THE saying by one scholar that, “we cannot always build the future for our youth, but we can build our youth for the future,” is timely.
What was misunderstood as a disease for prostitutes some decades ago saw families put under a tremendous financial and emotional strain.
Because there was no treatment or cure for HIV infection in the late1980s and 1990s, Government strategies had to focus on prevention efforts that often included encouraging people to revise their sexual behaviour by abstaining from sex and being faithful to one sexual partner.
To date, HIV/AIDS still remains one of Africa’s biggest obstacles to development and one of the most important societal challenges.
Despite significant progress against HIV prevention and treatment, there is still need to address the key factors to end the public health concern.
Sadly, in Africa, the face of HIV/AIDS in 2021 was that of 200,000 new infections being found among adolescent girls and young women aged 15 to 24 who make up 27 per cent of the new cases.
The 2021 preliminary findings by the Ministry of Health in the Zambia Population-based HIV Impact Assessment (ZAMPHIA) report indicates that out of 38, 000 new HIV infections recorded last year, 42 per cent of those infected with the virus were adolescents and youths.
The fight against HIV amongst adolescents and young women in Zambia involves a number of factors that have been seen to be conflicting with morals, religion, culture and human rights arguments.
This fight has also been a struggle extending between reproductive health rights, such as negotiating for safer sex through condom use and abstinence.
The alarming situation in Mambwe District in Eastern Province, where authorities have recorded 325 cases of teenage pregnancies and 343 cases of HIV infections in the first quarter of 2022, cannot go unnoticed.
News of 187 girls aged between 10 and 14 years, as well as 108 girls aged between 15 and 19 years testing positive to HIV in the same period and have been put on antiretroviral therapy (ART) makes sad reading.
Sinazongwe District Commissioner Nchimunya Siakole also recently raised concern on Collum Coal Mining Company to expedite its process of working on a new parking area away from Sinazeze Town as trucks were allegedly used for illicit sexual activities that involved small girls.
Among the contributing factors is that of long distance truck drivers, alongside other migrants, such as traders.
These have been identified to play a role in the spread of Sexually Transmitted Infections (STIs) in border towns and trading routes.
This is the picture of HIV that is now focused on girls in rural Zambia, including border towns and their surrounding areas.
What is evident both in urban and rural towns is that teaching abstinence only until young people acknowledge their sexual activity and denying them access to comprehensive information about sexuality as they are growing up has not yielded any positive change.
Young people need key survival knowledge, positive attitudes and skills before they become sexually active so that they can make informed decisions to protect themselves in different situations.
Here are some factors contributing to high HIV cases among girls in rural areas.
- Gender roles
Gender roles, have created difficulties for both girls and women in initiating and negotiating for safer sex through condom use with their\ partners.
The low social status of both girls and young married women in these rural communities increases their vulnerability to HIV as they are not empowered to negotiate for safer sex with partners.
Musonda Chibale, a retired nurse who worked in the rural Central Province in Zambia, said most of the women infected with HIV in rural areas are mostly infected by their spouses or regular partners.
“What is also common in these communities is male partners making decisions concerning their wives’ healthcare, limiting their access to proper treatment and other healthcare services.
Having worked in the antenatal and family planning section, it was challenging to see women participate in family planning methods and later put them on ART during their pregnancy because they either had to get permission from their partners or would come to the clinic without their partner’s knowledge,” she said. - Education
According to Ms Chibale, education levels are lower among rural women compared to men.
She said a good number of girls and women are unaware that consistent condom use can prevent HIV transmission.
However, Ms Chibale said even among the girls with information on protection, condom use has been hindered by factors, including societal norms and gender roles.
This has created difficulties for them to negotiate for safer sex.
“Because of limited education, adolescents in rural communities face unique economic and social challenges that further limit their access to sexual reproductive healthcare, making them uniquely vulnerable to STIs and unintended pregnancy,” she said. - Poverty
Poverty continues to be a major hindrance among girls coming from vulnerable rural communities.
Putting food on the table is a priority.
So, going to school with all the chaos that is happening in their lives, education is not on their list of priorities.
A regular trader selling beans and groundnuts in Luwingu, Isoka and other rural places said girls in remote communities were no longer interested in school because of the activities that were taking place in their areas.
Peggy Nkonde said teenage pregnancy and HIV cases are slowly rising in these communities and if not addressed, the future is at stake.
“As a trader, I have witnessed how some male migrant traders, local and foreign investors in road construction, small scale mining, agriculture, whose human resource is mainly from other towns, interact with the young girls. And because these girls are innocent and vulnerable, they are thought to be free from HIV and hence they are exposed to early sex,” she said.
Ms Nkonde said, “Unfortunately, these girls cannot not even negotiate for safer sex and even if they do, they encounter hostile situations which may see them lose their income.”
She said sadly, the parents of the girls were aware about what their daughters do with different men, but because they have to feed the family, it is business as usual.
Ms Nkonde said the cycle was on going as different migrant traders and other laborers continue to visit these places, impacting the social life among other community members. - Limited access of health and legal facilities
Considering the situation and the lack of access to health services, rural areas tend to have fewer health providers and other related services than urban areas.
Some areas are very remotely located and difficult to reach.
Many adolescents do not have knowledge on legal information and lack access to services which are also important in making decisions when exposed to social challenges such as prostitution, Gender Based Violence (GBV).
Creating a youth friendly environment in adolescent sexual reproductive health clinics has been found to be essential in addressing reproductive issues among the youth.
Therefore, it is important to note that the sexual behaviour of rural adolescents is now similar to those living in urban areas, and their vulnerability and risk exposure to HIV/AIDS needs equal attention.
For comments jessiengm@gmail.com
