Polygamous Communities Have Lowest HIV Burden In Zimbabwe

By Michael Gwarisa

HIV estimates in Zimbabwe show that HIV prevalence and the number of new infections in communities that practice polygamy are lower compared to other settings, HealthTimes has learnt.

The HIV response in Zimbabwe emphasizes the need for sexually active individuals to have not more than one sexual partner as having multiple concurrent partners increases the risk of HIV infection.

Numerous studies have been conducted in other parts of Sub-Saharan Africa showing that polygamy was a risk factor for new HIV infections. However, it seems some cultural practices observed within polygamous settings play a part in regulating sexual behavior in these communities.

Mashonaland West Province, for example is a high HIV burden province in Zimbabwe with an estimated population of 1,245,000 and an estimated 143,000 people living with HIV from its seven administrative districts. However, Kariba district where polygamy is rife, has the lowest HIV prevelence.

Mr Davison Mamombe, the National AIDS Council Programs Officer for Mashonaland West Province said Kariba, despite being a polygamous community, has the lowest HIV and Sexually Transmitted Infections (STIs) burden in the province.

In terms of the highest disease burden, Mhondoro Ngezi has the highest HIV burden in the province at 14.3% followed by Chegutu at 13.7% then  Zvimba, at 12.6%, Makonde at 12%, Hurungwe at 11.06% and Kariba has 9%,” said Mr Mambudzi.

“Kariba becomes unique in the sense that we have people who have strong cultural roots and those people practice polygamy. However for an outsider to penetrate their circles, it becomes a challenge so because of that, HIV prevalence in those communities is very low including sexually transmitted infections.”

Key drivers of HIV in the province are inter-generational sex, low-risk risk perception and multiple concurrent partners. According to the Zimbabwe Demographic Health Survey (ZDHS), the province has an HIV prevalence 13% HIV prevalence and an incidence of 0.16%. HIV estimates put the number of people in need of antiretroviral therapy (ART) at 130,000 in Mashonaland West province. The province has a 95% ART coverage for adults and 78% ART coverage for children.

In Matabeleland North province, Tsholotsho District has the highest HIV prevalence at 21,9% while Binga, also a highly polygamous community has the lowest HIV prevalence at 5,3%.  In an earlier article in the Chronicle newspaper, NAC national monitoring and evaluation director Mr Amon Mpofu said the Tonga people in Binga had a lot to share about their culture which kept the prevalence lower than other areas in Zimbabwe.

He attributed the low prevalence to strong moral values practised by Tongas coupled with 
less movement.

“HIV is a sexually transmitted disease as we all know and this means Tonga values are strong and as a result, the transmission is low. They also have strong values when it comes to marriage. They avoid casual sex and value marriage, something which we should all emulate,” he said.

Meanwhile, the role of concurrency in the spread of HIV remains contested with some researchers questioning the sufficiency of the epidemiologic evidence base in support of this risk factor.

The National AIDS Council Chief Executive Officer, Dr Benard Madzima said Polygamy was not the factor behind the low HIV prevalence in communities where polygamy is prevalent.

“Maybe the protective factor is not necessarily polygamy. The prevalence might be low but to attribute it to polygamy that’s where my question is,” said Dr Madzima.

Polygamy is a tradition which is legally sanctioned in African culture and allows husbands to have more than one wife. Polygamy operates to create concurrent sexual networks within marriage between multiple wives and their husbands, in addition to any extra-marital sexual contacts the spouse may have.

However, direct sexual transmission of HIV can occur in these concurrent sexual networks where the virus is introduced through the spouse’s extra-marital sexual contacts or where a new wife who is already HIV positive enters the polygamous union.

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