“The sad part is that this is coming at a time we have the best options to prevent HIV, from rapid testing, PrEP, condoms, PEP to injectables,” said Dr Misheck Ruwende, a Zimbabwean family physician and advocate for reducing HIV stigma, in a public address shared online.
Zimbabwe faces a growing public health challenge as decades of progress against HIV collide with changing attitudes among young people. Antiretroviral treatment and prevention tools have dramatically reduced transmission rates across the country since the late 1990s, yet health workers warn that younger generations may not fully appreciate the ongoing risks of infection.
UNAIDS estimates that annual new HIV infections dropped from 79,000 in 2010 to 15,000 in 2023. Infections among individuals aged 15 to 24 fell from 27,000 down to 4,400 over the same period.
Shifting Attitudes Among Younger Generations
For medical professionals who witnessed the peak of the epidemic, the complacency of some young people remains a source of frustration. Shaun Moyo, a 48-year-old nurse working locum shifts at two major public hospitals in Harare, recalled the constant funerals of the 1990s compared to today’s climate of effective treatment.
“Seeing today’s youth who are blessed with condoms, ARVs and PrEP meds makes me furious,” Moyo said, as reported by Al Jazeera.
“In the 90s every weekend was a trek to cemeteries, not weddings.”
Moyo worries that because antiretroviral therapy transformed HIV from an immediate death sentence into a manageable chronic illness, some individuals underestimate the consequences of contracting the virus.
She noted online conversations where participants suggested that managing high blood pressure is worse than contracting HIV.
This anxiety extends beyond national borders. UNAIDS estimated that 210,000 adolescent girls and young women aged 15 to 24 acquired HIV worldwide in 2023. Nearly 60 percent of those global infections occurred in Eastern and Southern Africa, keeping regional health authorities on high alert.
Regional Warning Signs Across Borders
South Africa highlights the persistent scale of the regional epidemic, with UNAIDS estimating that 7.7 million people lived with HIV there in 2023. Provincial health data also point to rising rates of other sexually transmitted infections that complicate public health efforts.
Data from South Africa’s Gauteng province show that 167,109 males attended public health facilities between April and December 2023, with 67,400 treated for Male Urethritis Syndrome. The provincial health department reported that the incidence of this syndrome increased from 12 percent in 2020 to 15 percent in 2023.
Dr Linda-Gail Bekker, a South African HIV physician-scientist and co-author of the PURPOSE 1 clinical trial, argues that traditional communication methods no longer suffice. The Phase 3 trial evaluated lenacapavir, a twice-yearly injectable HIV prevention drug, and found that none of the 2,134 participating women who received the medication acquired HIV.
“Beating the old drum about the horrors of HIV, and shouting to youths about condoms is not necessarily going to cut it,” Bekker said. She emphasizes the need for non-judgmental information and accessible prevention services.
Advocates Bring Health Services Directly to Communities
Funding pressures have complicated these efforts. UNAIDS reported that disruptions to United States-funded HIV programmes in Zimbabwe affected services for key populations, including access to pre-exposure prophylaxis and testing counselling.
To overcome these barriers, health advocates and local authorities are bringing care directly to communities. A peer educator in Harare helps organize pop-up health services at transport hubs, markets, university campuses, and sporting events.
“It’s about speaking young people’s lingo, taking away the HIV stigma,” the peer educator said. These pop-up clinics offer HIV self-testing kits and condoms, alongside mobile health worker referrals for PrEP.
Dr Innocent Hove, Provincial Medical Officer for Harare Metropolitan Province, said that the government is decentralizing services. Officials are deploying mobile healthcare trucks to reach remote artisanal gold-mining sites and informal mining communities where conventional facilities remain out of reach.
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