GENDER, FOOD SECURITY AND LIVELIHOOD DIMENSIONS OF HIV AND AIDS PREVENTION INTERVENTIONS: AN ANALYSIS OF RHETORIC AND PRACTICE IN ZIMBABWE
This study sought to examine the barriers to effective HIV and AIDS preventive measures to accelerate efforts to achieving the set UN targets and sustainable development goals. Specifically, the objectives of this study were to: assess the current situation of HIV and AIDS prevention, intervention and their practice in Zimbabwe; examine mechanisms that could be adopted to close the gap between rhetoric and practice in prevention interventions; and develop a model for effective HIV and AIDS prevention in Zimbabwe. Research was conducted at Opportunistic Infection (OI) clinics in urban, peri-urban, rural and farming communities of Zimbabwe for the period February 2018 to May 2018. The research was based on questionnaires to people living with HIV and AIDS (PLHIV) and AIDS Service Providers at OI clinics using random sampling. Triangulation methods included key informant interviews, face to face in-depth interviews, focus group discussions and documentary analysis. Secondary data were collected from OI clinics the data consisting of ARV collectors and defaulters, reports on some challenges as well as the delivery and distribution of condoms, ARVs and test kits as well as Voluntary medical male circumcision (VMMC) data; personal observation method was also used. Four themes emerged from this study: gender, culture, religion, and food security. Challenges faced by Aids Service Providers (ASP) were further isolated from each of these themes. Gender emerged as one of the major issues affecting the HIV and AIDS prevention interventions particularly on the ability to negotiate for safer sex. Respondents raised issues on capacity and vulnerability of people living with HIV and AIDS (PLHIV), disclosure and decision making capabilities. Cultural issues were mostly centered on inheritance norms, cleansing and other rituals performed within some Zimbabwean societies. Major challenges faced by ASPs during the delivery of HIV and AIDS prevention included shortage of Interventions staff, Cultural related challenges especially linkages to witchcraft, Stocks running out (such as condoms, test kits and ARV’s), adolescent sexual reproductive health, adolescent behavior. The study concluded that: the models, programs and policies that address HIV and AIDS need to be diverse and inclusive in their formulation and implementation; there is need to acknowledge sexual delivery models, strengthening the capacity of local actors and institutions to deliver high quality health care systems; similar to all health interventions, there is need to recognize that gendered context is essential in HIV and AIDS preventions; and there is no unidirectional approach when it comes to HIV and AIDS prevention interventions hence the need to include mixed approaches.