Moving Zimbabwe from 75:89:81 to 90:90:90 Messaging:

Zimbabwe can move from 75% who are aware of their HIV status:89% on HIV treatment:81% virally suppressed to 90:90:90 target by 2020.  By 2016, Zimbabwe has the sixth highest HIV prevalence in sub-Saharan Africa at 13.5%, with 1.3 million people living with HIV.  The high literacy rate is put to use in Zimbabwe through a robust births and deaths record keeping. Deaths from AIDS-related illnesses are well documented and they show continued to fall with figures showing a fall from 61,000 in 2013 to 30,000 in 2016.  The HIV epidemic in Zimbabwe is generalised and is largely driven by unprotected heterosexual sex. Women are disproportionately affected, particularly adolescent girls and young women. However, there are growing epidemics among key populations such as sex workers and men who have sex with men who are at higher risk of HIV. National data on these populations is sparse as only a minimal amount of data is collected and reported in national documents. In 2016, new infections dropped to 40,000 from 79,000 in 2010, with behaviour change communication, high treatment coverage and prevention of mother-to-child transmission services thought to be responsible for this decline. Unprotected heterosexual sex in Zimbabwe means that men are not accepting women to take more safer sex negotiation roles. This is corroborated in various studies. Gender inequality is present within relationships and marriages, and drives HIV infections. For example, only 69% of men believe a woman has the right to refuse sexual intercourse if she knows he has sex with other women.  More than a third of the women in relationships have experienced physical or sexual violence from their partner. There is a general reluctance to test among the younger generation attributed to invisibility of males.  64% of young women (15-24) and 47.5% of young men have ever tested for HIV.  76% of women and girls living with HIV aware of their status, compared to 68% of positive men and boys. The people most affected by HIV are: women, young girls, young men, sex workers and men-who-have-sex-with-men. Combination Prevention Strategy approach, which focuses on a number of areas to prevent new infections is employed in Zimbabwe. This is followed by condom availability and use with 33 male condoms per man per year. This makes Zimbabwe one of only five countries to meet or exceed the United Nations Population Fund’s regional benchmark of 30 male condoms per man per year. HIV education has made it possible for many to overcome some misconceptions about HIV transmission such as whether mosquitoes pass HIV. Zimbabwe rolled out Option B+ in order to maintain the prevention of mother-to-child transmission. TB is tackled by the government through a comprehensive plan integrated within the existing service initiatives. Voluntary medical male circumcision is gaining popularity after male-driven approaches are made available. The soccer programme called Make-The-Cut-Plus, more than doubled the odds of service uptake. Zimbabwe had a calamitous colonial past but this does not stop Zimbabweans both White and Black embracing. Addressing stigma, discrimination, a more disaggregated documentation and record keeping will make it possible to Zimbabwe to meet and exceed the 90:90:90 goal if maleness or masculinity are not used for abuse in the largely male HIV epidemic.