Culture and its Impact on the Prevention of HIV and AIDS in Zambia

Statistics on the prevalence of HIV in Zambia seem to indicate a plateau since the mid-nineties. However, the UNAIDS Gap Report in 2015 recorded 1.2 million people living with HIV, and in 2013 over 54,000 adults and 12,000 children became newly infected with the virus. This has had a devastating effect on the country, both socially and economically.

That is not to say that great advancements haven’t been made in the treatment of HIV and AIDS — the distribution of antiretroviral drugs, and the increase of condom usage and testing facilities. But there is still a lot to do in order to contain the virus and prevent its spread.

Speaking at a University of Roehampton, London Online webinar, Master of Public Health student Rita Mukupa took a closer look at the cultural factors that have also had an impact on the evolution of this disease throughout Zambia and the rest of sub-Saharan Africa.

Here are four influencing factors Rita believes have contributed to the spread of HIV/AIDS in the region:

  1. Migration
  2. Many Zambians travel to other regions of the country in search of work. Migratory labour and cross-border trading, combined movement of people due to food shortages, can affect the spread of disease. Parts of Sub-Saharan Africa are also susceptible to drought, increased poverty and civil unrest which can also lead to the displacement of people.
  3. Weak healthcare systems
  4. According to the USAID, PEPFAR & Health Policy Project (2016) report, only 5% of Zambia’s GDP¹ is allocated towards healthcare provision. This allocation is not enough to provide effective healthcare for the population. HIV/AIDS prevention programmes are limited and often concentrated in urban areas neglecting hard to reach rural areas. USAID, PEPFAR & Health Policy Project, (2016)
  5. Stigma
  6. There is still a stigma surrounding sufferers of the disease. This can cause feelings of shame, fear or guilt and discrimination as a result of diagnosis. In some instances, this can prevent people from seeking treatment or disclosing that they are carriers. Same-sex intercourse is illegal in Zambia.
  7. Tribal/traditional healing practices
  8. In parts of sub-Saharan Africa, people still believe that having sex with children will cure them of HIV/AIDS. The practise of “sexual cleansing” also still exists in parts of Zambia. This practice relies on the belief that a widow or widower must have sexual relations with a relative of the dead spouse in order to be rid of the spouse’s ghost. Other traditions such as tribal scarring if carried out using the same unsterilized instruments can also lead to the spread of HIV/AIDS.

Rita Mukupa has worked in the health sector in Zambia for over 10 years. Starting out as a Clinical Officer General in the Ministry of Health, she then worked as a Centre and Outreach Manager for Marie Stopes International, also in Zambia. Currently a university lecturer in clinical medicine at Citizen University Zambia, Rita hopes that through her MPH studies at Roehampton Online she will gain a complete understanding of the healthcare system in Zambia — its policy, the frameworks used to implement it, and how it could be improved or redesigned.

“I would like to use this study to make recommendations of how the Zambian healthcare system can be improved in areas where gaps still exist.”

Rita hopes Zambian authorities will implement the following:

  1. Increase health-sector manpower.
  2. Increase access to antiretroviral treatment.
  3. Build healthcare provisions in areas where they are lacking.
  4. Develop and implement high-impact programmes aimed not only at preventing the spread of the disease but also at reducing the stigma associated with HIV and AIDS.
  5. Raise awareness through social marketing campaigns that address vulnerable at-risk groups.
  6. Improve epidemiological surveillance systems and data collection related to HIV, to inform preventionists.

Studying online provides Rita with a unique opportunity to share her own country-specific perspective and knowledge on epidemics such as HIV, Ebola and the Zika virus with other public-health professionals around the world. By collaborating on shared activities online, students can discover current best practices and implement them directly into their working roles. Coming together in this way can only yield positive results, because the future of public health lies firmly in their hands.

Master of Public Health webinar

Listen to Rita and Dr. Srikanta Banerjee (an award-winning HIV researcher) presenting at a Roehampton Online MPH webinar, entitled “Has the world stopped focusing on HIV/AIDS?”

References 
¹USAID, PEPFAR & Health Policy Project, (2016) Health Financing Profile Zambia, Available at: https//www.healthpolicyproject.com

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