The report further states that in 2003 the government launched a national policy to provide free and universal access to antiretroviral therapy (ART), which was expanded in 2005 to include all ART related services. By the end of 2005, out of the 200,000 people living with HIV and AIDS requiring ART, an estimated 50,000 people were on it. In other words, ART services catered for only 25% of those in need.

HIV/AIDS epidemiological projections (ZDHS 2007:27) estimated that 8,153 persons would be HIV positive in Mongu district by 2010. However, to date the district has recorded at least 15,000 people accessing HIV and AIDS treatment at Lewanika ART clinic alone, while the default rate among a total of 14,706 clients enrolled on the ART programmes by end of 2010 ranged lies between 20 and 25% (CIDRZ: 2010).This implies that only 75% to 80% of the enrolled clients adhere to ART and related services in Mongu district.

The calamity that has befallen Mongu district is that the 25% default rate above represents the fact that about 2,927 persons living with HIV and AIDS in Mongu district are bound to get sick and may even die due to non-compliance to the requirements for HIV and AIDS treatment regimes.

Against this background, it is evident that various factors affect the ability of clients to access HIV treatment services and adhere to the prescribed requirements of the life-long treatment, especially in Mongu district which has only seven ART clinics.

On a daily basis, at least 300 clients visit the Lewanika ART clinic for ARV refills, CD4 counts and related checkups, all standard requirements for accessing HIV and AIDS treatment. Clients coming from distant places around Mongu have to wait hours to be served due to the overwhelming number of appointments. Owing to the fact that HIV treatment is not an emergency, sometimes clients are told to return to their homes and come another time without being seen by medical personnel. Thus, some squat at the mother’s shelter awaiting their next appointment date. In the meantime, clients engage in menial work to make ends meet whilst at the shelter. Unfortunately, one male client died at the Lewanika General Hospital mother’s shelter in February this year whilst waiting for his appointed date to commence ART. The saddest ordeal for such clients is that the process is long for every kind of clinic visit, be it a CD4 test results collection, drawing blood for the tests, opening a new file or picking up doses.

Due to the circumstances described above, some clients give up on the ART programme.

One client from Lealui narrated how she had been cut-off by floods in the Barotse Plains for about five months, from January to early June 2011, causing her to fail to collect her bi-monthly first line dose of ARVs. Near her home is the Lealui clinic, which is not accredited to dispense ART and so does not offer the service. Conversely, some clinics in a similar capacity such as Liyoyelo Urban Health Centre, located in the Wenela area of Mongu district, does offer ART services despite the fact that it is not accredited as an ART site.

The saddest part of her story is that upon her first visit to Lewanika ART clinic for refill after defaulting for all that time, the ART nurses instructed the treatment support workers at Lewanika ART clinic to put the defaulting client on a two week adherence counselling session before she could be given the usual two months dosage. This meant she was given a week supply of medicine then expected to walk 14 kilometres to the ART site in two week’s time. Besides, she suffers from nerve damage! Hence, for fear of the long trek to and fro Lealui, the client spent the two weeks at the mother’s shelter at the General Hospital. She returned home with a three months dose of a second line regimen, recommended after running a CD4 count test.

Wamunyima (pseudo name) from Wenela area of Mongu district is a mother of two children and has been living with HIV since 2008. She was commenced on ART in the same year because her CD4 was low enough to make her eligible for the treatment. Alas, due to bad influence from a self pronounced ’Prophet’ in Ilute Compound, Wamunyima stopped taking her medication in 2010.When asked why, she says the Prophet said she has been healed with Holy Water and so the virus has no power over her body. This client is still looking healthy on the outside but HIV is definitely replicating inside her body. Within a certain time she will have a different strain of HIV, which may be resistant to ART.

Meanwhile, it’s business as usual. She has had more than five boyfriends since she last took her pills, and it is not clear whether she discloses her HIV status to any of her sexual partners. To make matters worse, she is now five months pregnant. What are the implications to the unborn child and indeed herself?

Another defaulter Mukuwe (pseudo name) says he had not taken his medication for six months because he had been away doing menial work at Kaleya Holdings in Mazabuka, where he was involved in sugar cane cutting. According to him, he was commenced on ART at Yuka Hospital in Kalabo where he resides. When he went to make ends meet in Mazabuka, he had carried three months dose, hoping to be able to collect the following dose near the work site. Alas, the staff at Mazabuka referred him to Yuka hospital because they did not have his name on their system! And so, Mukuwe continued working until he finished his portion of work and got paid. He returned home after missing doses for six (6) months and fell sick shortly after re-starting his medication following the usual rebuke and counselling at Yuka Hospital. However, his health has not been any better since then. He wonders whether he will be able to work again as before.

