Bulawayo is showing remarkable progress in the fight against HIV, with new infections nearly halved and treatment coverage exceeding 98 percent, according to the 2025 HIV Estimates Report for Bulawayo Metropolitan Province. However, the report also highlights persistent gender disparities, the challenges of aging with HIV, and the increasing impact of non-communicable diseases (NCDs).
Presented by the National AIDS Council (NAC) at a recent media workshop, the report draws on data from 2024 and combines clinic records, surveys, and advanced modeling tools to provide a comprehensive view of the epidemic’s trajectory.
Primrose Dube, NAC Bulawayo’s Monitoring and Evaluation Officer, explained that these estimates are essential for tracking progress and adapting HIV interventions. “We triangulate high-quality data to calculate the best possible estimates to guide our response,” she said.
The findings show that 76,608 people were living with HIV in Bulawayo in 2024, a decline from 79,711 in 2020, reflecting improved health management and prevention efforts. Antiretroviral therapy (ART) coverage rose significantly, from 87.5 percent in 2020 to 98.3 percent in 2024, moving the region closer to UNAIDS’ global 95-95-95 targets and Zimbabwe’s 2030 goals.
New HIV infections dropped by 44 percent across all age groups, signaling a strong positive trend. Yet, the epidemic remains unevenly distributed between genders. In 2024, women living with HIV numbered 47,832, substantially higher than the 28,776 men affected. HIV prevalence among women stood at 13.6 percent, compared to 7.8 percent for men, underscoring ongoing structural inequalities.
The report reveals that HIV prevalence peaks in women aged 30 to 39, with 26 to 28 percent living with the virus, whereas men peak later, between 40 and 49 years. Even among adolescents aged 15 to 19, females have a higher infection rate (5 percent) than males (2 to 3 percent).
Children and young people remain key focus areas. In 2024, an estimated 3,056 children aged 0 to 14 were living with HIV, and about 3,713 young people aged 15 to 24 were HIV-positive. Encouragingly, prevention of mother-to-child transmission (PMTCT) programs have reduced new infections among children by half, from 158 in 2020 to 88 in 2024.
The report also highlights significant reductions in HIV incidence and AIDS-related deaths. Among adults aged 15 to 49, new infections fell by 52 percent between 2020 and 2024. Deaths attributed to AIDS in Bulawayo numbered 946 in 2024, representing 5.7 percent of Zimbabwe’s total, signaling improvements in treatment and care.
An emerging concern is the growing population of older adults living with HIV, who now face the additional burden of NCDs like hypertension, diabetes, and cancer. This dual challenge complicates treatment and requires health systems to adapt.
Douglas Moyo, NAC’s acting programmes manager for Bulawayo, emphasized the need to sustain progress while addressing remaining gaps. “While prevention and treatment efforts are yielding results, the gender gap, young women’s high prevalence, and older patients’ evolving needs demand targeted approaches,” he said.
Dube concluded that the estimates serve not just as data but as a strategic tool to guide policy and ensure no group is left behind in Bulawayo’s ongoing fight against HIV.
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