













































_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

CHALLENGES EXPERIENCED BY 
UNEMPLOYED ADULTS ON  

ANTI-RETROVIRAL THERAPY IN HARARE 
Zinyemba, Lizzy 

 
ABSTRACT 
 
The Anti -Retroviral Therapy (ART) study sought to investigate the 
challenges that were experienced by unemployed adults on ART in 
Harare, Zimbabwe over two periods, 2008 and 2013. The 2008 
period marked the time when Zimbabwe was experiencing social and 
economic challenges mainly evidenced by hyperinflation and 
collapse of the local currency.  In 2009, a multi-currency economy 
was introduced and this immediately contained inflation. The study 
concentrated on the health, social and nutritional aspects of the 
respondents during the two different economies and was analysed 
using the Marxist school of thought. The study was a repeated cross 
sectional survey, where data was presented simultaneously for the 
two periods revealing the socio-economic status of individuals as the 
strongest predictor of health, opportunistic disease causation and 
longetivity on people and on medical treatment. The study concludes 
that there is a co-relationship between socio economic status and 
ART adherence and recommends a holistic approach to ART. 
 
 
KEY TERMS:  Anti-retroviral therapy, nutrition, health, medical 
treatment, adherence, social class and Marxism 
 

 

 

 

School of Social Work, University of Zimbabwe. Contacts:  
lizzyzinyemba@gmail.com, P. Bag 66022 Kopje, Harare.  

African Journal of Social Work, 4(1), June 2014                                                55 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

INTRODUCTION 

 

In 2008, Zimbabwe experienced severe social and 

economic challenges, the economy was characterised by 

an extra ordinary hyperinflation and shortages of foreign 

currency which affected all sectors of the economy 

including the health sector. The health sector was equally 

affected   as the hyperinflation eroded the salaries of 

health workers. A parliament report from the Ministry of 

Health and Child Welfare cited in Labour and Economic 

Development Research Institute Zimbabwe (LEDRIZ, 

2012) confirmed that 80% of all health professionals 

trained in Zimbabwe had migrated to other countries. 

The shortage of foreign currency made it difficult to 

import drugs and hospital equipment. After the 

introduction of a multi-currency system an improvement 

was noted in the supply of drugs and health personnel. 

This paper will look at the challenges that were faced by 

unemployed adults on Anti- Retro Viral Therapy (ART)   

when inflation officially reached an overwhelming 231 

million percent by July 2008 and when inflation figures 

African Journal of Social Work, 4(1), June 2014                                                56 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

stabilised to a single digit after the introduction of the 

multi-currency (LEDRIZ, 2012).  

 

BACKGROUND 

 

During 2008, the country experienced severe macro-

economic constraints, such as rising poverty levels, 

unstable exchange rates and hyperinflation. These factors 

necessitated the need for long term planning while 

making it difficult both to plan for and adhere to 

expenditure and revenue targets (Sims, 2013).  HIV and 

AIDS further strained already stretched health budgets 

and systems. The situation in the country in 2008 

deteriorated to the extent that the government introduced 

a wide range of measures to try to respond to the 

situation but could not be effected due to economic 

challenges. The National Health Strategy, dubbed the 

1997-2007: Working for Quality and Equity in Health, 

was the main policy that had been in place. This policy 

was supposed to be succeeded by the National Health 

Strategy for Zimbabwe 2009-2013. This strategy was 

delayed in its implementation due the socio economic 

African Journal of Social Work, 4(1), June 2014                                                57 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

challenges that the country faced. The country thus had 

policy on paper to plan for the attainment of effective 

ART but could not be implemented. The unprecedented 

hyperinflation and shortages of foreign currency faced by 

the country had a detrimental effect on health personnel. 

Salaries were eroded and the country experienced 

massive brain drain of health personnel (Matendere, 

2010). Drugs became unaffordable to the generality of 

the population. Basic drugs like ARVs were scant in 

most government hospitals to the extent that it was a 

challenge to initiate new patients on ART (Matendere, 

2010). An estimated 80% of admission in public 

hospitals was attributed to HIV related illness (LEDRIZ, 

2012). The kind of strain that the general populace went 

through varied depending on the level of services and 

nature of the demand and the capacity of the hospital. 

