The twin challenges of HIV and the political crisis had debilitating effects on the communication efforts of health organizations in Zimbabwe. This study explores the effects of political violence on the implementation of behavior change programs by eight implementing organizations. Drawing from the structural intervention approach, this study analyzed political obstacles to successful health programming in Zimbabwe and highlighted the bi-directional causal connections between HIV and conflict. Key findings for the study are the government ban of field operations of NGOs, widespread violence against beneficiaries and staff, collapse of public health delivery system, migration, decline in funding and abuse of power by political leaders. This raises questions of program design, dealing with an intransigent government, donor funding in conflict zones, human resources capacity of NGOs and civil society’s role in development in Zimbabwe. This study recommends safe participatory communication strategies, capacity strengthening, creative partnerships and the positive deviance approach as alternative and potentially effective measures for health programmers in conflict settings.