By Brenna Matendere
The Health Director for Masvingo, Suzanne Madamombe, has confirmed that the city has resumed critical provision of HIV prevention services, including the long-acting injectable cabotegravir (CAB-LA) after the stop-work order pronounced by United States early this year.
CAB-LA is a form of pre-exposure prophylaxis (PrEP) for HIV prevention. It’s an injectable medication administered every two months (after an initial two doses a month apart) that has been shown to be highly effective in preventing HIV infection.
More importantly, CAB-LA also acts as a long-acting option that can be more discreet and easier to adhere to than daily oral PrEP pills for some individuals.
City Health Director for Masvingo, Suzanne Madamombe (pictured) confirmed the resumption of CAB-LA and the Vaginal Ring rollout for Key Populations.
“We resumed these programs on the 9th of June,” Madamombe said. “It’s also important to note that clients who were already on the program before the stop-work order have maintained their HIV-negative status. They successfully migrated to oral PrEP without major issues.”
In another giant step towards achieving the country’s target of ending AIDS by 2030, a Community-Led Monitoring (CLM) initiative that involves Key Populations on service delivery and evaluation has kicked off in Masvingo.
Gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs and prisoners and other incarcerated people constitute the five main key population groups that are particularly vulnerable to HIV and frequently lack adequate access to services.
These are the ones being targeted by the city of Masvingo.
The UNAIDS 2016–2021 Strategy called for bold action to Fast-Track the AIDS response and incorporated a human rights-based approach to development aiming to leave no one behind in the AIDS response and this is the direction that Masvingo city’s health department has taken.
Researches show that by 2016, outside of sub-Saharan Africa, key populations and their sexual partners accounted for 80% of new HIV infections. Even in sub-Saharan Africa, key populations accounted for 25% of new HIV infections in 2016.
The CLM approach introduced in Masvingo ensures healthcare services are more responsive to the needs of key and vulnerable populations.
Sister Chauke, the Acting Sister-in-Charge at Runyararo Clinic says the programme is transforming lives in Masvingo.
“At the beginning, the clinic was only seeing MSM and three female sex workers. We had a committee to track the progress of the KP program, which included representatives from NAC, the Ministry of Health, and the Provincial Authority,” said Sr. Chauke.
“The CLM acts as a bridge between the community and the facility. It ensures that challenges in service delivery are addressed, allowing KPs to access services without stigma or discrimination.”
Since the implementation of CLM, client numbers have increased, and community members now refer peers to the clinic. Follow-ups on defaulting clients have also improved.
“Currently, we have 79 female sex workers, 32 MSM, and one transgender person on antiretroviral therapy (ART),” said Sr. Chauke.
“On PrEP, we serve 20 female sex workers, 14 MSM, and two transgender individuals.”
The clinic, which serves a catchment population of over 28,000 people, now offers a range of services including STI management, PrEP, PEP, condom and lubricant distribution, and maternal care.
Madamombe noted that while donor support had been critical, the city had made deliberate efforts to sustain KP services using internal resources.
“As a local authority, we’ve maintained some level of independence. Even during the funding freeze, we had budgeted for expansions to improve privacy in our clinics, especially for KP clients, that work is ongoing,” she said.
The city also benefited from prior training of nurses and community health workers, who are now implementing community models and conducting patient follow-ups.
“We’re fortunate to have retained most of our trained staff. Those staff are now training others, though we still need more capacity building to strengthen KP services,” she added. “We’ve also trained nurses to support adolescent KPs, particularly those living with HIV, by establishing adolescent support groups.”
Munorwei Munyikwa, the National AIDS Council (NAC) Masvingo Provincial Monitoring and Evaluation Officer, praised KP-friendly services.
“Runyararo Clinic is an illustrative health facility where we’ve trained a number of healthcare workers to provide KP-friendly services. With sufficient funding, our goal is to ensure every healthcare worker receives training to serve key and vulnerable populations,” he said.
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