This supports Marx school of thought that the economic 

mode of production that a country is going through 

determines the general character of the social political 

and spiritual process of life that is experienced by the 

people (Giddens, 2009). The economic situation that 

Zimbabwe went through in 2008 affected almost 

African Journal of Social Work, 4(1), June 2014                                                58 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

everyone and hit hard all areas of life. For the 

unemployed adult on ART it was a very difficult 

situation as their health condition and treatment 

requirements needed to be adhered to despite the 

economic challenges being experienced in the country.  

The economic challenges also contributed to the already 

tremendous rises in the adult mortality rates. Zimbabwe 

Statistics, (2006) also indicated that the largest increase 

in mortality rates was observed among women aged 

twenty five years and above and among men aged thirty 

years and above. These age patterns of adult mortality 

were consistent with the age pattern of HIV infection in 

Zimbabwe.  The situation, however improved after the 

introduction of the multi-currency system. The 

government embarked on comprehensive intervention 

strategies to prevent effects of HIV and AIDS, on all 

sectors of the economy.  It was, however, noted that 

these efforts still had challenges up to date as lot of harm 

had taken place (Kramarenko, 2010).   

 

METHODOLOGY 

 

African Journal of Social Work, 4(1), June 2014                                                59 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

The research was a repeated cross sectional design that 

looked at the challenges being experienced by 

unemployed adults on ART.   Data was collected in 2008 

when Zimbabwe was at its peak of economic meltdown 

and in 2013 when the economic situation was reported to 

have improved (Kramarenko, 2010).  A total of 100 

people participated in the study, 50 respondents in 2008 

and 50 respondents in 2013. The same tools were used to 

collect data in both years, a desk review and observations 

were made to identify if the introduction of the multi-

currency system had made a positive impact in achieving 

treatment for unemployed adults on ART. Respondents 

were interviewed as they came in the hospital to collect 

their monthly medicines. The researcher made use of the 

patients’ files and interviewed those that had indicated 

that they were unemployed.  Data was collected from 

patients at Beatrice Road Infectious Disease Hospital 

(BRIDH) in Harare. The hospital is situated in Mbare 

along Simon Mazorodze road. The hospital caters for 

people in the southern suburbs of Harare. It treats 

diseases like tuberculosis, cholera, typhoid, dysentery 

and measles amongst others. It also has an Opportunistic 

African Journal of Social Work, 4(1), June 2014                                                60 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

Infections Clinic (OIC) that caters for HIV and AIDS 

patients (City of Harare, 2013). The position of BRIDH 

is shown on the map, Figure 1. 

    

Figure 1: Position of Beatrice Road Infectious Disease 

Hospital, Harare, Zimbabwe 

 

 
Source: Google Maps, 2013 

 

THEORETICAL FRAMEWORK 

 

This paper used the Marx theory on social class to 

explain the impact of social class on unemployed adults 

African Journal of Social Work, 4(1), June 2014                                                61 
_____________________________________________________________________ 
  

javascript:void(0)
javascript:void(0)


_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

on ART.  In Marxism, the needs and freedom of the 

individual are very important.  Marx condemns any 

society that imposes a division of labour without 

considering the need for the well being and for maximum 

self realization of each and every individual. He criticizes 

the class society which is a situation in which an 

individual’s fate tends to be determined by his class 

position (Barry and Yuill, 2008). This was the case for 

the unemployed adults on ART as their social class 

determined their fate, which was failure to adhere to the 

requirements of their monthly treatments.   The   Marxist 

school of thought was used to present how the situational 

analysis of unemployed adults on ART’s, nutrition and 

health were determined by the social class position that 

they occupied in the society.  

 

RESULTS AND DISCUSSION 

 

Demographic analysis  

Women were more forth coming to the study than men. 

This might be because of the cultural background where 

women are expected to participate in community health 

African Journal of Social Work, 4(1), June 2014                                                62 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

programmes. The study targeted men and women who 

were between the ages of twenty years and sixty years in 

both 2008 and 2013, with the minimum age being 21 and 

maximum 60. This meant that the sexually and 

economically active age group was covered.  

