In Zimbabwe’s second largest city, Bulawayo, every pregnant woman is tested for HIV as part of a drive to prevent mothers passing on the virus to their babies.
But many women, especially teenagers, are reluctant or afraid to use these potentially live-saving testing services.
Part of the reason is because of the lasting stigma surrounding HIV/Aids among sexually active teenagers who feel isolated if people know about their HIV positive.
Midwives At a local maternity clinic in Bulawayo's packed suburbs, midwives struggle to explain to pregnant teenagers why they need to be tested for HIV before they give birth.
But the teenager, who lightly beats her chest in an effort to pacify what seems like a painful cough, will not hear of it. She is afraid that her worst fears will be confirmed as she already suspects she could be HIV-positive.
Midwife Nontando Siziba, 53, says it is not unusual: “We now test all pregnant women for HIV as part of attempts to protect both the health of the mother and the unborn baby,” she told Inter Presse Service news agency. “But this is sometimes very difficult when we are working with teenagers.”
This is because of the stigma among teenage girls about being known to be sexually active and HIV positive, Ms Siziba explains. “Though they are sexually active, not all are willing to take the responsibility to take precautions. We have had cases where these young people are told not to breastfeed, but do so anyway, saying that if the community know they are not breast feeding, they will know they are living with the virus."
A new report by east and southern Africa’s Regional Psychosocial Support Initiative found that many young mothers only find out that they are HIV positive when they are pregnant, and some only find this out when their children get sick. Brighton Gwezera, the programme’s manager said: “The adolescents are still failing to handle issues relating to stigma and this has seen them failing to fully benefit from antenatal health care.”
With about one in seven people in Zimbabwe living with HIV, the south African nation is suffering one of the harshest Aids epidemics in the world, according to Aids organisation, Avert. And because of the country’s tense political and social climate, it has been hard to tackle the crisis. President Robert Mugabe and his government have been widely criticised by the international community, and Zimbabwe has become isolated, both politically and economically.