AIDS in Zambia

Here is a portion of an article that talks about the prevalence of AIDS in Zambia.

“Zambia, in southern Africa, has one of the world’s most devastating HIV and AIDS epidemics. More than one in every seven adults in the country is living with HIV1 and life expectancy at birth has fallen to just 39 years.2 In 2009, nearly 83,000 adults were newly infected with HIV, that is about 200 new infections each day.3 After four decades of independence, Zambia has found peace but not prosperity and today it is one of the poorest and least developed nations on earth.

Zambia’s first reported AIDS diagnosis in 1984 was followed by a rapid rise in the proportion of people living with HIV. Although Zambia has received hundreds of millions of dollars for HIV programmes from rich country governments, prevalence rates are not dropping and have remained more or less stable since the nineties, at as high as 25% in some urban areas.4

The history of AIDS in Zambia

Zambia’s first AIDS case was reported in 1984.5 Within two years the National AIDS Surveillance Committee (NASC) and National AIDS Prevention and Control Programme (NAPCP) were established to coordinate HIV/AIDS-related activities.

In the early stages of the epidemic much of what was known about HIV prevalence was kept secret by the authorities under President Kaunda. Senior politicians were reluctant to speak out about the growing epidemic (the President’s announcement in 1987 that his son had died of AIDS6 was a notable exception), and the press did not mention AIDS.

By the early nineties it was estimated that as many as 1 in 5 adults had been infected with HIV, leading the World Health Organization to call for the establishment of a National AIDS Advisory Council in Zambia. According to Stephen Lewis, the UN’s Special Envoy for HIV/AIDS in Africa, throughout the 1990s the government was ‘disavowing the reality of AIDS’ and doing ‘nothing’ to combat the problem.7

The new millennium signalled a marked change in political attitude and, according to Stephen Lewis, ‘an entirely new level of determination’8 to confront the epidemic. The National HIV/AIDS/STD/TB Council (NAC) became operational in 2002 when Parliament passed a national AIDS bill that made the NAC a legally-established body able to apply for funding (the prospect of a large World Bank grant provided much of the necessary motivation). At the passing of this bill, the NAC became the single, high-level institution responsible for coordinating the actions of all segments of government and society in the fight against HIV and AIDS and is in charge of guiding the implementation of the National HIV and AIDS Strategic Framework (2006-2010).

In 2004, President Mwanawasa declared HIV/AIDS a national emergency and promised to provide antiretroviral drugs to 10,000 people by the end of the year. Having exceeded this target, he set another to provide free treatment for 100,000 by the end of 2005.

Government ministers and officials at all levels are now much more willing and able to talk about the epidemic. Even former president Kaunda has changed – he is now one of the most vocal and committed AIDS activists in the country.

In 2008 UNAIDS reported a stabilising of Zambia’s epidemic and some evidence of favourable behaviour change.9

The impact of HIV/AIDS in Zambia

Unlike in some countries, HIV in Zambia does not primarily affect the most underprivileged; infection rates are very high among wealthier people and the better educated. HIV is most prevalent in the two urban centres of Lusaka and the Central Province, rather than in poorer rural populations.10 11

The collapse of copper prices in the 1970’s weakened Zambia’s economy and saw an increase in the number of men seeking work away from home. The movement of miners, seasonal agricultural workers and young men between rural areas and urban centres has been shown to spread HIV to new areas.12 Zambia is now the most urbanised country in sub-Saharan Africa, with only a third of its population living in rural areas.13

The impact on women

Although the HIV epidemic has spread throughout Zambia and to all parts of its society, some groups are especially vulnerable – most notably young women and girls. Among young women aged 15-24, HIV prevalence is nearly four times that of men in this age category.14

A number of factors resulting from gender inequality contribute to the higher prevalence among women. Women are often taught never to refuse their husbands sex or to insist their partner uses a condom. In a Zambian behavioural survey, around 15 percent of women reported forced sex, although this may not reflect the true number as many women do not disclose this information.15 In addition, young women in Zambia typically become sexually active earlier than men, with a partner who will be on average five years her senior, who may already have had a number of sexual partners.16

The impact on economic productivity

The impact of AIDS has gone far beyond the household and community level. All areas of the public sector and the economy have been weakened, and national development has been stifled. As Zambia’s Poverty Reduction Strategy Paper acknowledges, “the epidemic is as much likely to affect economic growth as it is affected by it”.17

Agriculture, from which the vast majority of Zambians make their living, is also affected by AIDS. The loss of a few workers at the crucial periods of planting and harvesting can significantly reduce the size of the harvest. AIDS is believed to have made a major contribution to the food shortages that hit Zambia in 2002, which were declared a national emergency.

The impact on children

Children have been much affected by the AIDS epidemic in Zambia, where over 30,000 children are HIV positive.18 However, being HIV infected is not the only way that children are affected by HIV and AIDS. In 2007 there were 600,000 AIDS orphans in the country and AIDS orphans made up half of all orphans in the country.19 20 Thousands of these children are abandoned due to stigma or a simple lack of resources, while others run away because they have been mistreated and abused by foster families.

Many of the most tragic stories connected with HIV transmission involve the sexual abuse of children. Men are targeting increasingly younger sexual partners whom they assume to be HIV-negative, and the “virgin cure” myth (which wrongly claims that sex with a virgin can cure AIDS) fuels much of the abuse. An increased proportion of the abusers are HIV-positive and many transmit their infection to their victims. Police handled more than 200 cases of child rape in the second quarter of 2003, and some experts believe that for every case published another ten go unheard.21″


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