In 1999, Zimbabwe was the world's most HIV-infected country. By 2006, behavioural changes had created the world's largest decline in new infection rates. But by 2015, large-scale responses to AIDS in Zimbabwe had begun to focus more on medication than on behavioural changes. This paper examines some of the deep tensions around sexuality, witchcraft and illness that have influenced this trajectory. Using evidence from missions, state administrators and ethnographers, the paper will highlight earlier debates around syphilis, sexual morality, and masculinity and ask why certain constructions of sexuality continue to have purchase in contemporary conditions, while others do not.