Conversations in AIDS

File:An unidentified youth distributing comdoms during the World Aids day event in Lusaka

By Theresa Lungu

A couple of years ago, while studying at Boston College in Massachusetts, I was asked to be a guest speaker in an undergraduate class; AIDS in Africa. I mulled over how I would portray the true picture of HIV/AIDS in Africa to this group of young people to whom for the most part, AIDS was as remote and foreign as Africa itself. I wrote down many words and notes, I researched numbers and statistics about the disease, particularly in Zambia. In the end, I didn’t have to say much. I just brought along my photo album and pointed out the numerous pictures of my friends and family who have died from AIDS. I
concluded the talk by sharing that the Zambian government played a leading role in the sensitization of HIV/AIDS and since 2003 had been providing free HIV drugs to its citizens. I thought I had the talk in control until one of the students asked me why there were still new infections of HIV in Zambia if there was extensive sensitization. I had no coherent answer.

Recently, Dr Aubrey Mwango, Coordinator of Antiretroviral Therapy (ART) at the Ministry of Health in Zambia said “We are currently having 1.1 percent new infections every year and although the number may seem small, this is cancelling all new patients on treatment.” Dr Mwango further stated that the government of Zambia is spending about US$100 million per year to procure antiretroviral drugs( ARVs), adding that this is likely to increase as the level of new infections has remained steady over the years.

So how does a country that is so sensitized on HIV/AIDS continue to have new infections? Either there are still people out there who do not have the proper information on the prevention of AIDS or they have the information but ignore precautionary measures. In lieu of the latter, perhaps we should drape black bunting from every door as a reminder of the scourge. The prevalent rate of HIV/AIDS in Zambia is 14.3 percent of the population aged between 15 and 49. Of this,roughly about 445,000 receive the free ARVs provided by the government. What about the rest? Despite advances in the treatment of HIV/AIDS there is still no cure for AIDS. The only way towards an AIDS free society is to curb those new infections.

This holiday season as you buy gifts for family and friends, give the gift of life and share with them the importance of testing for HIV. Have conversations on AIDS with loved ones. When people have cancer or malaria they call family and friends for support, but with AIDS the afflicted shy away and die shrouded in shame and fear of rejection.The loneliness of AIDS is still profound for patients and the reason for that is many of us stigmatize them.Many families in Zambia are struggling with opening up when a family member is infected. They would rather blame the illness on the old lady across the street or the ‘jealous’ co-worker.

In essence, preventing new HIV infections starts in the home, and in the community by participation from all of us. I get very saddened at how awkward some Zambians get when the conversation turns to HIV/AIDS.I have heard whispers about who is on ARVs and speculation about whom they got ‘it’ from. I always ask these doom whisperers how they would like to be perceived if they happened to be infected. Usually,the conversation ends there. I salute the late Winston Zulu who was very instrumental in erasing some of the stigma associated with AIDS in Zambia and along the way fostered acceptance among others with the disease.

To quote Dr. Kenneth Kaunda, who is a strong advocate in the fight against HIV/AIDS; “Africa, our mother Africa, must be free, and it has fallen to our lot to free this part. Be of good cheer, we are just beginning.”

Onwards to an HIV/AIDS free Zambia!


  1. Very thoughtful Theresa, Harvard is lucky to have you!.

    I hope we can all think about having conversations on AIDS as we celebrate Christmas.

  2. At this stage anyway over 3 decades since Aids was was first diagnised,poeple should come out in the open and speak about the virus,be tested and get treatment.stigmatization wont help much.we are either infected or affeted by Aids.A person with HIV can now live more than 30years with treatment which probably more than the life expetance in zambia.

  3. Iwe chi coulor Theresa Lungu, while I appreciate your concern and a possible way forward, you should equally address the issue of poverty. The root cause of this is purely poverty which has lead to people going into Fatalism. In the Fatalism situation any warning against something fatal will never work. And never be cheated that poverty has been created by the Zambian politicians has it has been perceived, its the powers that be in the Global north that have always controlled how global resources should be shared. Lastly, can you research on how many billions of dollars the Global north is making in supplying Africa with HIV/AIDS drugs and the so callled expertise.