 

The data set in 2008 was bimodal because it had two sets 

of age groups that appeared most frequently. That is 36 

and 34 while in 2013 the mode was 36. These age groups 

are the most sexually active as revealed by UNAIDS 

(2012). These age groups have a high risk of being 

infected by HIV and AIDS (UNAIDS, 2012). They are 

also the most economically productive age groups which 

are supported by studies carried out by UNAIDS, (2012) 

that HIV and AIDS has affected the economy by 

reducing the labour force.  

 

The high utilization of medical services by the 

economically active age group due to the HIV and AIDS 

pandemic is opposed to what is cited in Barry etal 2008   

that    utilization of medical services is most common 

amongst the elderly as the use is determined more by 

African Journal of Social Work, 4(1), June 2014                                                63 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

need than any other factors.  The table below shows the 

percentage distribution by gender and age of the 

respondents who participated in the study. 

 

Table 1: The percentage distribution of respondents by 
age and gender 
 

 Year  2008 Year  2013 

Variabl
e 

 Frequency % Frequency % 

Gender Male 20 40 14 28 

 Female 30 60 36 72 

 Total 50 100 50 100 
Age 21-30years 20 40 18 36 
 31-40 years 22 44 24 48 
 41-50 years 4 8 6 12 
 51-60 years 2 4 2 4 
 61++ years 2 4 0 0 

 

The marital status of the respondents reflects that in both 

years, unemployed adults on ART were without a partner 

and this probably affected their survival strategies and 

the idea of taking medication on time as they needed 

someone to remind them. This may also be attributed to 

disclosure among the AIDS patients as they were 

required to disclose to people who were close to them so 

African Journal of Social Work, 4(1), June 2014                                                64 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

as to get assistance with their treatments. Table 2 below 

depicts the marital status of the respondents. 

 

Table 2: Percentage distribution of respondents by marital 
status  
 
     

Year      2008 Year    2013 

Marital 

status 

Frequency    % Frequency   % 

Married 22 44 18 36 

Widowed 14 28 20 40 

Divorced 4 8 2 4 

Single  2 4 0 0 

Deserted  4 8 8 16 

Living in 4 8 2 4 

Total  50 100% 50 100% 

 

The majority of the respondents who had attained 

secondary school education and beyond were 76% and 

80% in 2008 and 2013 respectively as shown in Table 3 

below. These were most likely to get some form of 

seasonal unskilled employment in the informal sector 

while the remaining 23% were still depending on petty 

African Journal of Social Work, 4(1), June 2014                                                65 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

trading and vending. Those that had attained post 

secondary school education were mainly affected by the 

high unemployment levels that the country has been 

going through in the past five years. (Zimbabwe 

statistics, 2013).  The level of education was worthy 

being discussed as education determines the economic 

status of individuals in societies, which in turn affects the 

way one adheres to ART. Table 3 shows the educational 

qualifications of the respondents. 

 

Table 3: Percentage distribution of respondents by 
education  
  

  Year 2008  Year 2013 

Level of Education Frequency 2008 

% 

Frequency 2013 

% 

None 1 2 0 0 

Primary 11 22 10 20 

Secondary 36 72 35 70 

Post secondary 2 4 5 10 

Total  50 100 50 100 

 

 

 

African Journal of Social Work, 4(1), June 2014                                                66 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

Health  

In ART taking care of health is a very crucial element. 

Living a healthy life will also contribute to an increased 

life span. The idea behind ART is meant to prevent 

people living with HIV and AIDS from easily being 

attacked by opportunistic diseases that reflect poor 

immunity (Brierley, 2013).  The treatment makes the sick 

people to be well and be in a position to carry out their 

day to day activities. People on ART, thus live longer 

and healthier, while on treatment. This is in support of 

Parsons concept of the sick role that the sick person 

should try to get well Barry etal, 2008. People living with 

HIV and AIDS try to get well by taking their daily and 

monthly treatments. In chronic diseases like HIV and 

AIDS Parsons cited in Barry etal, (2008) acknowledges 

that the goal of complete recovery is impractical. The 

chronic disease can be managed so that a person can be 

able to maintain a relatively normal pattern of 

physiological and social functioning. This is made 

possible in ART patients as the treatment restores the 

normal functioning of the individual.   In ART treatment, 

taking in medication is very important as defaulting 

African Journal of Social Work, 4(1), June 2014                                                67 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

