New Obstacles to HIV Treatment in Zambia

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Zambia, a landlocked country in southern Africa, documented its first case of AIDS in 1984. Since then, the nation has become home to one of the most widespread epidemics in the world. The Zambian government has made significant efforts to combat the outbreak of HIV and AIDS, but these measures are not readily available to everyone. According to a report from Human Rights Watch, few of these programs are accessible to the disabled, which is creating new obstacles to HIV treatment in Zambia.

Human Rights Watch recorded the findings from more than 200 interviews conducted among Zambian citizens with disabilities. These individuals included parents of disabled children, officials of nondenominational organizations, educators, government representatives and healthcare employees. Many of these people claimed to be seen as asexual by the community, and thus endure social stigmas regarding marriage and child-rearing. One disabled woman, Yvone L., said, “When you go for VCT [voluntary HIV counseling and testing]…people say, ‘Why should you be in the line? Who could give you HIV?’ They don’t expect disabled women to be sexually active.”

HIV in Zambia has spread throughout all avenues of society, which is in direct contrast to other countries where the lentivirus primarily targets the impoverished. However, some demographics are more susceptible to infection than others. Zambian women between the ages of 15 and 24 are more than twice as likely to contract HIV than their male counterparts. This is due in part to gender inequality. Women in Zambia are regularly taught never to insist their partner wear a condom during sexual intercourse. Additionally, children compose a large portion of the population suffering from HIV. An estimated 170,000 children in Zambia are currently living with the disease, but some lives are being impacted ever further. Many children have abandoned their homes altogether after enduring abuse from foster families.

There are many factors contributing to these new obstacles to HIV treatment in Zambia. A large percentage of disabled children are restricted from attending school and receiving preventative information because of familial discrimination, admission barriers and a lack of physical accessibility. The few who are able to attend classes are often excluded from HIV preventative programs.

Women with disabilities are at an increased risk of HIV infection because of the high rates of sexual violence. These women are even more vulnerable because information regarding gender-based violence, social protection services and HIV prevention is not being equally distributed. Many disabled individuals are unable to receive satisfactory pre- and post-HIV testing counseling due to healthcare workers’ substandard abilities to address the questions and concerns of those with disabilities. Disabled people who begin antiretroviral treatments sometimes fail to make scheduled appointments because of their dependence on others.

Zambian efforts to prevent the outbreak of HIV and AIDS began shortly after the first recorded case, and there are many campaigns endeavoring to raise awareness. The Ministry of Education is developing ways to further integrate AIDS education into school curriculums after a governmental study conducted in 2009 found that many teachers had little to no knowledge of HIV and AIDS education, and lacked the ability to incorporate it into their classrooms. In 2012, Zambia launched its “U-Report” plan on World AIDS Day. People who enlisted benefited by receiving information about HIV and other sexually transmitted diseases (STDs) sent directly to their cellular phones.

In response to the new obstacles in HIV treatment in Zambia, the government has ratified treaties with a special focus on human rights. The Convention on the Rights of Persons with Disabilities is designed to provide disabled people equal access to health care and preventative programs. In addition, the Persons with Disabilities Act, enacted in 2012, legislated that sexual and reproductive health care and public health programs be made readily available to the entire population.

Acquiring proper funding necessary to ensure HIV preventative measures are distributed equally remains a concern. Approximately 75 percent of HIV and AIDS funding in Zambia is reliant upon donations from foreign parties. The Global Fund for HIV/AIDS suspended donations of more than $137 million in 2009, after it was discovered that donor aid to the Zambian Ministry of Health had been stolen. This dependence on foreign donors has placed additional pressure on the Zambian government to implement new alternatives for HIV and AIDS funding. While Zambia has finally begun to address the issues faced by people with disabilities, eliminating social stigma and gender inequality is another matter.

By Samuel Williams

Human Rights Watch