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Holding anti-retroviral medicines in Zambia: Fear of violence has prompted some women to hide or forgo using them.

Photograph: UNICEF / NYHQ2009-0327 / Christine Nesbitt

Maria is living with HIV, the virus that causes AIDS. Anti-retroviral medicines (ARVs) are now more widely available and are supposed to make her life better. But her continued therapy is under threat because she fears that if her husband discovers her HIV status he will become verbally abusive or even divorce her. As a result, Maria says, she has had to hide her life-prolonging ARV drugs and only takes them when her husband is not around.

Maria鈥檚 tale was one of the many cases documented by Human Rights Watch (HRW) in Zambia. The international non-governmental organization (NGO), headquartered in New York, warns that if gender violence is not addressed, the government鈥檚 comprehensive programme to provide free ARVs through the public health system will be frustrated. 鈥淕ender-based abuses will continue to shatter the lives of countless Zambian women in acute need of anti-retroviral treatments and contribute to avoidable losses of health and lives,鈥� notes HRW researcher Nada Ali.

According to the Joint UN Programme on HIV/AIDS (UNAIDS), there are 33.3 million people worldwide living with HIV. Of those, slightly over half (52 per cent) are women. In Africa, however, women account for 60 per cent of all adults living with HIV. In parts of Africa, adds UN Women, the UN鈥檚 gender agency, young females aged 15鈥�24 are up to six times more likely to be HIV-positive than males of the same age.

鈥淪exual violence,鈥� notes UN Women, is not only 鈥渁 widespread and brutal violation of women鈥檚 rights.鈥� It also 鈥渆xacerbates the risk of transmission鈥� of HIV. In Africa and other regions, UN Women coordinates the UN Secretary-General鈥檚 campaign 鈥淯nite to End Violence Against Women,鈥� first launched in 2008.

Activists in Southern Africa are now drawing attention to the contribution of gender violence to other ills, such as the AIDS pandemic. The Zambian chapter of Women and the Law in Southern Africa (WLSA), a research and advocacy group, argues that unless such violence is addressed, combating HIV/AIDS will be an even more arduous task. 鈥淰iolence against women has affected treatment of HIV/AIDS and this is worrying,鈥� says Mrs. Matrine Chuulu, the chapter鈥檚 national coordinator.

The Zambian chapter of the Young Women鈥檚 Christian Association (YWCA), with funding from the European Union, runs a crisis centre for battered women and provides such services as psychotherapy and legal advice. According to data collected by the YWCA, in cases of gender violence reported since 2006, nearly half of the women were found to be HIV-positive.

NGOs have lobbied the government to strengthen legislation. In 2005 it amended the penal code to prohibit indecent assault, sexual harassment and trafficking of women and children, and in April 2011 enacted a new law to combat gender-based violence.鈥傗�傗�傗�傗�傗��