In a tiny room on the edge of Harare, three women sat huddled on a worn-out mattress, worried about what tomorrow will bring. These women are part of Zimbabwe’s 40,000 sex workers, a group now facing a health crisis after the United States government cut foreign health aid earlier this year.
For nearly two decades, Zimbabwe relied heavily on US-funded programmes like PEPFAR, the world’s largest HIV prevention and treatment initiative. These programmes provided free condoms, HIV testing, and antiretroviral drugs to vulnerable groups, including sex workers.
But after the aid cuts announced by US President Donald Trump, many clinics have shut down or run out of stock, leaving thousands without access to essential health services.
“These little baby socks were my condoms,” said Sharon Mukakanhanga, a 43-year-old sex worker, as she pulled a pair from her bag. “I became so desperate after the clinic closed. I knew it wasn’t safe, but I had no other choice.”
The impact has been severe. Government data shows 5,932 AIDS-related deaths in the first half of 2025, a rise from 5,712 in the same period last year.
Cecilia Ruzvidzo, a 47-year-old HIV-positive mother of four, said she was left with only 10 days’ worth of medication after her last clinic visit.
“I literally lost my mind,” she said. “Without condoms or medicine, my life and the lives of my clients were at risk.”
Medical charity Doctors without Borders (MSF), one of the few organisations still providing free treatment, says its clinics in Epworth and Mbare are overwhelmed.
“They don’t know where to go,” said Charlotte Pignon, MSF project lead. “We are stretched to the limit. The cuts have left a huge gap.”
Experts warn the situation could worsen. Wonder Mufunda, head of the Centre for Humanitarian Analytics, said US funding previously stood at about $522 million, with $90 million specifically for HIV programmes.
“You wake up and the funding is gone — it’s a huge blow,” Mufunda said. “If nothing is done, deaths will continue to rise.”
Zimbabwe’s collapsing economy is also forcing more women into sex work, with some charging as little as 50 US cents per client, making it nearly impossible to afford condoms or medical care.
Activists are now urging the government to step in with emergency funding to keep HIV prevention services running, warning that failing to act will reverse years of progress in the fight against AIDS.
