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Globally, there have been considerable achievements towards HIV care and treatment. AIDS-related deaths have been reduced by 60% since the peak in 2004. Potentially, the fight against the HIV epidemic was made more difficult with the outbreak of COVID-19. Thus, this study examined the implications of COVID-19 in the utilization of HIV care and treatment services among people living with HIV on antiretroviral therapy (ART) in Zimbabwe. The study aimed to identify the critical factors defining the utilization of HIV services at the advent of COVID-19 using the fifth revision of the Anderson Behavioral Model of Healthcare Utilization. The study utilized a concurrent triangulation design of which only one data collection phase was used. The quantitative data was collected from 2,157 people living with HIV on antiretroviral viral therapy through a structured interviewer-administered questionnaire. On the other hand, qualitative data was collected through in-depth interviews. Regarding accessing ART refills, the study findings revealed that adolescents aged 15–19 (aOR = 2.16; 95% CI: 1.18–3.96) had higher odds of utilizing ART refills compared to their counterparts who were aged 20–24. Living in a rural area was associated with higher odds of utilizing the ART refill service (aOR = 2.20; 95% CI: 1.49–3.24). Regarding accessing viral load monitoring adults aged 25–39 (aOR = 0.41; 95% CI: 0.26–0.66) were less likely to utilize viral load monitoring compared to young people aged 20–24. Being vaccinated for COVID-19 was significantly associated with higher odds of utilizing the viral load monitoring service (aOR = 1.97; 95% CI: 1.36–2.87) than those not yet vaccinated. Living in a rural area was associated with higher odds of utilizing viral load monitoring (aOR = 1.50; 95% CI: 1.09–2.08). Regarding tuberculosis preventative therapy, adults aged 25–39 (aOR = 0.30; 95% CI: 0.20–0.47) were less likely to utilize tuberculosis preventative therapy compared to young people aged 20–24. Being vaccinated for COVID-19 was significantly associated with higher odds of utilizing tuberculosis preventative therapy (aOR = 1.59; 95% CI: 1.12–2.25) than those not yet vaccinated. Living in a rural area was associated with higher odds of utilizing tuberculosis preventive therapy (aOR = 1.58; 95% CI: 1.19–2.08). Regarding tuberculosis screening being vaccinated for COVID-19 was significantly associated with higher odds of utilizing tuberculosis screening services (aOR = 1.89; 95% CI: 1.41–2.54) than those not yet vaccinated. Although the severity of the COVID-19 pandemic has dwindled, COVID-19 appears to come and go in waves, and a few countries are still recording relatively high cases. It is therefore likely that the factors associated with utilization of HIV services identified by the study such as age, residence, type of health facility, vaccination of COVID-19 and fear of contracting COVID-19, among others, need to be included when planning to improve access to health utilization. [ABSTRACT FROM AUTHOR]

The emergence of fertility stalling in Zimbabwe post 2005 highlights the need for continued search for determinants of fertility change. Despite research showing the efficacy of two-sex modelling in understanding men's influence in reproductive behaviour, there is a lack of studies on Zimbabwe's fertility changes employing two-sex modelling. This study addresses this gap by applying the Oaxaca-Blinder decomposition technique in a two-sex framework to the study of the emergence of fertility stalling in Zimbabwe. Data on recent fertility from the 2005-2006 and 2010-2011 Zimbabwe Demographic and Health Surveys for 12,235 women in unions, incorporating their partners' characteristics, were analysed. Results indicate that stalling of fertility transition in Zimbabwe cannot be explained by compositional changes in individual female characteristics. Instead, changes in coefficients related to education characteristics of men were more positively associated with rebounds in marital fertility. The study concludes that, despite focusing on a limited range variables, incorporating characteristics of women's partners potentially enhances understanding of fertility stalling in Zimbabwe. [ABSTRACT FROM AUTHOR]

Under-five mortality remains a major public health challenge in sub-Saharan Africa. Zimbabwe is one of the countries in the region that failed to achieve Millennium Developmental Goal 4 in 2015. The objective of this study was to examine the extent to which maternal health-seeking behaviour prior to and during pregnancy and post-delivery influences the likelihood of under-five mortality among Zimbabwean children. The study was cross-sectional and data were extracted from the 2010/11 Zimbabwe Demographic and Health Survey (ZDHS). The study sample comprised 5155 children who were born five years preceding the 2010/11 ZDHS to a sample of 4128 women of reproductive age (15–49 years). Cox Proportional Hazard regression modelling was used to examine the relationship between maternal health-seeking behaviour and under-five mortality. The results showed that maternal health-seeking behaviour factors are associated with the risk of dying during childhood. Children born to mothers who had ever used contraceptives (HR: 0.38, CI 0.28–0.51) had a lower risk of dying during childhood compared with children born to mothers who had never used any contraceptive method. The risk of under-five mortality among children who had a postnatal check-up within two months after birth (HR: 0.36, CI 0.23–0.56) was lower than that of children who did not receive postnatal care. Small birth size (HR: 1.70, CI 1.20–2.41) and higher birth order (2+) increased the risk of under-five mortality. Good maternal health-seeking behaviour practices at the three critical stages around childbirth have the potential to reduce under-five mortality. Therefore, public health programmes should focus on influencing health-seeking behaviour among women and removing obstacles to effective maternal health-seeking behaviour in Zimbabwe. [ABSTRACT FROM PUBLISHER]