treatments has serious implications on one’s health that 

include drug resistance and recurring of opportunistic 

infections (UNAIDS, 2013). This is in support with 

Parsons’ line of thinking in his sick role that the sick 

person should seek technically competent help and 

cooperate with the physician (Barry et al, 2008). 

 

Defaulting treatment is one of the major health 

challenges that were cited by the respondents. Defaulting 

treatments was due to a number of factors like socio-

cultural factors (Zimbabwe Statistics, 2011). During 

2008 and 2013, the study revealed that 64% and 86% 

respectively of the respondents did not buy their 

prescribed drugs of opportunistic infections on time. This 

was because of other demanding aspects of life like 

buying food and payments for shelter.  In both 

economies, the respondents indicated that they defaulted 

because they could not afford transport costs and other 

demanding aspects of their lives. It was noted that those 

respondents in the lower social classes of the economy 

migrated, to other countries in search of employment 

(Murombedzi, 2013).  The paper indicated that those 

African Journal of Social Work, 4(1), June 2014                                                68 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

who were in the lower social class were still experiencing 

difficulties to adhere to their monthly treatments as they 

ended up migrating to nearby countries in search of 

menial jobs. It was also noted that those that migrated 

could not afford to come and collect their monthly 

treatments on time and ended up defaulting as they 

would have not made enough savings to come back home 

and collect their treatments.   

 

Despite the economy improving, the respondents still 

indicated that they could not raise the multi currency 

required to meet their health needs as they made a living 

by mainly engaging in petty trading and menial work. 

This was a common trend that was persistent among the 

unemployed adults on ART that were interviewed during 

the periods of economic hardships and the multicurrency 

economy.  In Marxism, once inequalities come into being 

they create better opportunities for the rich than for the 

poor, as it was noted by Murombedzi (2013) that after 

the introduction of the multi currency the same health 

problems that were experienced by the lower class were 

no longer experienced by the respondents in better social 

African Journal of Social Work, 4(1), June 2014                                                69 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

classes like the middle class, that were working. Even 

though the economic situation had changed, the 

unemployed adults on ART still had challenges in 

adhering to their treatments. The unemployed adults on 

ART could not work as a team and cooperate with the 

physician due to high levels of poverty that surrounded 

them. Thus cooperation on ART adherence and early 

treatment of opportunistic infections with the physician 

was secondary as they could not meet their basic needs. 

This is opposed to what WHO (2013) indicated that for 

better health, there is need for the patient to cooperate 

with the physician. This defeated the whole idea of ART. 

 

From the   study findings it can be noted that 

unemployed adults on ART could not assume    Parson’s 

sick role. This was due to the economic situation in the 

country in 2008, many unemployed adults on ART did 

not have the opportunity to enjoy the sick role status 

because assuming the sick role status rendered them less 

likely to be able to earn a living or survive in conditions 

of poverty. This is supported by Parsons cited in Barry et 

al (2008) who noted that people living in a poverty 

African Journal of Social Work, 4(1), June 2014                                                70 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

stricken environment might work regardless of how sick 

they might be as long as they felt that they might be able 

to perform some of their work activities. To further 

exacerbate the situation, most of the unemployed adults 

on ART could not access adequate health services and 

their health was no longer being taken as a human right 

but as a privilege. This shows how the political situation 

in Zimbabwe influenced the socio economic status of 

unemployed adults on ART. This is supported by 

Giddens (2009) in the political economy theory that 

emphasizes on the role of economic and political systems 

in shaping and reproducing the prevailing inequalities in 

society 

 

Nutrition 

The coexistence of high rates of malnutrition and HIV 

and AIDS in Africa creates an additional challenge 

UNAIDS (2008). HIV is characterized by progressive 

destruction of the immune system leading to recurrent 

opportunistic infections and malignancies, progressive 

dilapidation and death. Malnutrition is recorded to be one 

of the major complications of HIV infections and is a 

African Journal of Social Work, 4(1), June 2014                                                71 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

significant factor in advancement of disease (WHO, 

2013). 

