'Condoms are hard to get by': access to HIV prevention methods during lockdown of the COVID-19 epidemic in eastern Zimbabwe

Glob Health Action. 2023 Dec 31;16(1):2206207. doi: 10.1080/16549716.2023.2206207.

Abstract

Background: In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, health services were disrupted worldwide, including HIV prevention services. While some studies have begun to document the effects of COVID-19 on HIV prevention, little has been done to qualitatively examine how lockdown measures were experienced and perceived to affect access to HIV prevention methods in sub-Saharan Africa.

Objectives: To explore how the COVID-19 pandemic was perceived to affect access to HIV prevention methods in eastern Zimbabwe.

Method: This article draws on qualitative data from the first three data collection points (involving telephone interviews, group discussions, and photography) of a telephone and WhatsApp-enabled digital ethnography. Data were collected from 11 adolescent girls and young women and five men over a 5-month period (March-July 2021). The data were analysed thematically.

Results: Participants reported widespread interruption to their condom supply when beerhalls were shut down as part of a nationwide lockdown. Restrictions in movement meant that participants who could afford to buy condoms from larger supermarkets or pharmacies were unable to. Additionally, the police reportedly refused to issue letters granting permission to travel for the purpose of accessing HIV prevention services. The COVID-19 pandemic was also described to obstruct the demand (fear of COVID-19, movement restrictions) and supply (de-prioritised, stock-outs) for HIV prevention services. Nonetheless, under certain formal and informal circumstances, such as accessing other and more prioritised health services, or 'knowing the right people', some participants were able to access HIV prevention methods.

Conclusion: People at risk of HIV experienced the COVID-19 epidemic in Zimbabwe as disruptive to access to HIV prevention methods. While the disruptions were temporary, they were long enough to catalyse local responses, and to highlight the need for future pandemic response capacities to circumvent a reversal of hard-won gains in HIV prevention.

Keywords: COVID-19; HIV prevention; Zimbabwe; condoms; pandemic response.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome* / epidemiology
  • Adolescent
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Communicable Disease Control
  • Condoms
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • Humans
  • Male
  • Pandemics / prevention & control
  • Zimbabwe / epidemiology

Grants and funding

This work was supported by the Bill and Melinda Gates Foundation under investment ID INV-023210; CN and SG acknowledge the joint MRC Centre for Global Infectious Disease Analysis funding from the UK Medical Research Council and Department for International Development under Grant MR/R015600/1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.