Zimbabwe recently launched its 2018 – 2020 Pre-Exposure Prophylaxis Strategy, which is geared at boosting the consumption of the drug (PreP tablets) among identified “key populations” who are at high risk of contracting HIV. These “key populations” are described as groups of individuals who face an increased risk of contracting the Human Immunodeficiency Virus (HIV) due to their behaviour or the nature of their sexual activities. To compound the problem, these groups often face legal and social issues, such as stigma and unfair discrimination, which drive them underground and serve to increase their vulnerability to infection.
Speaking at the launch of the document, Zimbabwe’s Minister of Health and Child Welfare, Dr David Parirenyatwa, said that this PreP programme would focus on, among other key populations, sex workers, men who have sex with other men (MSM), truck drivers, married couples, tertiary institution students and young people.
The nation’s Health Ministry aspires to work towards ending AIDS by 2030. According to the United Nations Aids Programme (UNAIDS), Zimbabwe is said to have the world’s highest prevalence of HIV infections. Dr Parirenyatwa is also on record as saying that HIV prevalence in prisons is higher than in the country at large.
It is encouraging to note that his Ministry is taking steps to tackle the spread of HIV in a realistic and holistic manner. It stands to be argued that this can be attributed to the tireless advocacy of various human rights organisations who work with the marginalised communities that make up the key populations in Zimbabwe. Still, this move is very important, especially since anal sex is the riskiest form of sex and therefore imprisoned men having sex with other men need to have access to condoms to lower risk of infection or re-infection.
Unfortunately, albeit unsurprisingly, this form of harm reduction does not always sit well with many people in a society that deems itself “conservative”. When condoms are supplied to groups whose behaviour or sexual activities are frowned upon by society for religious or cultural reasons, such a move is seen to be instigating or perpetuating the destruction of our social mores. In such instances, what is viewed as “immoral”, “a sin” or “un-African” is perceived to be encouraged. Many people in our society therefore do not take kindly to the distribution of condoms in prisons since they believe that this will “promote homosexuality”.
Critics have also argued that same-sex activity is illegal in Zimbabwe and consequently providing condoms in prisons would be tantamount to encouraging an act that is outlawed. Section 73 of Zimbabwe’s Criminal Law and Codification Act stipulates that “any male person who has consensual anal sex with another male person shall be guilty of sodomy, which is punishable by up to 1 year in prison”. This is just another instance where some people are quick to use statutory clauses to serve their purpose, even though these very clauses have been found wanting and in urgent need of reform because of their oppressive and divisive nature. Granted, these people may support the goal to curb the spread of sexually transmitted infections. However, they fail to appreciate how opposing the mandate to ensure access to condoms for certain people whose ways of being or sexual behaviour are not aligned to their morals only impedes our collective efforts to eradicate certain social challenges.
Countries such as Lesotho have come to that realisation and are now distributing condoms in prisons. We should all follow suit.
Countries such as Lesotho have already – or finally – come to that realisation and are now distributing condoms in prisons. It is high time we all followed suit. We need to make the tough decision of accepting reality and taking substantive steps to curb the spread of HIV. Lopsided interventions guided by religious or cultural ideologies will not get us anywhere. It is a fact that people in prisons have sex, whether we legally or morally approve of it or not. And if the report by Matooke Republic is anything to go by, prison officials are also engaging in sexual activities with prisoners. Even if the prisoners might engage in sex only in exchange for certain items, the reality still stands: Where (sexual) human beings are, sexual encounters are very likely to occur. Even if we provided prisoners with the material resources or food they need, some of us would be disappointed to find that sexual activities still prevailed.
Prisoners at very high risk
The catch is that in settings such as prisons, much of the sexual engagement is unprotected, placing prisoners at a high risk of contracting HIV. So, if we are serious about curbing HIV transmissions, it makes no sense that such sexually active, high-risk individuals would be left out of any HIV (or STI) prevention programme. In fact, it is irresponsible of us to leave the prisoners to endanger themselves as they engage in sexual activities without adequate protection. We are leaving them at risk of contracting what are preventable diseases. When we do this, we are failing to appreciate the interconnectedness of our lives – and that should scare us all.
Instead of fretting over the promotion of homosexuality, which only brings our homophobia to the fore, the transmission of HIV among prison inmates ought to be our collective concern – just as the transmission of HIV among sex workers and their clients ought to be our collective concern, and just as the transmission of HIV among the LGBTQI+ community ought to be our collective concern too. The reality that is overlooked by opponents is that, depending on their sentence, any infected prisoner is bound to be released back into society at some point. Once that happens, they will, through more inevitable sexual contact, bring the virus back into the community.
This will perpetuate the spread of HIV. And when recidivism comes into play and the former prison inmate re-offends the infected party takes the virus back to prison, where they may infect new prisoners. In this way the dangerous cycle is maintained.
One of the results is high public expenditure on health, because controlling the spread of the virus is pricey. And we all know that a Public Health Bill is just another financial burden that the taxpayer will have to bear. The higher it is, the heavier the burden.
Is it not obvious that this reality cannot be ignored if we are truly serious about reducing the incidence of HIV infection in every way possible?