By Thabisani Dube

In rural communities across Zimbabwe, it is still common to see a frail man being supported by his relatives as he struggles to reach the nearest clinic. By the time he arrives—weak, skeletal, and gasping for strength—the nurses can often do little more than start him on anti-retroviral therapy (ART) and hope it is not too late. Too often, it is.

While women routinely visit clinics for antenatal care, child immunisation, or family planning, many men seek medical attention only when their health has deteriorated beyond repair. This gender gap in health-seeking behaviour continues to cost lives.

The National AIDS Council reports that men bear a disproportionate share of HIV deaths in Zimbabwe, despite higher infection rates in women. The 2024 ZIMPHIA survey shows only 63 per cent of HIV-positive men are on treatment versus 77 per cent of women, leaving thousands at risk from a fully manageable disease.

These figures point to a deeper inequality built into the very design of the health system — one that makes care far more accessible to women than to men.

For years, the explanation has been simple: men avoid clinics out of pride — the so-called “macho” attitude. But the reality is more complex.

Zimbabwe’s health system focuses on maternal and child services, so women regularly access clinics and receive HIV testing. Men, however, often face unwelcoming clinics, long queues, limited privacy, and inconvenient hours, discouraging attendance.

Private clinics offer discretion, but are unaffordable to low-income earners. Many therefore remain untested—or begin treatment only when it is almost too late.

In most rural districts country-wide, nurses recount men arriving too weak to walk, suffering from advanced HIV/AIDS illnesses such as tuberculosis or meningitis. 

“We call them the invisible patients,” says Constance Sibanda, a nurse at Lupote Clinic in Hwange District, in Matabeleland North Province. “They only come when death is close.”

The consequences ripple far beyond the individual. Families lose breadwinners, children become orphans, and communities lose valuable labour.

For Mr. Richard Ndlovu, a 47-year-old father of three from Nkayi, a late diagnosis nearly cost his life—but treatment gave him a second chance.

“When I finally went to the clinic, my weight had dropped to 45 kilogrammes and I could barely stand,” he recalls. “The nurses told me it was advanced HIV. I thought that was the end for me. But after starting ART, I began to feel stronger every week. Now, I’m back at work and helping other men get tested early.”

He adds: “I used to think clinics were for women. Now, I tell other men — there is nothing strong about dying silently. Real strength is knowing when to seek help.”

There are signs of change. In Bulawayo, HIV prevalence dropped from 13 percent in 2022 to 10.7 percent in 2025, according to Provincial Medical Director Dr. Maphios Siamuchembu. Among men, the rate fell from 9.9 to 7.8 percent — attributed to improved awareness and outreach.

However, defaulting patients remain a concern.

“We have people still dying from advanced HIV disease in 2025 when treatment is free and widely available,” he says. “The fight against stigma must start with each of us—because without tackling stigma, we will not win.”

Community initiatives are helping close the gender gap. Organisations like ZNNP+ and Population Services Zimbabwe (PSZ) run male-friendly HIV testing at workplaces, mines, and transport hubs, often alongside other health checks. Digital campaigns on WhatsApp, radio, and Facebook promote HIV care as responsible and strong, challenging traditional masculinity.

Experts argue that the health system itself must evolve. In an interview with New Ziana, Dr. Claudius Madanhire, who studies masculinity and health in Zimbabwe, explained how social expectations around manhood influence men’s engagement with health services.

“Social expectations around manhood continue to shape how men perceive and engage with health services. Health services must be restructured to include men—through flexible hours, privacy, and male counsellors who make the clinic experience less intimidating. We need to move from seeing men as ‘hard to reach’ to understanding the barriers that keep them away.”

Dr. Madanhire highlights the need for HIV services that address men’s structural and cultural barriers. The Ministry of Health has expanded testing and counselling for men and youth, with Dr. Tsitsi Apollo stressing dignity-based care. 

“Re-engagement services should ensure that recipients of care are received with dignity, assisted, clinically managed, and given quality psychosocial support.”

Traditional medicine practitioners have also become key allies in reaching men who avoid clinics.

George Kandiero, spokesperson for the Zimbabwe National Traditional Healers Association (ZINATHA), says collaboration between traditional healers and health workers has been vital in changing attitudes.

“Since the advent of HIV and AIDS in the 1980s, ZINATHA has played a pivotal role in improving people’s health, including men who often feel shy to visit clinics,” he explains. 

He notes that while some patients still use locally developed immune boosters, ZINATHA encourages regular testing and ART adherence, working closely with the Ministry of Health and Child Care. 

A UNAIDS report, The Path that Ends AIDS, highlights that ending AIDS is a political and financial choice. Following this path, including in Zimbabwe, yields strong results and strengthens preparedness for future pandemics while advancing the Sustainable Development Goals.

Botswana, Eswatini, Rwanda, Tanzania, and Zimbabwe have already achieved the “95-95-95” targets—meaning 95 percent of people living with HIV know their status, 95 percent of those are on treatment, and 95 percent are virally suppressed.

“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders,” said Winnie Byanyima, Executive Director of UNAIDS. “They could be remembered by future generations as those who put a stop to the world’s deadliest pandemic.”

HIV is no longer a death sentence. Yet for many Zimbabwean men, it still feels like one—not because treatment doesn’t exist, but because the system hasn’t fully reached them. Until clinics, communities, and cultural norms make care truly stigma-free, too many sons will still push their fathers to clinics too late—for a disease no Zimbabwean should die from today.