 Prior to the dollarization, all the respondents indicated 

that they had nutritional challenges. It was difficult for 

them to put a meal on their table. 12% of the respondents 

could afford one meal a day and this was usually supper. 

The respondents reported this to be a 001 meal plan 

where they had no meal in the morning and afternoon 

and one meal in the evening. The majority of the 

respondents (52%) could afford two meals a day and this 

was usually breakfast and supper. 36% of the 

respondents had three meals a day. For breakfast 8% of 

the respondents indicated that they had porridge and 

plain tea. The respondents that consumed porridge alone 

were 22%. The respondents that indicated that they had 

tea with bread were 20%. Some of the respondents, 24% 

had sadza and vegetables in the morning, which is not a 

balanced diet. The remainder 26% did not eat anything in 

the morning despite their poor health that requires food. 

52% of the respondents indicated that they had lunch, 

80% of the respondents indicated that they consumed 

sadza and vegetables. 19% reported that they either had 

African Journal of Social Work, 4(1), June 2014                                                72 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

tea with bread or tea with sadza. All the respondents 

indicated that they had supper. The respondents that 

indicated that they had a fruit highlighted that it was not 

bought but home grown or they were indigenous fruits. 

Due to the above stated challenges 80% of respondents 

ended up eating food that they did not want to eat. Most 

of the respondents (90%) indicated that they could not 

afford a balanced diet due to not eating a variety of 

foods. 88% of the sample indicated that they rationed 

their meals so that they could take them longer. These 

results validate the contention by UNAIDS (2008) that 

most adults who were unemployed and living with HIV, 

could not afford a balanced diet, despite the fact that it 

was essential for the ART to work effectively.  The 

situation was further exacerbated by the economic mode 

of production that the country was going through that 

was characterized by the unavailability of basic 

commodities in most retail shops in the country. The 

unemployed adults on ART in 2013 also indicated that 

with the little money that they got from petty trading and 

menial jobs   in the multi currency economy, they could 

afford to eat anything that they wanted to eat as food was 

African Journal of Social Work, 4(1), June 2014                                                73 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

now available and affordable. The majority of the 

respondents (80%) could afford three meals a day. 20% 

of the respondents had two meals a day. For breakfast all 

the respondents indicated that they had porridge, tea and 

bread while some few respondents indicated that on 

some of the days they could afford a sandwich. For the 

respondents that indicated that they had lunch the 

majority of the respondents (90%) indicated that they 

consumed sadza and vegetables or sadza and beans.  The 

remaining 10% had either tea with bread or rice with 

soup. All the respondents indicated that they had supper. 

The respondents (60%) in 2013 also indicated that they 

rationed their meals so that they could take them longer. 

This shows a decline in the number of respondents that 

rationed their food from (88%) in 2008 to (60%) in 

2013.The majority 70% of the respondents indicated that 

life was better. Their only challenge was raising the 

money required to buy food as it was noted that the 

foreign currency was very difficult to come by to those 

people who were not formally employed and depended 

on pieces of work like manual labour and petty trade in 

African Journal of Social Work, 4(1), June 2014                                                74 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

the community, and donations   from the civic society   

and the extended family.  

 

Figure 2 shows the equation that the unemployed adults 

on ART were facing. Instead of adhering to ART and 

receiving early treatments of opportunistic infections and 

eating balanced diet the opposite was true and lead to 

non achievement of ART.  

