Zimbabwe is turning the tide against HIV – although some people still refuse treatment

HARARE, Zimbabwe – Michelle and Michael Mutsvaki were infected with HIV at birth by their mother, but while their parents have eschewed antiretroviral (ARV) drugs to treat their HIV, the siblings have opted for treatment.

The siblings, aged 22 and 24, learned about their HIV status from their mother, but she assured them that their faith would protect them from succumbing to the disease.

But faith did not save their father. Instead, they watched him die from HIV complications a decade ago, despite the intervention of faith healers.

Meanwhile, their mother is a follower of the African indigenous people Johane Masowe Churchstill clings to her religious beliefs and concoctions instead of taking ARVs.

But after Michelle and Michael heard about the importance of antiretroviral treatment from HIV/AIDS activists who visited their school in 2017, they made one of the most important decisions of their lives: choosing to undergo ARV treatment, despite the advice of their parents. Seven years later, they are doing well.

The siblings were both born at home without the assistance of nurses because their parents avoided clinics and hospitals due to their religious beliefs.

Labor and birth are a risky time for newborn babies born to mothers with HIV because there is a lot of exposure to body fluids, the way HIV is transmitted.

Mother-to-child transmission of HIV is rare today because pregnant women with HIV are encouraged to take ARVs to ensure their viral load is undetectable before delivery, and newborns are also given ARVs at birth to prevent infection.

Unfortunately, without medical help, Michelle and Michael could not avoid contracting HIV at birth.

Citizens embrace ARVs

Zimbabwe’s adult population has embraced HIV treatment. The Zimbabwean Population-based HIV impact assessment survey A 2020 study found that 86.8% of adults living with HIV knew their status, and of those who were aware they were living with HIV, 97% were receiving antiretroviral treatment.

About 1.4 million people in Zimbabwe are living with HIV, and the Ministry of Health says about 1.2 million Zimbabweans are taking ARVs.

The massive adoption of ARVs has been the main reason for a 50% drop in national HIV incidence over the past decade, according to a report from the United Nations Development Program (UNDP)which works with the Ministry of Health and the Global Fund to Prevent HIV.

HIV prevalence in adults (15-49 years) has fallen from a peak of 26.5% in 1997 to 11% in 2021. In 2022, the incidence of new infections was 0.17% and there was a decline in the number new HIV infections for all age groups.

Meanwhile, deaths from AIDS have also fallen sharply over the past twenty years. In 2002, an estimated 130,000 people died from HIV-related complications, while in 2021 the death toll was around 20,200, according to a UNICEF report.

Treatment delays

But as the southern African country sees success in the fight against HIV/AIDS, other people living with the disease have remained adamant they will not receive treatment.

Susan Mutsvaki, mother of Michelle and Michael, has openly expressed her disdain for ARV drugs, citing her faith as a barrier to taking modern medications for any form of illness.

Mutsvaki, 47, says she has lived with HIV for the past two decades without taking any treatment or ARVs. Instead, she firmly believes that a mixture of water and pebbles, which her bishop made her drink at her church a decade ago, has helped her stay safe while living with HIV.

Mutsvaki is a member of the Johane Masowe Church, which traditionally worships at open-air gatherings where all congregants don white clothing.

Mutsvaki operates a market stall at the Rezende Bus terminus in central Harare, selling fruits, vegetables, popcorn and cigarettes.

She carries a white bag containing a 750ml bottle of water mixed with pebbles, which she sips as told by her religious leader, whom she calls a “prophet.”

“I have not been sick with HIV at all. This bottle and the stones in it are my prayers from our prophet and I believe these work wonders for me seeing how fit I look,” said Mutsvaki.

While Zimbabwe prides itself on its success in preventing HIV/AIDS, there are a few laggards who have moved in the opposite direction.

Hector Chinopa is one of them. When he contracted COVID-19 in 2020, he asked staff at Wilkins Hospital in Harare for an HIV test, which came out positive.

But just four years after surviving the coronavirus, 36-year-old Chinopa is dodging antiretroviral drugs.

Like Mutsvaki, he reasons that he hasn’t been sick since contracting COVID, so he hasn’t felt a strong need to seek treatment.

“I’m not sick. Do I look sick when you look at me? No, I’m not sick,” said Chinopa Check the health policy.

Teenage sons may have died from HIV

Linet Gavi, 41, who tested HIV positive two years ago, has also not undergone any treatment. But she isn’t sure if her two teenage sons, who died in 2019, were living with HIV.

According to their mother, the boys, who were 15 and 18 years old at the time of their death, suffered from severe headaches and coughing, and diarrhea. They vomited frequently and during their illness they both lost their hair and weight.

At the time, Gavi was in the dark about her HIV status. Since she was diagnosed, she has wondered if she might have passed the virus on to them at birth.

But Gavi is resistant to taking ARVs because she claims she has witnessed friends and family becoming seriously ill after starting ARV treatment.

“I don’t want to die from taking ARVs. I had family members and friends who were on ARVs after suffering from HIV, but they are no longer. I am doing well without treatment and have not been sick. I just eat some crushed garlic to boost my immune system,” Gavi claimed.

Chinopa, Gavi and Mutsvaki all said they have not dared to seek treatment at government clinics after testing positive for HIV, even though the Zimbabwean government has urged all HIV patients to get treatment.

The Zimbabwe Program for the Prevention of Mother-to-Child HIV Transmission has been operational since 2002, moving from a pilot program in 1999 to a national initiative. Children born since then, like Michelle and Michael, could have been spared HIV infection if their mothers had consulted clinics and delivered in health care facilities.

International aid

Between 2003 and 2022, the Global Fund did just that invested $1.8 billion to Zimbabwe’s HIV program and recently approved a three-year $437 million HIV grant (2024-2026).

Despite a few people refusing ARVs to this day, Zimbabwe has made significant progress in prevention and treatment.

A Zimbabwean health ministry official, who declined to be named, told Health Policy Watch that ARVs were available to anyone who tested HIV positive and was willing to undergo the treatment.

“The people you say are refusing treatment are making their own decision not to get the ARVs, but I can tell you that the treatment is available to anyone who tests positive for HIV,” said the government official, who was not authorized to to speak with the authorities. Press.

Although some Zimbabweans resisted HIV treatment late last year authorities announced that 95% of the HIV-positive population reached undetectable levels of the virus.

In November 2022, the Ministry of Health Dr. Chiedza Mupanguri said this during a press conference that 95% of Zimbabweans with HIV had achieved an undetectable viral load, meaning the level of virus in their bodies is so small that it cannot be transmitted to others.

This year, Zimbabwe became the first country in Africa, and the third in the world, after Australia and the US, to approve CAB-LA, a long-acting injectable drug that prevents HIV.

CAB-LA acts as pre-exposure prophylaxis (PrEP) and is recommended by the World Health Organization (WHO) for people at high risk of contracting HIV.

Although the country has pledged to target the entire population in the fight against HIV, individuals like Chinopa, Gavi and Mutsvaki remain steadfast in their refusal to participate.

HIV/AIDS activists attribute current deaths to people living with the disease because they have rejected treatment due to myths suggesting the drugs were intended to help them actually hasten their demise.

“Many who are killed by AIDS today are neglecting treatment or not receiving treatment at all,” Moris Mukundu, an AIDS activist in Harare, told Heath Policy Watch.

Image credits: UNICEF Zimbabwe.