In the nutshell, various factors including an individual’s lack of understanding about HIV treatment; fear of stigma and discrimination, peer pressure, medical attitudes towards clients; long distances to access ART services and religious or cultural beliefs all contribute to the 25% default rate of clients on ART in Mongu district.

A pastor in Lusaka has claimed to have healed an 18-year-old boy and his sister of HIV.

The claims came to light when Mr. Yamba, the father to the two children, reported the matter to TALC Country Coordinator Felix Mwanza.

Mr Yamba said that Pastor Kabwe of Power Harvest Church, Chazanga area had stopped his two children from taking antiretrovirals (ARVs) after they were prayed for, claiming they had been healed by faith.

He said the situation was sad because the health of the 18-year-old boy had since deteriorated.

“The boy has severe diarrhoea and skin rash is all over his body. I need help,” pleaded said Mr. Yamba.

The development prompted Mr. Mwanza to write a letter of introduction of the boy to the Matero Reference ART Clinic urging them to re-start the boy on ARVs, after necessary clinical tests were done. The doctor at the clinic agreed and the boy was put on Atripla, an ARV combination of Tenofovir, Emtricitabine and Efavizenz.

Just three days after re-starting ARVs, the rash began to heal and the diarrhoea had stopped.

The boy is now properly adhering to treatment. But despite her older brother’s encouragement, the younger sister is still in denial and believes that the prayers from Pastor Kabwe have healed her from HIV.

When I arrived at the house of Pastor Kabwe where the purported healing session took place, I found about 30 women seated outside the Pastor’s house and others inside waiting to be prayed for, the group included a few men.

I told the usher, who was seated at the entrance to the door, that I urgently wanted to see the Pastor so that he could pray for me. The usher gave me a small piece of paper on which I was asked to write my problem. I wrote that I had HIV and was in need of a healing prayer.

The usher then gave me a personal testimony of his wife; of how she was ‘healed’ from HIV at the time she was pregnant 10-years-ago after being prayed for by a Pastor.

“My wife had HIV 10-years-ago, she is healed now, she does not have HIV, we did HIV tests three times to be convinced that, she was healed from HIV. This HIV is a demon, the prayer worked,” narrated the usher, who was later identified as Brother Ngolofwani.

I waited for 1 hour 30 minutes before my turn to be prayed for arrived. As I waited I listened patiently to different problems that people presented to the Pastor with the hope of being prayed for. Problems ranged from spiritual deliverance, different diseases, health conditions and illnesses to interpreting dreams.

When it was my turn to be prayed for Pastor Kabwe got the slip of paper where I had written my problem. He said HIV can be cured through prayer and many people have been healed through faith.

“I could have shown you videos and tapes of people that have been healed from HIV after being prayed for. Anything is possible with the God if you believe,” Pastor Kabwe shouted.

He said at one time he prayed for a person living with HIV who was on ARV treatment who could not eat or walk.

“As I’m speaking now the person is now perfect –HIV free.” The person has since gone to the village and doing farming, he told me.

He called Brother Ngolofwani the usher, who gave a personal testimony of how his wife was healed from HIV 10-years-ago.

Kneeling before Pastor Kabwe Brother Ngolofwani said in full view of the people inside the house that his wife’s CD4 count was very high at the time she was diagnosed HIV positive. The doctors said that they could not put her on ARVs because of the high CD 4 count.

According to Brother Ngolofwani the high CD 4 count of his wife was a sign that she was healed from HIV. At one point, he declared that Satan is a liar and that HIV is a demon, hence the reason people should be referred for healing prayers.

He said when his wife was prayed for several HIV tests have been done by different doctors from Chawama Clinic and University Teaching Hospital.

“All these tests have shown that my wife is now HIV negative-HIV free,” Brother Ngolofwani claimed.

It was also disheartening to find out that Pastor Kabwe, upon listening to Brother Ngolofwani’s testimony, who I expected to be knowledgeable about HIV, did not know how HIV testing is done and what ARVs are.

According to him, the person he claimed to have prayed for did three HIV tests and what the doctors used to check the test results was a computer. He said the doctors tested HIV in computer 1, 2 and 3 and all the test results were HIV negative.

I was then advised to come the following day so that my sins could be prayed for and I could seek forgiveness from God.

Church mother bodies have condemned pastors who are stopping people from taking ARVs after being prayed for and have called the act tantamount to murder.

Furthermore, the Joseph Katema, the Minister of Community Development Mother and Child Health, has called on the church mother bodies to reprimand pastors who are stopping people from taking ARVs on the pretext of faith healing.