  

Figure 2: The sequential steps that depict the plan of ART 

 

 
 

There were significant changes that the unemployed 

adults on ART reported to have occurred. The change in 

the country’s economy has impacted positively on the 

unemployed adults on ART. The variable change of life 

style was noted by all the respondents in 2008. While in 

2013 few of the respondents (30%) indicated that they 

African Journal of Social Work, 4(1), June 2014                                                75 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

maintained their life style.   In 2008 (88%) of the 

respondents indicated that household poverty levels had 

increased. The number reduced to 20% in 2013.  This is 

in support with the Marxist school of thought that notes 

that the economic mode of production determines the 

general character of the social political and spiritual 

process of life that is experienced by the people (Giddens 

2009). As the economic situation improved the processes 

of life also improved as highlighted in the table above. In 

2008, the minority of respondents indicated that they 

could afford a balanced diet (20%) while the number 

increased to 60% in 2013. Table 4 below shows the 

distribution of the social challenges faced by the 

respondents during the two periods. 

 

Table 4: Percentage distribution of respondents Social 
Challenges in 2008 and 2013 
 
 
 
 
 
 
 

African Journal of Social Work, 4(1), June 2014                                                76 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

Year 2008 2013 

Social challenge  Frequency 

2008 

% Frequency 

2013 

% 

Change of life style 50 100 35 70 

Reduced expenditure 46 92 15 30 

Increased poverty levels  44 88 10 20 

Selling  of asserts  30 60 2 4 

Defaulting treatment  36 72 0 0 

Afford a balanced diet 10 20 30 60 

 

Coping mechanism  

The respondents highlighted that they depended on the 

extended family members, the community and the civic 

society to supplement their needs.  The respondents 

indicated that the extended family had large numbers of 

people to look after, thus the burden was rather too heavy 

for them.  It was also noted that the extended family was 

willing to assist but had no sufficient resources to cater 

for the needs of the unemployed adult on ART. This 

supports UNICEF, (2006) findings that the extended 

family needs support in order to efficiently assist other 

family members. This shows Durkheim’s solidarity 

theory where he postulated the importance of a society’s 

African Journal of Social Work, 4(1), June 2014                                                77 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

cohesion and integration (Giddens, 2009). This solidarity 

was observed in Zimbabwe during the economic 

challenges as the extended family and the community 

played a pivotal role in assisting unemployed adults on 

ART.  

 

From the study findings in both 2008 and 2013, it was 

quite normal for the unemployed adults on ART to leave 

their social roles being attended to by other coping 

mechanism like the extended family, community and the 

civic society. This is in agreement with what Parson’s, 

sick role that the sick person is exempted from his 

normal social roles.  Although the extended family was 

still functional it was noted that this coping mechanism 

was not reliable. The extended family could not buy their 

medication on time, and they had to forgo their 

medication because the extended family had no money to 

buy the medication for the treatment of opportunistic 

infections. The study revealed that the extended family 

provided food when the respondents were left with 

absolutely nothing.  

 

African Journal of Social Work, 4(1), June 2014                                                78 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

The civic society has played a pivotal role in assisting the 

unemployed adults on ART. The studies revealed that the 

unemployed adults on ART were assisted by the Non 

Governmental Organizations (NGO).   In 2013, 76% of 

the respondents whose health needs were taken care of 

by NGOs also highlighted that they got their medication 

on time. However, the respondents indicated that the 

need to target more beneficiaries in their interventions as 

the intervention targeted a few people.  Eighty four 

percent (84%) of the respondents that were assisted with 

food from NGOs in 2008 indicated that the food was not 

enough to take them up to the next month when they 

received the next food ration. This was because they had 

to share the food with the extended family that usually 

gave them a helping hand when they had problems.  In 

2013, 72% of the respondents highlighted that they 

received food rations from the NGOs and their main 

challenge was that there was nothing for breakfast. 

Psycho-social support from the NGO was also reported 

in both 2008 and 2013, and was reported to be very 

useful to the unemployed adults on ART. However this 

coping mechanism was reported to target a few people.   

African Journal of Social Work, 4(1), June 2014                                                79 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

 

The community also played an essential role in the lives 

of the unemployed adults on ART in both 2008 and 

2013. The respondents indicated that the community 

assisted them with food, clothing and psycho- social 

support.  The study revealed that the community assisted 

the unemployed adults on ART with small amounts of 

food only when requested and money for transport to 

visit the hospital to collect their monthly treatments.  

