Fighting the dual challenges of child sexual abuse and HIV in Zambia

Posted on Posted in Children's Rights, Education, Health

Child sexual abuse (CSA) and HIV remain two of the most pressing threats to children’s health and well-being in Zambia. Cultural myths and inadequate health responses further exacerbate this crisis. Tackling these issues therefore requires a holistic approach that combines legal reforms, community engagement, and strengthened healthcare systems.

Zambia’s socio-cultural landscape

Child sexual abuse (CSA) in Zambia is fueled by cultural norms, family dynamics, and economic dependence. Many cases go unreported due to fear of family and community shame, as well as the risk of damaging a child’s future marriage prospects. When perpetrators are family members or breadwinners, families often choose to handle abuse privately to avoid financial instability or social stigma, prioritizing family unity over justice for victims (Chitundu et al., 2018).

The failure to report CSA is further compounded by systemic issues within law enforcement. Police corruption, lack of confidentiality, and the costly legal process discourage families from pursuing justice. In some cases, police officers request bribes or suggest informal settlements where families accept compensation from the abuser. Victims are often questioned in public, exposing them to humiliation and reducing their willingness to speak out (Chitundu et al., 2018).

Further compounding the issue, abuse plays a critical role in predicting high-risk behaviors linked to HIV infection, even when socio-demographic factors are considered, according to a 2007 study by Slonim-Nevo and Mukuka. Their research examined how physical and sexual abuse by family members impacts HIV/AIDS-related knowledge, attitudes, self-efficacy, and behaviors among Zambian adolescents (Slonim-Nevo & Mukuka, 2007).

The study, involving 3,360 adolescents aged 10 to 19 from both urban and rural areas, found that higher levels of abuse correlated with lower HIV/AIDS knowledge, less favorable attitudes toward prevention, and diminished confidence in avoiding the virus. Adolescents who had experienced abuse were more likely to engage in risky behaviors, further increasing their vulnerability to HIV infection (Slonim-Nevo & Mukuka, 2007).

How myths and misinformation fuel Zambia’s HIV/AIDS epidemic

Adding to the difficulty, myths about how the virus spreads as well as negative attitudes towards those living with HIV prevent many people from seeking testing and treatment. Fear of discrimination often leads individuals to avoid healthcare services, increasing the risk of further transmission. As a result, Zambia is experiencing a serious HIV/AIDS epidemic, with over 16% of the adult population infected (The HIV/AIDS Twinning Center, n.d.).

One dangerous and persistent myth in sub-Saharan Africa is the belief that having sexual intercourse with a virgin can cure AIDS. This misconception not only fuels the spread of HIV but also exacerbates the vulnerability of young girls, particularly in countries like Zambia.

The perpetuation of this belief reflects deeply rooted misinformation and systemic gender inequality, resulting in irreversible physical and psychological harm to victims. The myth exposes children to sexual abuse and exploitation, further entrenching cycles of trauma and health risks (Powder, 2008).

To combat this harmful belief, public health campaigns and grassroots initiatives have been employed to raise awareness and correct misinformation. For example, a billboard in Zambia featuring a young girl boldly declares: “Having sex with me does not cure AIDS.” This direct messaging aims to challenge dangerous societal misconceptions while advocating for the protection of children (Powder, 2008).

Another persistent and harmful myth in Zambia and other parts of sub-Saharan Africa is the belief that the HIV/AIDS epidemic is exaggerated or even fabricated. This denial has been perpetuated by false narratives and, at times, downplayed by certain media figures. Such narratives can seriously undermine public health efforts, leading to complacency, reduced preventive measures, and further spread of the virus (Godfrey-Faussett et. al., 1994).

While the early 90s saw efforts to dispel denialism through scientific research and public health campaigns, today’s approach involves leveraging social media, podcasts, and public demonstrations to normalize HIV treatment. As stigma persists, particularly in Eastern and Southern Africa where HIV remains a leading cause of death among adolescents, these advocacy efforts are crucial in ensuring more young people stay on treatment and feel supported (Shahryar, 2024).

Combating HIV, isolation, and educational disruption

The HIV epidemic in Zambia continues to deeply affect children and adolescents, leaving many vulnerable to health complications, social isolation, and disrupted education. For example, Kelvin, a 12-year-old boy from rural Chongwe, represents the struggles faced by many children born with HIV. Dealing with depression and isolation, Kelvin stopped taking his medication in secret, hiding it under his carpet (Schwartz, 2023).

