Suspended HIV services resume and vaginal ring returns

After months of uncertainty and suspended services, HIV prevention efforts in Masvingo have received a major boost with the resumption of long-acting injectable Pre-Exposure Prophylaxis (PrEP) and the Dapivirine Vaginal Ring. The reintroduction of these services marks a significant victory for key populations (KPs) who were left vulnerable by the funding freeze earlier this year.

Among those breathing a sigh of relief is Wellington, a 41-year-old male sex worker and MSM (man who has sex with men), who had been relying on oral PrEP and occasional PEP (Post-Exposure Prophylaxis) for the past year.

"I am hopeful that this time I will get my shot," he said. "The pill helped me, but there were days I forgot. It put my life at risk."

Wellington is among many MSM receiving services at Runyararo Clinic, one of the city's KP-friendly facilities. When injectable PrEP was initially introduced, it was targeted mainly at female sex workers (FSWs). Now, with the June 9 resumption of services, Wellington hopes to finally access Cabotegravir Long-Acting (CAB-LA) for more reliable protection.

For Sarudzai (35), a sex worker of five years, the return of both the Vaginal Ring and CAB-LA is equally welcome. She began oral PrEP in 2021 and has remained diligent in her prevention regimen.

"Even when the injectable was suspended, I continued taking pills and used both female and male condoms," she said. "Now that the injection is back, I'm very glad. It's one more tool to stay safe."

Runyararo Clinic has enhanced service delivery in recent months, offering three-month medication allocations and expanding privacy for clients. According to Masvingo City Health Director Suzanne Madamombe, resuming CAB-LA and ring provision represents a broader return to comprehensive HIV prevention services.

"We resumed these programs on June 9," Madamombe confirmed. "Clients who were previously on injectables transitioned smoothly to oral PrEP during the suspension and maintained their HIV-negative status."

Masvingo's efforts have been bolstered by a Community-Led Monitoring (CLM) approach, empowering KPs to actively participate in service delivery and oversight.

Sister Chauke, Acting Sister-in-Charge at Runyararo Clinic, explained how CLM has shifted the landscape since its introduction in 2019.

"At first, we had just a few clients. With CLM, KPs became involved in identifying barriers and improving the clinic. That changed everything," she said.

Now, Runyararo Clinic serves 79 female sex workers, 32 MSM, and one transgender person on antiretroviral therapy (ART). On PrEP, they serve 20 FSWs, 14 MSM, and two transgender clients. Services have expanded to include STI management, PEP, maternal care, TB screening, mental health support, and adolescent KP support groups.

Despite the earlier disruption due to halted U.S. funding, Masvingo City Council has made efforts to sustain services using internal resources, including clinic refurbishments for enhanced privacy.

"We budgeted for KP expansions even during the funding freeze," said Madamombe. "We've also retained most trained staff and are now training others to continue the work."

Munorwei Munyikwa, Masvingo Provincial Monitoring and Evaluation Officer for the National AIDS Council (NAC), emphasised the importance of KP training for healthcare workers.

"With enough funding, we aim to train every health worker in KP-friendly services. Runyararo Clinic is a model of what can be achieved," he said.

As Masvingo regains its HIV prevention footing, the reintroduction of injectable PrEP and the vaginal ring is being hailed not just as a medical achievement, but as a testament to resilience, inclusion, and the power of community-driven health responses.

For Wellington, Sarudzai, and many others, the return of these tools means renewed confidence in their future - and a clearer path toward ending new HIV infections among Zimbabwe's most vulnerable groups.