Such figures forced former UN Secretary General Kofi Annan to launch a call for action on women, girls and HIV/AIDS.

In Southern Africa, the Zambian version was launched in 2004 by the former Vice President Dr Nevers Mumba, but has yet to be implemented.

Dr Deji Popoola, Zambia’s United Nations Population Fund (UNFPA) representative, reinforced the areas of concern raised in Annan’s call, advising sub-Saharan countries to address the hopes and fears of a generation of women and girls through the consideration of some serious issues described below.

Prevention

In Zambia, women make up about 50% of all those infected with HIV/AIDS according to the Central Statistics Office. Women’s vulnerability stems from inadequate knowledge about AIDS, insufficient access to HIV prevention services, inability to negotiate safer sex and lack of female-controlled HIV prevention methods such as microbicides.

Condoms have been proven effective in HIV prevention, but their correct and consistent use rests with the male partner, making it more difficult for women to negotiate the most effective means of preventing infection: safer sex.

Access to Medical Care and Treatment

Many women in sub-Saharan Africa still face significant gender-based barriers to treatment including stigma, discrimination, and even violence, which is not the case with men.

In the era of AIDS, even men face barriers that deter them from seeking out voluntary counseling and testing services. Most women find out their status during antenatal care visits, which has made it difficult for women to adhere to medication.

Violence Against Women and AIDS

One of the most common forms of violence against women is that perpetrated by intimate partners (10 – 50 % of women globally report physical abuse by an intimate partner).

Fear of violence prevents women from accessing HIV and AIDS information, being tested, disclosing their HIV status, accessing services for the prevention of HIV transmission to infants, and receiving treatment and counseling even when they know they have been infected. The high incidence of non-consensual sex,
women’s inability to negotiate safer sex, and in many cases fear of abandonment or eviction from homes and communities present extreme challenges – particularly for women who lack economic means.

A study in Zambia found that only 11% of women interviewed believed that a woman had the right to ask her husband to use condoms even if he had proven himself to be unfaithful and was HIV positive.

Securing Women’s Property and Inheritance Rights

The UN Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) requires signatories to take all appropriate measures to eliminate discrimination against women in all maters relating to marriages and families to ensure a basis of equality.

Despite the existence of CEDAW most women are not aware of its provisions and of those who do know, the majority are not in a position to seek legal advice.
Usually widows have no right to inherit property, most risk being evicted and even inherited by their brother-in-law.

Wife inheritance is a custom that has been known to propagate the spread of HIV and AIDS, while economic security can make women less vulnerable to domestic violence. It also protects them from resorting to unsafe sex in exchange for food or shelter - thereby helping to prevent HIV infection.

Education

Young people 25 years and younger account for 68% of the country’s total population. It is worthwhile to note that half of the women in Zambia have a child by the age of 18. This has resulted in a significant number of girls dropping out of school. There is also an indication of low condom use and lack of knowledge or accessibility of contraceptives by youth.

Women and Girls as Care Givers

Research has established that up to 90% of care due to illness is provided in the home. Women and girls pay dearly when undertaking unpaid care work for HIV and AIDS. Young girls and adolescents sacrifice their education to provide care within the home and face reduced prospects for decent work opportunities. They are further put at a risk because most of these homes lack disinfectants and other basic necessities.

Treatment Realities and Barriers to Success

Currently there are 10,000 people on free antiretrovirals out of the 100,000 who need them, an indication that little is being done by the Zambian Government to address the HIV/AIDS crisis. Official figures on children living with the virus are not yet clear.

The only program the Zambian government has implemented to address the HIV/AIDS pandemic is the introduction of the distribution of antiretrovirals (ARVs) to infected people. The program is performing well in urban areas but has failed to serve rural populations as these people face many logistical roadblocks that prevent them from accessing the HIV/AIDS drugs.

As for prevention, little progress is being made by the government. Non-governmental organizations like the New Start Center and Go Center are picking up the slack and are trying hard to do what the government does not, including reaching out to the previously un-served rural areas.