HIV/AIDS in Zambia
HIV/AIDS in Zambia
Generally, women lack complete control over their lives and are taught from early childhood to be obedient and submissive to males, particularly males who command power such as a father, uncle, elder brother or guardian. In sexual relations, a woman is expected to please her male partner, even at the expense of her own pleasure or well-being. Dominance of male interests and lack of self-assertiveness on the part of women puts them at risk. Women are taught never to refuse having sex with their husbands, regardless of the number of partners he may have or his non-willingness to use condoms,
even if he is suspected of having HIV or another STD.
—Ministry of Health/Central Board of Health, “HIV/AIDS in Zambia: Background, Projections, Impacts, Interventions,” September 1999
Sex for Survival
Although the line is sometimes blurred, there are distinctions between young women who sell sex at various times and those who are sex workers. Girls and young women may trade sex as a currency in exchange for food, money or protection but may not consider themselves to be sex workers. According to the 1999 report by the Ministry of Health/Central Board of Health, this is a “frequent occurrence”: “Exchange of sex for money or gifts is a coping strategy for dealing with poverty and may not be perceived as commercial sex work.”
Girls who are orphaned, often taking care of younger siblings, or who have fled their homes due to abuse, neglect, or poverty reported finding themselves having to trade sex to survive, having nothing else to trade, and in some cases engaging in more regular sex work. This puts them at high risk for contracting HIV/AIDS and suffering a range other abuses. Increasing poverty in Zambia has contributed to a rise in the sexual exploitation of girls. The National AIDS Council summarized the situation as follows: “In order to cope, households pull their children, particularly girls, from school, reduce their food intake and in some cases [they] resort to begging. In these circumstances, some women and girls are forced to engage in sex for money to meet their household expenses.” Human Rights Watch, interview at Tasintha, Lusaka, May 23, 2002.
Poverty forces large numbers of African men to migrate long distances in search of work, and while away from home they may have multiple sex partners, increasing their risk of infection. Some of these partners may be women who engage in commercial or “transactional” sex because of poverty, and they are also highly vulnerable to infection.
Migrant workers may carry the infection back to their wives when they return home. Long distance truck and public transport drivers are also seen as key agents in the spread of HIV.
Safer sex campaigns have had some success preventing HIV transmission, and safer sex will continue to play a vital role in our prevention efforts. We need to consider some key questions, however, in analyzing what makes prevention programs effective to ensure that prevention efforts are proactive.