The Challenges of The HIV and AIDS Pandemic Among Informal Settlements – A Case Study of Hatcliffe Extension in Harare, Zimbabwe

This research was a descriptive study on the challenges of the HIV and AIDS pandemic in informal (slum) settlements, case studying the Hatcliffe Extension slum in Harare, Zimbabwe. With slums identified as areas of high risk and vulnerability with regards to HIV infection and spread due to high levels of poverty, information gaps existed as to the exact causative factors and transmission dynamics of the pandemic in such areas in the country. This particular study therefore sought to fill in these information gaps as well as to further go on and recommend on how to best address the pandemic in these highly vulnerable communities. More specifically, it sought to determine the factors increasing risk and vulnerability to HIV infection among the informal settlement dwellers, to establish sex networking linkages within and around the settlement as well as to establish the levels of care and support for People Living With HIV and AIDS (PLWHA) and OVC in the settlement. It also had as its other objectives to assess the slum dwellers’ knowledge, attitude and practices with regards to HIV and AIDS, establish the factors inhibiting the effective response to HIV and AIDS in the informal settlement and finally to draw lessons and good practices with regards to responding to the HIV and AIDS pandemic in informal settlements. Data collection included review of project documents of the various development organizations operating in the area, participatory observations, focus group discussions(with grandparents caring for orphans, children heading households, adolescents and adults), key informant interviews with local leadership, government and non-governmental development programmes implementers, as well as in-depth interviews with People Living With HIV and AIDS and orphans. Adolescents and adults were interviewed in-depth in a KAPB survey to establish their knowledge, attitudes, practices and behaviours with regards to sexuality issues. The results clearly showed that poverty and unemployment were the main factors driving HIV infection and spread in the community as people particularly women, engaged in transactional sex as a survival strategy, as affirmed by 62 (60.8%) of the KAPB survey respondents. Poverty also limited care and support for PLWHA as well as orphans. Other factors identified as driving the pandemic in the community were noted as liberal attitude towards sexuality/‘loose morals’ among the youth (14.7%), child sexual abuse (7.8%), inadequate housing (10.8%) and finally culture-based social re-engineering (5.9%).Challenges towards effective response to the pandemic in Hatcliffe Extension included political interference, donor fatigue to programmes, dependency syndrome of the community as well as lack of coordination in the response strategy itself. Operation Restore Order/Murambatsvina, which saw the displacement of people from Hatcliffe Extension, was also noted to have interfered with HIV and AIDS programmes in the area. The study overally confirmed the interlinkage between HIV and AIDS and poverty informal settlements which was punctuated by gender dynamics, and hence a need was underscored to provide socio-economic empowerment to people in slum settlements, particularly women for response programmes to be effective. Slums were also shown to be a policy blindspot in Zimbabwe, yet a growing reality which could reverse gains made in fighting against HIV and AIDS, because of their high risk nature as well their potential to spread infection into wider society. A need was therefore seen to curb the slum phenomena in the country through rural development, economic growth as well as provision of adequate housing. The effective coordination of the response against HIV and AIDS in informal settlements was also seen as pivotal in attaining real results on the ground, a role which the National AIDS Council needed strengthening in