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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.
Responsible Editor Maria Nilsson
Responsible Editor Maria Nilsson
Acknowledgments
We would like to thank all the participants for their time and valuable insight. We would also like to thank Tafadzwa Museka, Ansley Tshugulu, Besley T. C. Tawonechi, and Martha Muzondo for their research support.
Author contributions
SG, CN and MS conceived and were involved in the design of the study. TM collected the data. TM, FD and RM participated in transcription and data management. CN and RM managed fieldwork activities and provided study oversight. MS and TM did the data analysis. MS drafted the manuscript in close dialogue with TM, PMM, BKM and FD. All authors reviewed and provided critical edits to the manuscript. All authors have approved the submitted manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The research project was reviewed and approved by the Imperial College Research Ethics Committee (ref. 20IC6436) and by the Medical Research Council of Zimbabwe (ref. MRCZ/A/2703). All participants provided informed consent to participate at the onset of the study as well as with each data collection activity.
Paper context
The past couple of years have seen the colliding of two global pandemics: AIDS and COVID-19. Growing evidence suggests that progress against HIV has not only stalled during the COVID-119 pandemic but actively lost ground. This paper provides insight into how people at risk of HIV have experienced this pandemic collision. Focusing on access to HIV prevention methods during lockdown, the findings both inform future pandemic preparedness responses and detail resilience of communities at HIV risk.