5 Lessons From Africa About Fighting AIDS

The continent hasn't done everything right, but America should take note of these strategies.

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In Zambia, HIV is more common in women than in men, and most women are infected by a husband or boyfriend in the context of a "stable" relationship. To reach men, last year Zambia launched a mass-media campaign called Brothers for Life. Its messages are blunt, targeted and to the point: "A man takes responsibility through his thoughts and actions. Be a man for life," and "Be a man who is not afraid to know his HIV status."

In the U.S., women account for one in four people living with HIV, and the vast majority are infected through sex with a man, often a spouse or a boyfriend. Nearly 70 percent are black. Women are urged to protect themselves and to insist that their partner use a condom every time. But what about men? They're the ones who wear the condoms. Where is the full-scale HIV-prevention campaign for men who have sex with women who are asking them to be honest and faithful and use condoms every time?

Think Way Outside the Box

One size doesn't fit all in terms of HIV prevention. To discourage women in Zambia's Mumbwa district from delivering their babies at home, health care providers enlisted the help of Senior Chief Shakumbila. (At a hospital or clinic, a pregnant woman who has HIV can receive medication to prevent her baby from becoming infected.) The chief created a rule that if a pregnant woman fails to deliver her baby in a medical setting, the family must pay the price of three goats.

"When you are dealing with human beings, you have to be strict," says Shakumbila, who governs 486 villages. "These men don't want to be punished, so they take their wives to the hospital. This has helped very much against HIV/AIDS."

This is a creative solution that respects the way of life of a community while pushing it toward an effective, 21st-century method to reduce HIV transmission.

Fight HIV, Not People With HIV

In our country, HIV/AIDS stigma is most intense in small towns, particularly in the South. Growing numbers of people living with HIV/AIDS in places like rural Mississippi and Alabama hide their status, terrified of being ostracized. In Zambia, while stigma exists, those in the field say that rural areas approach HIV with less judgment than compassion.

"Everyone knows someone with the disease in these rural villages, so there's less shame," says Yoram Siame, advocacy and public relations manager for CHAZ. "And there's also a sense of community-ness, of caring for each other in rural areas."

Angela Maseka, a no-nonsense nurse-midwife at the Maramba Clinic in Livingstone, Zambia, treats and counsels HIV-positive women -- most of whom are pregnant -- who come from poor, sometimes remote areas where HIV/AIDS is widespread. "HIV is not an illness," says Maseka. "It is just a virus that affects some people. What's the shame?"

HIV/AIDS in Zambia: The Faces of an Epidemic

A writer snapped these photos depicting the daily battle against the disease in Ethiopia and Zambia.