Geospatial and Sociodemographic Disparities in HIV Prevalence and HIV Diagnosis Among Men in Zimbabwe Using ZIMPHIA 2020 Data

Abstract Introduction Although Zimbabwe is among the countries on track to end the HIV epidemic by 2030, important gaps remain. Recent disruptions in HIV funding risk reversing decades of progress. Understanding disparities in the HIV burden and care is crucial for optimizing resource allocation. Methods We used data from the ZIMPHIA 2020 survey. Among the 7,664 men included in the study, we estimated survey-weighted descriptive statistics and HIV prevalence across sociodemographic characteristics. The first 95 target was assessed by sociodemographic characteristics, while all 95–95–95 targets were described and mapped. Multivariable logistic regression was performed to identify factors associated with HIV awareness status. Spatial autocorrelation and hotspot analyses were used to assess geographic clustering. Results HIV prevalence among men was 10.2% (95% CI: 9.5%–11.0%). Among HIV-positive men (n = 906), 84.3% were aware of their status, 95.9% of those aware were on ART, and 89% of those on ART were virally suppressed. HIV prevalence was highest among men aged 45 + years (21.1%; 95% CI: 19.1%–23.2%). Conversely, unawareness was highest among men aged 15–24. Each additional year reduced the odds of unawareness by 9% (OR = 0.91; 95% CI: 0.88–0.94). HIV prevalence was highest in the Matabeleland provinces, with significant spatial clustering and hotspots. Unawareness was highest in Mashonaland Central and Masvingo, with no significant clustering. Conclusion Our findings suggest that men lag behind in HIV care, especially in diagnosis. There is sociodemographic and geographic heterogeneity in HIV prevalence and unawareness among men, hence resource allocation should be targeted accordingly. Clinical Trial: Not Applicable