Nurse and midwife Angela Maseka is no stranger to the realities of HIV.A resident of Livingstone, a border community and tourist destination known for its proximity to the wondrous Victoria Falls and to neighboring Zimbabwe, Maseka said being a regional hub and "mobile city" are factors helping drive HIV infection rates.
Maseka's work places her at the center of Livingstone's fight against AIDS.
Working in a clinic that provides prenatal care and treats pregnant women who are HIV-positive, Maseka and her colleagues see about 10 to 15 pregnant women a day. About three-quarters of them are HIV-positive.
One of them, Melody Pumulo, 32, eight months pregnant with her fourth child, lives in one of Livingstone's shanty towns. Pumulo is not sure how she contracted the virus that causes AIDS, but ruefully notes that her husband has steadfastly refused to be tested.
Pumulo accepted the news of her HIV status with certain fatalism: "It has come," she recalled thinking when she got the news.
Recent advances in medical treatment have given Pumulo some hope that her child -- a girl, she hopes -- will not be born with HIV. Advanced pregnant mother-to-child treatments are given through antiretroviral drugs. However, the child's eventual HIV status will not be known until after birth.
"She's prepared for all eventualities, prepared for any treatment," Maseka said of Pumulo.
"The child did not invite the HIV," Pumulo said. "I just want her to be free of HIV, go to school, work."
Pumulo's experience offers something of a glimpse into the realities of HIV and AIDS in a southern African country struggling, and occasionally winning, the battle against a stubborn and persistent menace.
Her visit to the Livingstone clinic last week also comes at a time when governmental bodies, health providers, activists and nongovernmental organizations -- including Roman Catholic Church representatives and those affiliated with Catholic institutions -- meet July 22-27 in Washington for the XIX International AIDS Conference.
"I would say Zambia is a success as far as trying to control the disease," Sithara Batcha, senior program officer for the Geneva-based Global Fund to Fight AIDS, Tuberculosis, and Malaria. The agency's international-based funding has provided treatment for 370,000 Zambians infected with HIV.
That represents more than a third of the estimated 980,000 people in Zambia -- with a population of 13 million -- who live with the virus. The rate of HIV infection for young people and adults between the ages of 15 and 49 stands at 13.5 percent, the fund reported. In the mid-1990s, the infection rate stood at 16 percent, according to Zambia's National HIV/AIDS/STI/TB Council. The council also noted that there are a higher percentage of women living with HIV in Zambia than men.
A report in advance of the Washington conference by UNAIDS, the United Nations' joint AIDS program, noted progress in Zambia as the country saw a decline in the number of new HIV infections among children between 2009 and 2011.The rate in Zambia has dropped by 55 percent, the report said.
Still, a Roman Catholic official said the country cannot be complacent.
At a mid-July meeting of the Africa Congress for Catholic Nurses in Lusaka, Zambia, Bishop George Lungu of Chipata, president of the Zambia Episcopal Conference, said HIV infection rates in the country remain too high despite the recent declines.
He urged church, government and health care organizations to redouble efforts to continue reducing infection rates.
"ZEC is ready and willing to listen to our brothers and sisters in the health profession,"
Lungu said, quoted by the Post Newspapers Zambia daily.
The Churches Health Association of Zambia is one of the largest providers of health care in the country, particularly in rural areas, and one of chief recipients of allocations from the global fund. The association is a joint Roman Catholic and Protestant network of community health centers, clinics and hospitals that work in nine provinces and nine Roman Catholic dioceses.
The association's work includes a campaign to increase male circumcision, which the World Health Organization and health officials believe can reduce the HIV infection rate among heterosexuals by as much as 60 percent.
While acknowledging the good work of church-based health organizations, Dr. Mannasseh Phiri, a physician and human rights and AIDS activist, told a group of visiting journalists July 10 in Lusaka that the wider church has done an inadequate job of dealing with the issue of HIV transmission among Zambian men who have sexual relations with other men.
He said the stigma attached to homosexuality in Zambia is a major barrier in reaching out to men who need to be tested and treated for HIV infection.
The Catholic Church teaches that sexual relations must be limited to one man and one woman within marriage.
Homosexual relations officially are illegal in Zambia, though some advocates are urging their decriminalization as part of proposed constitutional changes being debated.