KEY POINTS
- US cuts leave Zimbabwe sex workers without HIV protection.
- AIDS-related deaths rose in 2025 amid shrinking support.
- Clinics warn they cannot meet growing demand.
In a dimly lit Harare room with peeling paint, three sex workers huddled on a mattress, describing how survival has grown more dangerous since Washington slashed health aid earlier this year.
Sharon Mukakanhanga, 43, pulled out a pair of baby socks she once used as condoms when supplies ran dry. “These little socks served as condoms when I became so desperate after the American government withdrew its support from my all-time go-to safe haven,” she said.
For years, U.S.-funded programs such as PEPFAR, the world’s largest HIV initiative, formed a lifeline in Zimbabwe’s fragile health system. Now, their absence is being felt sharply.
Rising deaths test fragile health system
Government figures show 5,932 AIDS-related deaths in the first half of 2025, up from 5,712 in the same period last year. The withdrawal has forced many sex workers and HIV-positive patients to scramble for dwindling supplies of antiretrovirals and condoms.
“It was a very difficult period. I literally lost my mind,” said 47-year-old sex worker Cecilia Ruzvidzo, who left a clinic with only 10 days of medication earlier this year. “Could not get condoms, which are a necessity for my work. I was at risk of contracting more infections. My clients were also exposed.”
Doctors Without Borders, which is not funded by Washington, said its Harare-area clinics are stretched thin as patients flood in. “They don’t know where to go,” said MSF’s Charlotte Pignon.
Clinics buckle as demand surges
The U.S. had previously committed about $522 million in health aid to Zimbabwe. Including $90 million for HIV programs, according to the Centre for Humanitarian Analytics. Losing that money created “serious disruptions,” said the think tank’s CEO, Wonder Mufunda.
Zimbabwe’s worsening economy is also driving more women into sex work, now estimated at 40,500 nationwide. The competition has pushed prices down so far that some workers charge 50 cents a client, less than the cost of a box of condoms.
“We knew it wasn’t safe,” said Ruzvidzo of using makeshift protection. “But I had to feed my children.”