By the time his great-grandmother discovered the pills, Kelvin’s health had worsened. Tests revealed a dangerously high viral load, along with tuberculosis and a lung infection. Through the intervention of health workers and community support programs, Kelvin was reconnected to treatment and counseling. His condition improved significantly, and he was able to return to school. With regular home visits and counseling, his viral load dropped drastically, allowing him to focus on his education (Schwartz, 2023).

Kelvin’s story is just one of many across Zambia, where the NGOs and community organizations need to continue making a vital impact by addressing not only the medical needs of children living with HIV but also their emotional well-being, access to education, and social integration (Schwartz, 2023).

Moreover, the lifesaving support from organizations around the world continues to make a significant impact. For example, the USAID Empowered Children and Adolescents Program in Zambia provided essential services to nearly 90,000 orphans affected by HIV. 

As part of its HIV prevention efforts, nearly 40,000 vulnerable children and adolescents under the age of 20 were assessed for their risk of acquiring HIV. Out of this group, 14,897 were identified as at risk and referred for testing. Following these efforts, children who were newly diagnosed with HIV were successfully linked to life-saving treatments (USAID, 2003).

Progress in pediatric HIV care and community-led child protection

In the late 1980s, as HIV testing began in Zambia, many children were hospitalized with severe illnesses like pneumonia and malnutrition. By 1989, no antiretroviral drugs were available, and resources were scarce. By the early 2000s, nearly 60% of pediatric hospital admissions were HIV-positive. However, efforts led by Dr. Dr Chipepo Kankasa secured pediatric antiretroviral drugs, and by 2004, Zambia opened its first consultation rooms for children with HIV (Nkole, 2022).

A major milestone came in 2011 with the opening of the Pediatric Centre of Excellence in Lusaka, providing comprehensive care for infants and children and becoming a national model for HIV prevention and treatment. The progress has been significant—mother-to-child transmission rates dropped from 60% to 1.3%, and new infections among children fell from 10,000 in 2010 to 6,000 in 2019. Annual AIDS-related deaths have decreased by 30% over the last decade (Nkole, 2022).

“When we just started, a lot of children had cerebral palsy-like symptoms because the HIV had gone to the brain as a result of there being no drugs.”

– Dr. Kankasa (Nkole, 2022)

Another encouraging development is the increased reporting of child abuse cases through peer-led initiatives. In Mazabuka, Zambia, a community-driven initiative is empowering teenagers to protect their peers from child abuse by training them as paralegals. This innovative program addresses the gap left by an under-resourced justice system, allowing young people to investigate abuse cases and raise awareness about legal protections (Yonga, 2011).

One notable success is how teenagers have become trusted advocates, increasing the number of reported abuse cases and supporting victims in seeking justice. This approach mirrors similar grassroots legal initiatives from South Africa’s apartheid era, where communities relied on informal legal aid to navigate systemic injustices. Initiatives like this continue to highlight how grassroots action, community engagement, and youth empowerment can drive meaningful change in child protection (Yonga, 2011).

Embracing cultural sensitivity and addressing root causes

There is a prevalent myth that African cultural practices, such as polygamy, sexual cleansing, and certain rituals, are the primary causes of the HIV/AIDS epidemic. This view oversimplifies the issue and overlooks the broader, more complex reality. 

In fact, focusing solely on them can backfire, creating friction with local communities and potentially hindering effective interventions. The real challenges in preventing HIV/AIDS are shared by both African and Western societies: issues like negotiating safe sex, dealing with infidelity, and managing economic hardships (Gausset, 2001).

Rather than trying to dismantle or replace cultural traditions, Associate Professor in Anthropology, Copenhagen University, Dr. Quentin Gausset suggests a more constructive approach: working within the culture to promote safer behaviors. Community health workers and drama groups, for instance, have been able to raise awareness and encourage change without disregarding local customs. Their goal was not to wage war on culture, but to understand and respect it, finding ways to introduce safer practices that can be integrated into people’s daily lives (Gausset, 2001).

While there has been progress in understanding the relationship between abuse and HIV risk, significant gaps remain. For instance, future research should focus on exploring how mental health challenges (such as depression and PTSD), lack of family support, peer pressure, and limited access to education or counseling contribute to risky behaviors.

The ultimate goal should be to design targeted interventions that address trauma-informed care, mental health services, empowerment programs, and community-based support systems. By addressing the underlying factors that drive risky behaviors, these interventions can help break the cycle of abuse and vulnerability, ultimately reducing the risk of HIV among adolescents who have experienced abuse.

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Written by Lidija Misic

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