The first official case of HIV in Zambia was reported in 1984.

Most of the early cases were found in urban areas, with subsequent infections being identified in rural areas as well.

With assistance from the World Health Organisation (WHO) through the Global Programme on AIDS, a national response started with the establishment of the National AIDS Surveillance Committee in 1986 and other national management structures to spearhead effective responses to the HIV and AIDS challenge.

In addition, through the National AIDS Council (NAC), Zambia has developed the Epidemiological Synthesis Report aimed at giving details on the modes of transmission as well as the HIV and AIDS Research Agenda aimed at highlighting national research priority areas.

In 2010 the national HIV prevalence is estimated at 14.3% of the adult Zambian population out of an approximated population of 12 million, with the prevalence as high as 21% in Lusaka.

Compared with the 5% prevalence in the entire sub-Saharan Africa, Zambia is one of the countries with a high HIV prevalence. UNAIDS estimates show that 445,000 adult men and 560,000 women in Zambia are living with HIV/AIDS; and about 95,000 children are also living with HIV and AIDS.

The burden of HIV on women and children
A number of studies have shown that traditional and legal systems have a fundamental impact on women and children’s vulnerability to HIV infection in Zambia.

This is attributed to a host of biological, social, cultural and economic factors including women’s entrenched social and economic inequality within sexual relationships and marriage compounded by low socio-economic status. Further, even if some women know their rights they may not have access to independent legal support.

Women’s unequal social, economic, and legal status is increased by a positive HIV status and vice versa. Violations of women’s social, economic and legal rights in turn compromises their ability to seek care, treatment and support, and to protect their sexual and reproductive health and rights.

Women and girls in Zambia, including those who are themselves HIV positive, also bear the physical and psychological burden of HIV and AIDS care. Women thus carry a ‘triple jeopardy’ of AIDS as:
(1) people infected with HIV
(2) as mothers of children infected
(3) as care givers of partners, parents or orphans with AIDS

In most cases a women is often the first member of a family to be tested for HIV through antenatal testing – sometimes without their informed consent – and can subsequently be blamed for bringing HIV into the family.

This often results in rejection or violence towards the woman from relatives. This kind of extreme discrimination, especially when combined with heavy domestic responsibilities and restrictions on access to resources, presents a strong barrier to women seeking care, treatment and support for HIV and AIDS – or even to getting tested in the first place.

Children may also act as care givers and providers in some homes. When parents die their socio-economic status plummets and they may engage in risky behaviour to meet their needs.

Traditionally, children are often subordinated and regarded as property by most parents to facilitate or ease their work especially in rural areas. They are engaged in domestic work as well as field work likely to militate against their wellbeing and development. Many children fail to attend school and access other basic needs. This is even worse in case of orphaned children who have to take care of themselves as well as fend for their siblings due to the poorly funded and overwhelmed social protection system.

Further, guardians/parents (some of them already poor) who are chronically ill can no longer carry the same load of household work or income generation which puts more pressure on children to engage in risky behaviour likely to expose them to HIV. The 2009 Zambia Sexual Behaviour Survey (ZSBS) indicates that Orphans and Volnerable Children (OVCs) were slightly less likely to attend school compared to non-OVCs and males were more likely to engage in sexual activities before the age of 15, compared to females.