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Published 13 June 2011

The spread of HIV in Zambia is the result of complex cultural, economic

and social challenges, says Sasha Kasthuriarachchi.

I have recently spent a lot of time conducting a SWOT analysis out in the field with the PEPAIDS' AIDS Action Clubs, finding out their needs and how we as an organisation can best support them. This work also brought me face to face with how HIV/AIDS deeply affects all these communities in a multitude of ways. It is evident not only in the subjects that the communities discuss - from caring for AIDS orphans to taking care of the sick in their community - but in the frequency and number of funerals that take place. In each of the meetings I have conducted - and I have facilitated over 20 with over 50 AIDS Action Clubs - there have always been some clubs who have been unable to attend due to funerals or sickness. This really brought home to me the impact of HIV/AIDS in the areas that we work in and in this blog I wanted to discuss some of the problems, cultural attitudes, beliefs and traditions that affect the spread of HIV and AIDS in Zambia.

Zambia is one of the countries worst hit by HIV/AIDS in Africa and around 17 per cent of 15-49-year-olds are estimated to be living with the virus. It scores low on most economic and health indicators with almost 65 per cent of the population living on less than $1.25 per day and it has an under-five mortality rate of almost one in five amongst the poorest and least educated mothers. The life-expectancy index rating for Zambia is also the second lowest in the world (UNDP, Human Development Report, 2009). The Southern Province, where SAPEP and PEPAIDS operate, has the highest rural HIV/AIDS prevalence rate in Zambia. Only Lusaka, the capital, and the Copperbelt in the Eastern Province, which are both urban areas, have a higher prevalence of HIV/AIDS (UNAIDS / WHO).

So why is Zambia (and sub-Saharan Africa in general) affected so greatly while other parts of the world have been able to control the virus? Importantly, the cause is not promiscuity. Studies have shown that, on average, Africans and Europeans have the same number of sexual partners as each other. In reality, a complex array of factors has arisen over the past century following the socio-cultural turbulence caused by Africa's colonisation and rapid modernisation.

Take the issues of trade and travel as examples. The towns of Monze and Mazabuka are situated on the Cape to Cairo Road, which is part of a chain of highways that cover the thousands of kilometres between South Africa and Egypt. The road provides many advantages for the area as trade with other countries in the region is much easier because of it. However there is also one major disadvantage - mass movement of people has increased the spread of STIs, including HIV/AIDS, in the areas surrounding the road. Truckers transport goods thousands of miles up and down the continent and inevitably stop off along the way for a bed, some food, alcohol and sex. HIV prevalence is heightened along this road all the way from Cape Town to Cairo as different strains of the virus are passed around among truckers and commercial sex workers. Condoms are rarely used - as a very common Tonga phrase goes, "you wouldn't eat a sweet with its wrapper still on, would you?"

We have a long road ahead of us in our quest to change attitudes to sexually transmitted diseases.

Sasha Kasthuriarachchi is one of the eight 2010 Vodafone Foundation World of Difference International winners. To find out more about this opportunity visit the World of Difference website.

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