  4. With all due respect @Alice… The author is encouraging a conversation. If you remove the first statement you made then you became part of it by providing an additional thought. Well done I always enjoy your writing voice. My mother wrote a book about my parent’s earliest awareness of AIDS in Zambia, which was visiting an old friend who had returned to Zambia from the USA. It is interesting that back then it was unknown in Africa and spoken of in the States. I discovered a 1977 British newspaper in attic with a screaming headline about stopping this American disease. Ignorance is universal.

  5. I agree with Alice – how sure are you that the effects of poverty caused by neoliberal supply side economics, World Bank and IMF policies, are not simply blamed on ‘HIV/AIDS’?

    Because there is no ‘AIDS defining illness’ anymore. Any persistent infection, in the presence of an ‘HIV positive’ test (usually a single screening test) can be called HIV/AIDS.

    The problem is that screening tests like ELISAs (EIAs) in the African context are not every specific. You can have malaria, tb, leprosy, bilharzia, or antibodies to some of the above, and test false positive on an ELISA (p24 or p55 only) screening test.

  6. A more extensive confirmation test called Western Blot is rarely performed, and costs $75 per test (retail). It is never used for confirmation in surveys, which is the number of positives can go through the roof, especially when surveys only include pregant women (Ante Natal Clinic or ANC surveys).

    Then, there is the phenomon that projections about population growth in Africa that take into account mortality from HIV/AIDS, always show a falling population. Population censuses, real headcounts, always show population growth, in every country, including the ‘Epicenter Of AIDS In The World’, like Uganda (1990s), or South Africa (2000s).

  7. Now they say it’s Swaziland, but anyone who has followed the goings on in Swaziland knows that it is under neoliberal attack, which started with the abolution of the Southern African Customs Union (1904), which provided 60% of the Swaziland government’s revenues. Today they are saying – the army is too big, the King’s lifestyle is too lavish, etc. All of which are intended to demolish the Swazi nation, to facilitate the stealing of their iron ore deposits. So now 30% of Swazis are ‘HIV positive’ again.

    Claims of high HIV rates are used to discredit the government, and governing in general.

    And yet, the population grows if you look at the censuses, and doesn’t decline as anyone who uses presumptions about HIV infection rate claims (US Census Bureau, UNAIDS).

  8. Ever since I came to australia in feb 2007, I have only seen HIV sensetisation on tv 3times In 6 years while in Zambia it’s Everyday on tv/radio/hospital walls/school wall, etc yet in Aussie the rate of HIV is still @ 0.2%.
    Then what is wrong with zambia that people don’t listen? Are we *****s who don’t listen?
    The same people who receive the drugs are going about infecting other people deliberately. And this is the problem. First tackle the issue of unemployment and hunger then the fight of HIV will be progressive.

    • Actually, there’s evidence that when people know they are positive, they are more likely to practice safer sex (fewer partners, condoms). I don’t think the same has been shown for people when they receive negative test results. There’s a myriad of reasons why prevalence is higher in Zambia: multiple concurrent partnerships are more common (note that it is the timing of relationships that is the biggest problem, not the number of partners), low circumcision rates, endemic malaria, high prevalence of STIs, social and gender inequalities that make sex work more common and more risky, and surrounding countries all have high HIV prevalence rates. ART actually decreases rate of new infections, as HIV+ are far less infectious when their viral loads are lower.

  9. MrK, the algorithm used in Zambia is Determine HIV 1/2 followed by UniGold if the first result is positive (serial testing), which are rapid tests, not ELISAs. However, both tests are subject false positives, and it would be a good idea for the country to perhaps consider using either Western Blot confirmatory tests or RNA PCR tests (which would catch acute infections). The falsoe positive rate would lower prevalence estimates, but not enough that these countries would be considered to not have an epidemic. Someone who tests positive for HIV is considered to be HIV positive; while the definition has changed for AIDS, it would be a CD4 count of less than 200 or presence of an AIDS defining illness (~20).

  10. No test for a disease is going to have 100% specificity; the current HIV tests come quite close though.Interestingly enough, the book “Tinderbox” notes how Thabo Mbeki and many in the West chose to make HIV/AIDS a poverty issue, which overshadowed the very real transmission risk factors, and led to ineffective prevention programs. I’m not sure what you’re trying to argue; yes, the statistics have been misused, and past data had prevalence rates that were too high. Yes, there are false positives. Yes, neoliberal development deepened poverty. But none of that disproves that there serious HIV epidemics and not enough is being done to prevent and treat infections. Not all countries with epidemics were victims of SAPs (e.g. Botswana).

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