Health officials in Bulawayo have reported a significant breakthrough in the city's response to the HIV epidemic, with treatment coverage reaching 94% of the population.
The latest data from the National Aids Council (NAC) reveals that 79,746 people were receiving antiretroviral therapy (ART) by the end of last year.
While the figures suggest the province is close to achieving total epidemic control, the data also highlighted a stark gender imbalance and ongoing challenges in reaching high-risk groups.
Douglas Moyo, the NAC metropolitan programmes officer for Bulawayo, confirmed that the vast majority of those currently on treatment were adults.
"Of those on treatment, 77,961 are adults (97.8%), while 1,785 are children (2.2%), highlighting a relatively small proportion of paediatric cases," Moyo said.
The clinical breakdown showed that 75,005 patients remained on first-line regimens.
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However, a small but significant number of patients have progressed to more complex treatments, with 4,620 people (5.8%) on second-line therapy and 121 on third-line regimens.
A recurring concern for health officials is the disproportionate number of women accessing care compared to men.
Women make up nearly 62%of ART clients in the province, totaling approximately 49,370 patients, while men account for only 30,376. This trend was consistent across every district in the province.
The disparity is even more pronounced in the detection of tuberculosis (TB).
Although 166,623 people living with HIV were screened for TB, men recorded a positivity rate of 1.3%, significantly higher than the 0.79% seen in women.
Moyo noted that this gap points to "potential gaps in early detection and care-seeking behaviour among male patients".
To combat the pressure on the city’s overstretched health facilities, the NAC transitioned 8,859 additional clients to differentiated service delivery (DSD) models in 2025.
These models are designed to improve patient convenience by providing easier access to medication outside of traditional hospital settings.
Success is also being measured through viral load monitoring, a key indicator of whether the virus is being effectively suppressed.
Out of more than 79,000 tests conducted, 51,519 adults and 843 children achieved undetectable viral loads.
However, the report warns that the fight is far from over. At least 2,741 adults and 134 children still have viral loads exceeding 1,000 copies/ml.
Health experts have warned that these patients require "enhanced adherence support" to prevent further illness and transmission.
While Moyo insists the data reflects "strong progress toward epidemic control," experts maintain that targeted interventions are essential to bridge the gender divide and support those failing to achieve viral suppression.