What will it take pastors such as Pastor Kabwe to stop?

My investigation took place on 1 May 2012.

The study revealed that one area, Maramba, has increased condom usage from 57 to 84% beating Dambwa which recorded an increase from 55 to 68%.

According to a survey policy brief released by Dr Charles Michelo, head of UNZA’s public health department, the Livingstone intervention study found increased condom distribution at ‘high risk places’ has led to condom utilization.

“There was a reduction in reported sexual risk taking among guests socializing in bars, guest houses and restaurants in both areas, but reporting of recent condom use increased among people interviewed in Maramba from 57 to 84% than in Dambwa from 55 to 68%,” the policy brief stated.

It further added that there were substantial changes observed in Dambwa over a five year period, an indication that there is an overall change in risk taking among people in Livingstone socializing in venues where people meet new sexual partners.

However, UNZA noted in the study, which was done in collaboration with the University of Bergen to strengthen HIV intervention, that the increase in condom usage in Maramba was due to the distribution of condoms and peer education that took place in 2009.

“A survey was conducted in 2005 in Maramba and Dambwa in places where people meet new sexual partners to access the need for targeted HIV prevention programme in the city. The survey found high turnover and unprotected sex to be common among guests in such venues [bars, restaurants and guest houses]. In addition there were major gaps in on-site condom availability,” UNZA stated.

The UNZA study, which is registered at clinical trials.gov as NCT01423357 and financed by the Norwegian Council for Higher Education’s programme for Development Research and Education (NUFU) from 2002 to 2012, further noted that the national HIV/AIDS, STI and TB policy does mention bars as important outlets for condom sales but the implementation needs to be substantially strengthened.

“Thus the government and other stakeholders should make specific and dedicated efforts to ensure stable condom availability in places where people meet new sexual partners,” UNZA stated.

Held on 21 July, directly preceding the International AIDS Conference in Washington D.C., the full-day event is titled From Stigma to STRENGTH: Strategies for MSM, Transgender People and Allies in a Changing AIDS Landscape.

The event comes at a time when HIV rates among MSM in countries as diverse as Mexico, Jamaica and Zambia have reached 25%, 31% and 32%, respectively.

In the United States, where the conference returns for the first time in 22 years, MSM account for nearly half of all people living with HIV and more than 60% of new infections.

“The way we handle HIV among MSM and other key populations will dictate the course of the global epidemic,” says Dr. George Ayala, Executive Director of the MSMGF and a speaker at the pre-conference.

“The major shifts at the Global Fund, persistent affronts to human rights, and the advent of pre-exposure prophylaxis (PrEP) have each changed the landscape for HIV prevention and treatment. It is crucial that we now take account of these developments and their implications for MSM and transgender people.”

The event will feature plenary addresses by Congresswoman Barbara Lee, retired High Court Justice Michael Kirby, and Dr. Kevin Fenton, Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. The first annual Robert Carr Memorial Speech will be delivered by Jamaican LGBT activist Maurice Tomlinson. Program sessions will cover the latest developments in HIV prevention, treatment, research, policy, and advocacy concerning MSM and transgender people around the world.

“In the past, the International AIDS Conference has failed to adequately address issues concerning MSM and other key populations,” said Dr. Ayala.

“Following the 2010 conference, we conducted an analysis that revealed only 2.6 percent of sessions at AIDS 2010 focused on MSM and 1.1 percent focused on transgender people. Although we expect to see improvements in this year’s conference, activists are already reporting the rejection of large numbers of high-quality abstracts that address MSM and transgender concerns. The MSMGF is collecting these rejected abstracts to be featured in a new publication that will be released at the pre-conference event.

“We are facing a global crisis that has been neglected for too long. These issues must be addressed if we are to bring this epidemic to an end. As the largest event of its kind, From stigma to STRENGTH represents an unparalleled opportunity to take stock of where we are, the challenges and opportunities we face, and to chart a collective path forward.”

Therefore, to effectively tackle the epidemic Zambia has adopted a multi-sectoral approach to respond to the ravages of HIV and AIDS.

Alas, one area of the prevention interventions – the promotion of safe sex through condom use – has eluded the majority of Zambia’s school-going, sexually active pupils over the duration of the epidemic. Arguably this can largely be attributed to the Ministry of Education policy, which speaks against condom distribution among pupils and instead promotes abstinence.

Misozi Chuma (pseudo name) is a grade nine pupil at a basic school in Mongu district who is having a relationship with a grade twelve schoolboy from another school in her area. Misozi says the couple has been having unprotected sex for two years and she had an illegal abortion early this year. When asked what would have made her circumstances different, she did not hesitate to say that had condoms been easily available and accessible she would not have been impregnated by her boyfriend.

