The Status of Prevention Programmes

Prevention of Mother To Child Transmission
Zimbabwe has made some progress in scaling up PMTCT. By end of 2006, 547 health facilities offered comprehensive PMTCT services. Further rapid progress needs to be made or Zimbabwe will fall short of the UNGASS target (Figure 4) and fail to prevent new infections in the majority of children born to women living with HIV.

Figure 4 PMTCT coverage against Zimbabwe UNGASS target 2004 to 2007 (Data from Epidemiological Fact Sheet on HIV and AIDS Core data on epidemiology and response Zimbabwe 2008 Update UNAIDS)

Awareness and Behaviour Change
Although condom use during the last sexual encounter is one of the highest in the region (64%) the most recent information shows a drop of about 5% in condom use in both men and women. It’s vital that prevention efforts address this for sustained behavior change. According to the 2006 Demographic and Health Survey 12.9% of males and 1.7% of females aged 15-49 reported more than one sexual partner in the last year. Of these, 40.1% of men and women reported using a condom in their last sexual encounter. Although levels of multiple partners are lower than some Southern African countries (perhaps due to economic constraints) condom use is still low in these situations. Worryingly, comprehensive knowledge of transmission and misconceptions was low at 46% in males and 44% in females and only 64% of all people surveyed used a condom in their last sexual encounter.

Prevention: What is Being Done?

Government planning

• Multisectoral response in the Zimbabwe National HIV/AIDS Strategic Plan (ZNASP) (2006-2010)
• National Strategic Framework implementation overseen by the National AIDS Council
• Implementation decentralized with local coordinating structures (AIDS Action Committees)
• Single monitoring and evaluation system linking national programmes and implementation partners (national programme monitoring system (NPMS)
• Monitoring decentralized to all levels through a standardized core data collection and a reporting tool
• Policy prevents PLHIV from discrimination in the workplace
• High risk groups (commercial sex workers, men who have sex with men) remain marginalized
• The Criminal Law (Codification and Reform) Act 23 of 2004 criminalises willful transmission of HIV

Condom programming

• 150 million condoms were distributed through the public sector in 2007
• Social marketing – PSI working and Ministry of Health and Child Welfare used to distribute 50 million male and female condoms at liquor stores, hair salons and supermarkets in 2006/7

Behaviour change campaigns

• After the Lesotho SADC meeting on prevention, the NAC carried out a Behaviour Change Review National Behaviour Change Strategy 2006 – 2010 introduced to work on sustaining prevention gains
• The ‘Engendering HIV prevention’ programme aims to create a health enabling environment through mobilizing community leaders and working for gender equality, as well as involving PLHIV in activities to reduce stigma and discrimination
• Life skills teaching on HIV and is now compulsory in primary, secondary and tertiary education.

Male Circumcision

• Action plan set out in 2007 for policy development and roll out in the public health system
• Survey conducted on MC knowledge
• Policy awaiting finalization