Silent crisis as women blocked from life-saving HIV prevention

At Katema Clinic, women spoke in hushed but resolute tones about how patriarchal traditions and male dominance are preventing them from using Pre-exposure prophylaxis (PrEP), a proven medicine that drastically reduces the risk of contracting HIV.

For Cleopatra Jongwe, 31, from Pomerai Village, PrEP represents hope in a marriage where her husband refuses HIV testing and condom use.

“I know that if I use PrEP, I will not be infected even if I engage in unprotected sex with that partner,” she explained.

But once she tried, her worst fears were confirmed.

“The moment you get home with PrEP, tensions mount with our traditional husbands who accuse us of promiscuity. We end up ditching the drugs and exposing ourselves to HIV because at the end of the day, we want to protect our marriages.”

Her story is echoed by many in Gokwe South, where women say male partners often equate prevention drugs with infidelity. Community leaders admit the deeply ingrained gender roles give men control over sexual and reproductive decisions, leaving women powerless to act, even in the face of clear risk.

Zimbabwe has been hailed for its progress against HIV. More than 1.3 million people live with the virus, but the country has reached the UNAIDS 95-95-95 fast-track targets: 95% of people living with HIV know their status, 95% of those diagnosed are on treatment, and 95% of those on treatment have suppressed the virus.

The country has also slashed mother-to-child transmission rates from about 30% in 2005 to 6.4% in 2025. But the figure remains slightly above the global elimination target of 5%, and experts warn that rural gender dynamics risk slowing the fight.

Community Health Nurse Nomatter Kamutande says the cost of men’s resistance is often borne by women and unborn children.

“Please, when situations like these arise, let us use condoms until the baby is born, so they come out uninfected with HIV,” she pleaded. “We want zero infections. We do not want that scenario where the mother transmits HIV to the unborn child, yet we have all prevention measures at our disposal.”

Health rights organisations say the resistance in communities like Gokwe is not about science or access alone but culture. In many patriarchal households, men’s authority extends to what women can do with their bodies.

While PrEP has been approved in Zimbabwe in multiple forms — oral pills, a long-acting injection, and a vaginal ring — distribution remains limited by funding, awareness, and stigma. In rural settings, stigma is often the harshest barrier.

“Cultural norms expect women to be faithful while allowing men multiple partners,” said one health outreach worker. “This means women are at risk even when they themselves are abstinent. Yet if a woman tries to take PrEP, she is branded unfaithful. It is a contradiction that keeps infections alive.”

Between January and June 2025, Zimbabwe recorded nearly 6,000 AIDS-related deaths, slightly higher than the same period in 2024. Health experts fear such numbers could rise if prevention tools remain out of reach for those most at risk.

In places like Gokwe South, women say they are trapped: protect their marriages and risk infection, or protect their health and risk domestic violence or rejection.

The choice, for many, is no choice at all.

Reporting by Anesu Masamvu