According to Misozi, it is a punishable offence to be found in possession of condoms at her school, and that sexual intercourse is very unpredictable in her relationship. In any case, whenever she meets her boyfriend, depending on how private the surrounding is, sex is very likely. Besides, she adds, sometimes they “have sex in a nearby bush at lunchtime then get back to school; business as usual”. Misozi says she cannot discuss the issue of safer sex with her boyfriend during such encounters.

Contrary to the Ministry of Education’s expected outcome, empirical evidence shows that Zambia’s pupils are accessing family planning pills and injections from health centres across the country, and pregnancies and sexually transmitted infections (STIs) have been recorded among this group for a long time now, indicating that young people are having unprotected sex. This state of affairs predisposes young people to HIV.

Furthermore, going by statistics, almost every government school has recorded a girl on maternity leave in the last ten years of implementing the current anti-condom policy framework.

Against this revelation and stories such as Misozi’s, it is prudent to advocate for a shift in policy direction regarding condom use, promotion, accessibility, and distribute this life saving commodity in the school environment via an appropriate peer mechanism. If Zambia is to pragmatically tackle the issue of new HIV infections, prevent unplanned pregnancies and STIs this must be implemented. Such a shift would greatly contribute toward the attainment of the Millennium Development Goals Four and Five and thus turn the tide. But this calls for a shift from a sentimental approach to problem solving to a more realistic approach to address our current situation. Is Zambia ready to take this brave but crucial step?

She was only 28-years-old when she contracted the human immunodeficiency virus, which is one of the greatest afflictions ever to strike human kind.

In her own words, contracting HIV has afforded her the chance to retract her steps on life, which saw her ceasing her reckless life of endless partying and drinking, and pursuing a positive life of HIV/Aids activism.

The 40-year-old mother of five says she wants to contribute meaningfully to the fight against HIV and Aids by helping to shake the foundations of the stigma which societal stereotypes have placed on HIV positive people over the years.

As an HIV/Aids volunteer and chairperson of a Ward Multi Sectoral Aids Committee, Masalila maintains that she will not rest until she has eliminated the stigma attached to HIV and Aids.

“If we allow stigma to prevail, we are going to fail in our fight against this disease. There is no how we can hope to win this fight without first fighting the stigma,” she says.

She adds that because of stigma, some people have default on taking their ARV medication while others have stop taking it altogether. She says this is because people are not free to talk about their HIV status to the people they live with as they fear they will be stigmatized.

“This in most cases leads to them hiding their ARV drugs and failing to take them properly when they are in the company of other people,” asserts Masalila.

She says although huge strides have been made over the years, people living with HIV are still being stigmatized for having been infected with the viral illness which can lead to Aids.

“We are continuing to lose ground as some people still stigmatise those that live with the virus,” she adds.

Masalil acknowledges how the epidemic has changed and that a person diagnosed of HIV can now expect to live longer into their 70s if they live a ‘proper’ life with the right treatment and support.

More people in Botswana than ever are living with HIV – passed on mostly through unprotected sex or coming into contact with infected blood.

Looking at Masalila one would not tell that she is living with HIV, but she would not hesitate to tell you that she has been living with HIV since 1999.

She is one of the many HIV-positive people who are receiving free medications and therapeutic regimens from the government, designed to prolong lifespan and improve quality of life.

Reminiscing about her past, she keenly relates how she came to contract the virus. For a moment, she attains a solemn pose as she puts in words the reckless kind of life she used to live.

By her own admission, Masalila says she used to lead a “life of carelessness”, characterised by endless partying and heavy drinking.

“I would run around with older men who promised me the moon and the stars,” she says with a grimace.

After testing HIV-positive, she reveals she then decided to pause and reflect on her life. With no work to do she decided to become a volunteer in the District Multi Sectoral Aids Committee in which she was elected chairperson for the ward committee.

Masalila was born in Tonota village, just 40 kilometres outside the city of Francistown and she lives with her husband and five children at a township called Monarch. Her husband and children are always very supportive to her ever since she went public about her status.

“I should confess that it was a bit of a difficult decision to take. After deciding on my own to go public, I informed my husband since I have been honest with him from the start. He was and still is very supportive of me because he too believes in helping to bury the stigma that people direct towards HIV positive people,” says Masalila.

According to Masalila, she wants to demonstrate to the world that one does not have to wallow in pain, misery and self-pity just because of their HIV status.

She says: “People have to look beyond the flesh and see the real you – a human being trying to live life to the fullest just like anyone else.”