school programmes we are still trying to make sure that we reach young children in schools with HIV prevention activities,” Moyo said.
“Because some of these children, once we miss them in school, we have lost them.”
He said guidance and counselling, taught as a formal subject covering sexual and reproductive health, remained a critical platform to reach as many learners as possible before risky behaviours are established.
