Mandla, 26, is a bright young man who knows his right to access HIV services. "Many people in my community had a lot of sayings concerning my sexual orientation: some say I am possessed and some say I need deliverance but the fact is that I am just like any person, despite my sexual orientation as a man who has sex with men."
Mandla experienced much stigma and discrimination both in private and public spaces. He was excluded by his siblings from family gatherings, and while walking about his neighbourhood, boys of his age would call out offensive words. The attitude he faced about his sexuality from his community made him nervous about accessing sexual health services.
"As I was developing into adulthood I started looking at a wide range of online media platforms searching for information on HIV prevention services and where l could access them," he said. "I just had a feeling that when I visited the nearest health facility the service providers might eavesdrop the service which I wanted to access."
Homophobia and transphobia in Zimbabwe
Everyone, particularly groups most vulnerable to HIV, must have access to the essential HIV services and health care they need. Yet homophobia in Zimbabwe is entrenched in the political arena and the majority of politicians who address people at any political gathering crush out the issue of gay rights. This presents a problem for men who have sex with men or transgender people.
Samuel Matsikure, programmes manager for Gays and Lesbians Association of Zimbabwe (GALZ), said: "The lesbian gay bisexual trans and intersex (LGBTI) community has been finding it difficult to associate among themselves and others, as the safe spaces continue to shrink. This has resulted in men who have sex with men and transgender persons not accessing services that are appropriate for them."
The Constitution of Zimbabwe Amended (No.20) chapter 56 stipulates equality and non-discrimination, stating every person has the right to not be treated in a discriminatory manner including on grounds of sex and gender. However, the reality is different.
Matsikure said: "The criminalisation of men who have sex with men and transgender people has allowed fear and intimidation by state agencies within public spaces to grow like cancer. Blackmail cases and extortion continue unabated resulting in the community not opening up to healthcare workers, and not seeking legal protection and demanding their rights as equal citizens."
Making progress with partnerships
With support from partners like Sexual Rights Centre, GALZ, National AIDS Council of Zimbabwe, the International HIV/AIDS Alliance and UNAIDS, national discussions about LGBTI rights have evolved and development programmers now understand the diverse issues facing this vulnerable group.
Matsikure said: "There is better acceptance of men who have sex with men and transgender persons within some healthcare facilities where healthcare workers have been sensitised. This has increased uptake of services although more awareness-raising within the LGBTI community and public still needs to be done."
The National AIDS Council of Zimbabwe coordinates a multi-sectorial response to HIV and has interventions specifically for men who have sex with men and transgender people. Other organisations are also scaling up HIV prevention services for these groups.
UNAIDS supports discussion platforms between communities, programmers and policy makers, looking at gaps, needs, and how to strengthen programme. This supports the engagement and participation of vulnerable groups and helps address stigma and discrimination.
Tamara Johnson, UNAIDS Zimbabwe youth and key populations programme officer, said: "UNAIDS together with the National AIDS Council, the Ministry of Health and Child Care and other partners are looking into how we can scale up HIV services for key populations. This includes looking into training and sensitising health service providers to understand the needs of key populations as well as working on creating spaces for men who have sex with men and LGBTI [people] in the AIDS response."
Tackling homophobia and transphobia
Each year GALZ holds an event to mark the International Day against Homophobia and Transphobia with local partners and communities.This year, the event which will take place on 17 May in Bulawayo is expected to attract over 200 people.
Matsikure said: "This year's theme is mental health and well-being for the LGBTI community. Many of us are affected by an unfriendly and unaccepting environment for people of different sexual orientations and gender identities. This has a great impact on mental health for individuals as they navigate through social terrain that is homophobic and transphobic. The wellbeing of the LGBTI community needs to be taken holistically beyond HIV. We need to create an enabling environment where LGBTI persons are treated as equal citizens and receive all the care they require."
Mandla's story has a positive ending, as with support from GALZ, he is now accessing a wide range of services including referral to sexual and reproductive health and HIV services. But there are many other people like Mandla who need more support, especially to access HIV prevention services.
If men who have sex with men and transgender people are not treated as equals and do not have access to such services, it will be difficult to get to zero new HIV infections, an important target in the HIV response. Zimbabwe must prioritise this vulnerable group in health guidelines, strategies and policy documents at national, regional and international level. Part of this means tackling homophobia and transphobia. Without it, we will not be able to end AIDS.