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By Dr T W Ngwenya Changamire

The 1st of December is a day for raising awareness on HIV/AIDS. World AIDS day helps us to remind each other on the impact of HIV/AIDS in our communities and the importance of HIV testing, the importance of putting an end to stigma and discrimination, the role that each of us can play in the fight against HIV/AIDS and the importance of early initiation of Antiretroviral agents.

We no longer wait for the immune system to get to a certain level for us to initiate treatment. The World Health Organisation advises on a test and treat policy.

This is to ensure that the virus is suppressed early, your immune system is protected and chances of developing opportunistic infections are reduced.

Men with the highest risk of contracting HIV are men who have sex with men and men who use injectable drugs of abuse. The centre for disease control states that men engaging in receptive anal sex are 13 times more likely to contract HIV from their HIV infected partner when compared to insertive anal sex.

Data on men who have sex with men are limited in Africa, however it is estimated that overall approximately 20% which is 1 in 5 men who have sex with men is HIV positive (UNAIDS,2019).



Before we go further let us define what HIV is. HIV or Human immunodeficiency virus is a virus that infects humans and destroys the immune system. The immune system is the bodies defence against infection. HIV weakens the immune system and makes people prone to developing illnesses.

Progressive weakening of the immune system leads to AIDS (acquired immunodeficiency syndrome). When one has a weakened immune system or when one develops AIDS they are prone to infections that are referred to as opportunistic infections.

In the acute stages or early stages of HIV infection (2 to 4 weeks) symptoms of HIV infection in men include development of a fever, body rash, sore throat, headaches and less common in men is development of lymph nodes, fatigue and generalised joint pains and muscle pains. This is followed by an asymptomatic stage which may last from months to years.

During this stage the virus is replicating and attacking the immune system.  This is why it is important to get checked for HIV because in most cases the immune system will be weakened gradually but no symptoms will show. The last stage is referred to as the Advanced stage.



This is the stage where the immune system is weakened and is prone to recurrent upper respiratory infections, skin rashes and skin infections and as this stage progresses one may get infected and succumb to opportunistic infections.

Opportunistic infections are life-threatening. Common opportunistic infections include candida which is a non-life-threatening fungal infection affecting the mouth, food pipe or airway of even the lung. It causes whitish plaques in the mouth and pain on swallowing.

A life-threatening fungal opportunistic infection which can affect the brain leading to meningitis is Cryptococcal meningitis. This is very common in immunosuppressed individuals.

Certain parasitic infections may cause chronic diarrhoea, vomiting, abdominal cramps which may affect appetite and lead to severe weight loss. CMV (Cytomegalovirus) is a virus that can affect your lung, intestines or brain. In the brain it affects the part responsible for eyesight called the retina and this will lead to irreversible blindness if it is not treated promptly.

Other common infections include bacterial Pneumonia’s, TB (Tuberculosis infection) and PCP (Pneumocystis Pneumonia) which are all life-threatening. TB can affect the lung, abdomen, brain or even bones particularly the spine.

The list is not exhaustive but includes conditions that are common, life-threatening or may have negative irreversible outcomes.



The total number of people living with HIV/AIDS (PLHIV) in SA has increased from an estimated 3.8 million in 2002 to 8.2 million by 2021. This is according to Statistics South Africa 2021. According to the World health organisation WHO Africa region has the highest number or people living with HIV/AIDS with the highest percentage in East and Southern Africa. Majority of men living with HIV are not aware of their HIV status.

It is imperative to mention that HIV also increases the risk of development of certain cancers. Cancer’s related to HIV infection in men include; Kaposi Sarcoma, Lymphoma and Anal cancers. HIV infection weakens the immune system and favours cancer development. Human papilloma virus (HPV) infection which is contracted during sexual intercourse may lead to cervical cancer in women but in men it may lead to anal cancers or penile cancers.

The risk of anal cancer is 17 times higher in men who have sex with men compared to men who have sex with women only. Throat cancers are also related to HPV infection contracted during oral sex. It is also important to note that HPV infection also causes penile warts in men. These are benign non-cancerous lesions.

How can men help to reduce the spread of HIV?

  • Know your HIV status by going for regular testing.
  • If you are found to be HIV positive enrol into an ARV programme. The goal is to be virologically suppressed. This is achieved by adhering to your treatment. This prevents your chance of getting opportunistic infections and chances of spreading HIV.
  • Get screened and treated for any sexually transmitted infections. This prevents your chances of getting HIV infection.
  • Practise safe sex practices. Safe sex practices include using condoms and knowing your partner’s HIV status
  • Men are encouraged to undergo circumcision. Voluntary medical male circumcision helps to reduce spread of HIV from males to females by 60%.
  • In high risk groups the use of PrEP is also encouraged. PrEP is the use of antiretroviral agents in a HIV negative person. This is to protect HIV negative people from potential HIV infection especially in groups of people who may not be able to negotiate the use of condoms like sex workers



We all have a role to play in the fight against the spread of HIV and the fight against stigma and discrimination around those affected or infected by HIV/AIDS because this is a major factor that deters friends, family, sexual partners and youth from seeking health care.

I urge PLHIV to also get vaccinated against COVID-19.


Contact All In 4 Health – Dr TW Ngwenya Changamire – for General Medical Consultation, Health Screening, Medical Check-up, Health Education and Promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton park 1619













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