Fear of social exclusion was the reason why the 

respondents did not make much use of the community as 

a coping strategy in both years. These  findings 

supported Matendere’s, 2010 findings that  People 

Living with HIV and AIDS are less likely to disclose 

their situation in fear of social exclusion and the stigma 

associated with the disease. 

 

CONCLUSION AND RECOMMENDATIONS 

 

The study concluded that there is a co-relationship 

between socio economic status and ART adherence. The 

unemployed adults on ART, faced challenges with their 

African Journal of Social Work, 4(1), June 2014                                                80 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

health needs and nutritional needs, while being in the 

lower social class and this negatively affected their 

adherence to ART. The study recommends a holistic 

approach to service provision, which incorporates a 

comprehensive service provision in all sectors of the 

economy for ART to be a success. ART should take into 

consideration the availability and affordability of health 

and nutritional needs of people living with HIV and 

AIDS. Hence there is need for a coordinated centralised 

system where medication, food, health and social 

requirements of unemployed adults on ART to be 

addressed and people’s welfare should be adequately 

addressed to complement the health treatments.   The 

study hence recommends a vibrant well co-ordinated 

referral system in all areas concerning the welfare of 

unemployed adults on ART for the successful 

achievement of ART.   

 
 
 
 
 
 
 

African Journal of Social Work, 4(1), June 2014                                                81 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

REFERENCES 
 
City of Harare; 2013. City of Harare hospitals. Available:   
http://www.hararecity.co.zw (Accessed 24 July 2013). 
 
Cockerham, W.; 1989. Medical sociology. London: 
Prentice Hall. 
   
Giddens, A.; 2009. Sociology. Cambridge: Polity press. 
 
Government of Zimbabwe; 2004. Zimbabwe Millennium 
Development Goals. Progress Report.  
Harare: Government of Zimbabwe. 
 
Kramarenko, S.; 2010  Zimbabwe : Challenges and 
policy Options after hyperinflation. Available: http://imf-
book-store.org.  (Accessed 12 May 2013). 
 
Labour & Economic Development Research Institute, 
Zimbabwe. (LEDRIZ); 2012.  Pro-poor and inclusive 
development in Zimbabwe. beyond the enclave. Harare: 
Weaver Press.  
 
Matendere, L.; 2010. Challenges associated with 
unemployed adult patients on Anti- Retroviral therapy 
(ART) at Beatrice Road infectious Disease hospital. A 
dissertation submitted to the University of Zimbabwe in 
partial fulfilment of the requirements of the Master of 
Social Work degree.   
 
Murombedzi, C.; 2013. ARVs versus migration. The 
Herald Newspaper  25 April 2013, pC5. 

African Journal of Social Work, 4(1), June 2014                                                82 
_____________________________________________________________________ 
  



_____________________________________________________________________ 
AJSW, Volume 4, Number 1, 2014                                                      Zinyemba, L. 

 
Scrambler, G.; 2008. Sociology as applied to medicine. 
Harcourt Publishers. 
 
Sims, C.;  2013. Restrictive measures and Zimbabwe: A 
political implications economic Impact and a way 
forward. Available: http://academia.edu_18 61567_res 
(Accessed 13.April 2013). 
 
UNAIDS; 2012. Impact of the global economic crises on 
women, girls and gender equality. Available: 
http://unaids/economic_ gender _equity (Accessed 4 
March 2013).  
   
UNAIDS; 2008. Aids in Africa: Three scenarios to 2015. 
Geneva: UNAIDS. 
 
UNICEF; 2006. Facing the future together. Harare: 
UNICEF.  
  
WHO; 2008. Towards universal access: Scaling Up 
priority HIV/AIDS Interventions in the health sector; 
progress report. Geneva: WHO. 
   
World Bank; 1999. HIV/AIDS and poverty. World Bank. 
      
Barry, A. and Yuill, C.; 2008.Understanding sociology of 
health. an introduction . London: Sage. 
 
Zimbabwe Statistics; 2010. Zimbabwe Demographic 
Health Survey 2010-2011. Harare, Zimbabwe Statistics. 

African Journal of Social Work, 4(1), June 2014                                                83 
_____________________________________________________________________ 
  


