June 23, 2001
A concerted campaign anchored to popular teenage culture is slowing down the rate of HIV-infection among one of Zambia's most vulnerable demographic groups: older teenagers in urban areas.
A ministry of health report obtained by IRIN said the prevalence of HIV-infection in the 15 to 19 year-old age group had slowed by nearly half in some areas over the past few years.
"The downward trend in this age group is especially marked in major urban areas, notably Lusaka (the capital of two million people)," the report, entitled 'HIV/AIDS in Zambia', said. "In Lusaka, for example, HIV prevalence among 15 to 19 year olds dropped from 28 percent in 1993 to 23 percent in 1994 to 15 percent in 1998." The infection rate in the northern mining town of Ndola, the country's second biggest city, dropped from 21 to 16 percent over the same period.
"Many believe that the data indicates a new and favourable trend in the HIV epidemic. In this view, the decline in prevalence among late teens probably corresponds to a reduced incidence in this age group attributable in turn to favourable changes in behaviour," the report said. "This declining incidence will eventually be reflected in a drop in overall HIV prevalence," it added.
The report said overall HIV prevalence rate in the country had stabilised at around 20 percent of the population.
Anti-AIDS crusaders believe that the drop in the rate of HIV infection among teenagers is largely the result of innovative programmes that are centred around teenage culture and that directly involve teenagers. "More young people are using condoms or abstaining from sex altogether," a ministry official told IRIN. "The involvement of performing artists in the anti-AIDS campaign has significantly helped in efforts to reach the young and the not-so-literate."
Several of Zambia's leading music groups are taking an active role in the country's anti-AIDS crusade. Led by veteran drummer Brian Chengala, the musicians have established a non-governmental organisation called 'Youth Alive' under which they stage regular concerts under the theme of safe sex and sober living.
Meanwhile, community-based and travelling theatre groups are extending the AIDS awareness campaign to the shanty townships in the urban centres and to rural communities. Free condoms are distributed during the performances.
Innovative media campaigns are also credited for changing sexual behaviour in the country. Observers particularly applaud 'Trendsetters', a monthly tabloid funded by USAID that is focused on reproductive health education for the young. Trendy, colourful and written in a lively style, 'Trendsetters' deliberately runs showbiz news titbits alongside educational features on HIV/AIDS and healthy living. Four years ago, the newspaper was awarded the Global Award for Media Excellence by the Population Institute of Washington DC.
"We believe that we have been effective in influencing teenage behaviour because we are both trendy and educative. Many teenagers buy us for the trendy stuff, but they get to read the more educative things as well," said 'Trendsetters' editor Mary Phiri.
Similarly, the Youth Activists Organisation integrates enhanced soccer training under professional coaches with reproductive health education. Youth Football and Sexual Reproductive Camps are run in eight of the country's 72 districts under the programme. "The youth camp also works with young women to change their attitudes and behaviour, foster communication and share responsibility to bring about sustainable improvements in gender relations," said project manager Clement Bwalya.
Youth Activists Organisation also runs an inter-faith outreach programme under which it encourages young people with diverse religious backgrounds to encourage their religious leaders to support the use of condoms. Many of Zambia's religious organisations see condoms as encouraging promiscuity. "However, the average age of first sex is 16 for females and 17 years for males. This means that among those Zambians now over the age of 15, nearly one out of every five is HIV-positive and will almost certainly die at a young age from the disease, mostly over the next two to 12 years," Bwalya said.
According to the government's central statistical office, life expectancy in Zambia has declined from a peak of 52 years in 1980 to below 40, largely as a consequence of HIV/AIDS. At the same time, the prevalence of HIV among adults above 19 remains high at around 20 percent, meaning that many more children will continue to be orphaned for a long time to come. The epidemic has already seen some 520,000 of the country's children orphaned by AIDS. The number of orphans is expected to have risen to 974,000 by 2014.
Meanwhile, poverty resulting from the death of their parents at a time when extended family systems are breaking down is expected to force many children, especially females, into sex work - possibly reversing the gains that may have been made in reducing the prevalence of infection.
Nevertheless, "the drop in the prevalence among 15 to 19 year olds in parts of the country is a hopeful and encouraging sign. It underscores the fact that prevalence can change in Zambia and should serve as a stimulus for even stronger pragmatic efforts to limit the further spread of HIV," the ministry report said.
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