MARTIN MAWAYA
GWERU—The Midlands provincial capital has witnessed a sharp rise in sexually transmitted infections from 36 in January to 62 in the month of March, a cause for concern for stakeholders in the health sector.
The sharp rise in STIs among key populations in the Gweru has heightened fears over growing risky behaviour, inconsistent condom use and disrupted treatment continuity among vulnerable groups.
The increase has also sparked concern among public health experts that the wider availability of HIV prevention drugs such as Pre-Exposure Prophylaxis (PrEP) may be fueling complacency towards other sexually transmitted infections.
Center for Sexual Health and Hiv Aids Research (CeSHHAR) Nursing Counsellor, Happy Marime revealed that STI cases recorded among key populations in Gweru increased from 36 in January to 62 in March this year, despite intensified safer sex awareness campaigns and expanded family planning services.
Speaking during the Family Planning and Adolescent Sexual Reproductive Health coordination forum held in Gweru last week, Marime said high mobility among key populations was negatively affecting continuity of care and consistent access to sexual health services.
She also highlighted confidentiality and privacy concerns in some service delivery settings, factors health experts say continue to discourage some clients from seeking treatment and reproductive health services.
According to data presented by CeSHHAR, uptake of short-term contraceptive methods rose steadily during the first quarter, with combined oral contraceptives, progesterone-only pills and Depo Provera injections increasing from 49 clients in January to 115 in March, bringing the quarterly total to 246.
Marime said there had been no stock-outs of family planning commodities during the period under review, a development that improved service delivery and client confidence.
She attributed improved repeat visits to “friendly and non-judgmental services” as well as appointment reminders and follow up systems that were improving continuation rates among clients.
The organisation also credited peer educators for successfully linking clients from hotspots to clinic services, while intensified health education campaigns reportedly helped reduce myths and misconceptions surrounding family planning.
However, health experts at the meeting warned that rising STI infections among key populations could reverse gains made in HIV prevention if urgent interventions are not implemented.
To address the growing crisis, CeSHHAR recommended integrating Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), family planning, STI screening and mental health services into a single-visit model to reduce missed opportunities.
The organisation also called for the use of peer navigators drawn from the same key population communities and stronger partnerships with community-based organisations working directly with vulnerable groups.
Zimbabwe continues to battle high HIV prevalence rates among key populations, including sex workers, amid growing concern among public health experts that stigma, discrimination and fragmented health services are pushing vulnerable groups away from critical interventions.
Public health experts have also raised concern over the impact of dwindling donor support on the country’s sexual reproductive health programmes, particularly condom distribution and STI prevention interventions.
Zimbabwe has for years relied heavily on international partners to finance condom procurement and HIV prevention programmes, with free condoms distributed through public health institutions, colleges, growth points and entertainment centres.
Recent funding constraints affecting global HIV and reproductive health programmes have, however, triggered fears of possible supply disruptions, especially in remote districts where vulnerable populations depend largely on free public sector condoms.
Health officials say intermittent shortages in some communities risk undermining safer sex campaigns at a time STI infections are already rising.
Experts further warned that while PrEP has significantly reduced new HIV infections among high-risk groups, some users were increasingly abandoning condoms under the false assumption that PrEP offers protection against all sexually transmitted infections.
“PrEP protects against HIV, but it does not prevent gonorrhoea, syphilis, chlamydia or other STIs. We are beginning to see behavioural complacency where some people engage in unprotected sex because they feel protected once they are on PrEP,” said one health practitioner who attended the meeting.
Zimbabwe has in recent years recorded notable progress in reducing HIV transmission through expanded antiretroviral therapy coverage, HIV testing services and PrEP rollout programmes.
However, health experts warn that rising STI infections could undermine those gains if condom use declines and integrated sexual health services are not strengthened.
