As Zimbabwe makes strides on HIV/AIDS, LGBTQ+ people left behind

A s a gay man in Zimbabwe, Admore braced himself for a hostile reception from medical staff when he went for an HIV test at a city-run clinic in Harare five years ago. His worries proved justified.

"When I (said) I was gay ... they gave each other that look that made me feel they thought I was not normal," said Admore, who asked to use a pseudonym to protect his identity.

Despite such uncomfortable dealings with health workers, Admore - who tested positive - has been able to access life-saving antiretroviral treatment (ART).

But his experience helps explain why LGBTQ+ Zimbabweans have lagged in the southern African country's massive strides towards combatting HIV/AIDS during the last 25 years.

Zimbabwe is one of only five countries to have reached 2025 UN targets on fighting the virus, and HIV/AIDS rates have plunged - boosted by foreign aid including some $1.7bn (R23.3bn) in US funding for ART access since 2006.

In 1997, the country's rate of HIV/AIDS was 25% among people aged 15 to 49. Today, that figure is 11%, according to UNAIDS, the Joint United Nations Programme on HIV/AIDS.

Botswana, Tanzania, Namibia and Eswatini have also met the so-called 95-95-95 goals.

Under the targets, 95% of people living with the virus should know their status, with 95% of those diagnosed receiving antiretroviral treatment. Among them, 95% should show viral suppression.

STIGMA AND DISCRIMINATION

But despite Zimbabwe's success on the goals set by UNAIDS, high-risk groups, including men who have sex with men, trans people and sex workers, have fallen behind.

Only an estimated 48% of men who have sex with men know their status, despite a much higher than average prevalence rate of 21%, according to UNAIDS. The situation is even worse among trans Zimbabweans.

Gay sex is illegal in Zimbabwe, and stigma deters members of the LGBTQ+ community from seeking testing and treatment, said Amon Mpofu, the monitoring and evaluation director of the National Aids Council (NAC), which coordinates Zimbabwe's HIV/AIDS response.

"Because their activities are criminalised, they tend to go underground," he said.

Partson Munyati, a 64-year-old gay man from the eastern city of Mutare who is HIV-positive, said four of his friends had died of AIDS, attributing their deaths to their reluctance to seek medical care.

When Munyati took a test after falling seriously ill, a supportive healthcare worker referred him to his local GALZ office, an LGBTQ+ rights group with centres in four cities, for counselling and support. He now works there himself as a volunteer, speaking with young LGBTQ+ people.

"I go for meetings at GALZ to encourage young people - I tell them about the need to be tested," he said.

CLINICS AND COUNSELLING

Other efforts are underway to close the gaps, many of them benefiting from foreign funding, which covers about 80% of the cost of Zimbabwe's HIV/AIDS programmes, according to Mpofu.

The NAC has set up a peer educator programme, recruiting people from the LGBTQ+ community and sex workers to engage their community members to provide targeted testing and care.

"We give the person a tablet (computer) and pay the person a monthly salary," Mpofu said. "We identify one who leads us to the others until we reach a caseload of 50 people - we call it snowballing."

NAC also provides funds for some organisations that run drop-in centres and clinics such as the Sexual Rights Centre.

A training programme was also developed by the Ministry of Health to address discrimination and other challenges faced by LGBTQ+ people and marginalised groups, and one-stop clinics are being opened with funding by the Global Fund to Fight AIDS, Tuberculosis and Malaria - an international partnership.

"The main purpose is to create an environment that is friendly and offers all services on healthcare such as HIV testing, ART, counselling," said Bee Chihera Meki, programme director of Harare-based Trans and Intersex Rising Zimbabwe.

The first one-stop centre was opened in December in Harare and the group will be opening centres in three other cities across the country, Gweru, Mutare and Masvingo, where there are fewer services for LGBTQ+ Zimbabweans.

The centres will offer HIV testing, STI screening, information on gender-affirming care, and other support services.

"We are creating mental well-being spaces at these centres," said Meki. "The main purpose is to create an environment that is friendly."

Thomson Reuters Foundation