Men lag as Bulawayo nears HIV control

Bulawayo is edging closer to HIV epidemic control, but health officials warn that progress could stall as men continue to test positive at higher rates while remaining less likely to access testing services, according to the 2025 HIV and AIDS Response report.

The findings show that the city has largely achieved the UNAIDS 95-95-95 targets, a global benchmark for HIV control, signalling strong progress in diagnosis, treatment and viral suppression.

According to National AIDS Council (NAC) Programmes Officer Douglas Moyo, Bulawayo is now close to epidemic control.

"Our programme data is showing that 95% of people living with HIV know their status, 98% of those diagnosed are on antiretroviral therapy (ART), and 96% are virally suppressed," he said.

"The province is close to achieving epidemic control. It means we are in progress."

As of the end of 2025, 79,746 people were on ART in the province, with most on first-line treatment. HIV incidence has also declined significantly, falling from 13.2% in 2020 to 10.7% among people aged 15 to 49.

However, officials say a persistent gender gap threatens these gains. Men recorded a higher HIV positivity rate of 5.4%, compared to 3.4% among women, yet women accounted for 73% of all HIV tests conducted in the city.

Moyo said the data suggests men are testing less frequently but presenting later and with higher positivity rates.

"This means many men are not accessing services, yet those who do are more likely to test positive," he said.

The disparity is most pronounced among adults aged 35 to 54, where positivity rates among men reach between 9% and 12%.

Women, however, continue to bear the heavier overall burden, with prevalence estimated at 13.6% compared to 7.8% among men, peaking among women aged 30 to 39 at up to 28%.

Health officials say late testing among men remains a key concern, particularly as it undermines early treatment and increases transmission risks.

Dr Maphios Siamuchembu said social and economic pressures are keeping men away from health services.

"Men are breadwinners, so they would benefit more from workplace-based programmes," he said, adding that cultural norms also discourage men from seeking care.

He suggested more tailored approaches, including faster, private testing and male-friendly services without long queues.

Bulawayo Deputy Mayor Edwin Ndlovu said fear and stigma also play a role in low uptake among men.

"Knowing your health status can be stressful, especially if the result is not good," he said, urging normalisation of HIV testing as part of routine health checks.

Community elder Giyani Moyo added that messaging should be reframed to better resonate with men, linking testing to responsibility and control rather than vulnerability.

In response, NAC says the upcoming Zimbabwe National AIDS Strategic Plan (ZNASP 5), set for 2026–2030, will prioritise men alongside other high-risk groups.

NAC Bulawayo Provincial Manager Sinatra Nyathi said the focus will shift toward "precision programming" and more targeted outreach.

"We need to rethink service delivery, bring testing closer to them, make it faster, more private and more relevant to their needs," she said.

Planned interventions include workplace testing, weekend services and integrated health screenings combining HIV tests with checks for conditions such as hypertension and diabetes.