After my mother died, I went to my mother's mother. In 2001, she died, so I stopped school.... Then we went to my auntie, my mom's younger sister.... Most girls find that they start keeping up with [having sex with] stepfathers or uncles. Most are raped. They have no say. They think if you bring them to the police, there will be no one to keep me. So they keep quiet.
-Patricia M., age sixteen
Each year, children are ushered into roles they're not supposed to perform; heading households, unable to attend school, getting pregnant, on the street, into commercial sex. Living with HIV/AIDS has a huge impact on the mind of a child. They lose parents very early, and they're ushered into these roles.
-Alick Nyirenda, Copperbelt Health Education Project, May 25, 2002
The catastrophe of HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) in Africa, which has already claimed over 18 million lives on that continent, has hit girls and women harder than boys and men. In many countries of eastern and southern Africa, HIV prevalence among girls under age eighteen is four to seven times higher than among boys the same age, an unusual disparity that means a lower average age of death from AIDS, as well as more deaths overall, among women than men.
Abuses of the human rights of girls, especially sexual violence and other sexual abuse, contribute directly to this disparity in infection and mortality. In Zambia, as in other countries in the region, tens of thousands of girls-many orphaned by AIDS or otherwise without parental care-suffer in silence as the government fails to provide basic protections from sexual assault that would lessen their vulnerability to HIV/AIDS.
Through girls' own testimonies, this report shows sexual assault of girls in Zambia in the era of HIV/AIDS to be widespread and complex. It documents several categories of abuse that heighten girls' risk of HIV infection, including (1) sexual assault of girls by family members, particularly the shocking and all too common practice of abuse of orphan girls by men who are their guardians, or by others who are charged to assist or look after them, including teachers, (2) abuse of girls, again often orphans, who are heads of household or otherwise desperately poor and have few options other than trading sex for their and their siblings' survival, and (3) abuse of girls who live on the street, of whom many are there because they are without parental care. All of these situations of abuse must be addressed as part of combating the HIV/AIDS epidemic in Zambia.
In addition, sexual violence and coercion of girls are fueled by men's targeting for sex younger and younger girls who are assumed to be HIV-negative or seeking them out based on the myth that sex with virgins will cure AIDS: the phenomenon of "sugar daddies," unscrupulous older men who entice girls into sex with offers of gifts or money, has been a particular focus of media and other accounts of the impact of HIV/AIDS on girls in Zambia and elsewhere in Africa. The subordinate social and legal status of women and girls makes it difficult for them to negotiate safer sex and to take steps to protect themselves from HIV infection and other sexually transmitted diseases (STDs). The incidents of sexual assault documented in this report were exacerbated by a number of factors, including discrimination girls in Zambia face in access to education. Many of the girls interviewed by Human Rights Watch were unable to continue in school either because their income or labor or capacity for caring for a sick person was needed in an AIDS-affected family while most boys in the family stayed in school, or due to other exclusionary barriers faced more by girls than by boys. The AIDS epidemic itself, which continues to claim the lives of parents and leave orphans at a rate unprecedented in history, perpetuates situations of particular vulnerability for girls as orphans and household heads.
As this report notes, one of the key problems in the state response is the failure of the criminal justice system to deal appropriately with complaints of sexual abuse. There are many barriers to effective reporting and prosecution of crimes of sexual assault, including additional elements of coercion. For orphaned girls being abused by men who are meant to be their guardians or otherwise to be helping to look after them, reporting the abuse may mean risking abandonment or violent punishment. Families will often go to great lengths to conceal this abuse. In other cases, victimized girls remain silent in the face of legal and social services systems that fail to act to protect girls' rights. To report a crime of sexual violence or abuse, a girl would face a police department that is rarely child- or gender-sensitive, health service providers that may scold her for being promiscuous, a court system lacking any facilities for youths, and a societal structure that teaches girls to be submissive to men. Even if she did report abuse, chances that officials would act against the abuser are minimal. As a result, the perpetrators remain free to abuse, and to infect, again.
The case of sexual abuse of girls, especially orphans, by members of their own family is particularly shocking, not least because adult female relatives often stand by, afraid or intimidated, but nevertheless silent in the face of this abuse. As the ranks of orphans continue to grow sharply, this silence and effective complicity within families bodes ill for Zambian society's ability to confront an epidemic that has favored women and girls among its victims.
The complexity of the risk of HIV transmission among girls is painfully apparent and poses a clear challenge to the global response to the pandemic. However, one relatively simple place to start is to improve the criminal justice system's response to complaints of sexual violence or other abuse. Although criminal prosecutions will never reach all those guilty of such abuse they can ensure that some perpetrators are imprisoned and are unable to reoffend, and they also send an important signal to society that such behavior is unacceptable, helping to change the attitudes that ensure social acceptance of, for example, the sexual exploitation of underage girls. The remedies required to improve the state's efforts to protect millions of girls in Africa represent a very small part of the cost and effort required to mount a comprehensive national program on HIV/AIDS. They do not require a massive overhaul of the justice system. In Zambia, as in many African countries, most of the laws that would protect girls from sexual assault are on the books, but they need to be enforced. The police need special training in gender violence and child abuse, as do medical professionals and educators. Abuses against girls must be investigated and prosecuted and appropriate punishments meted out. Discriminatory practices against girls and women, including under the customary law that is still widely applied in Zambia (even where statutory law or the constitution outlaws such practices), must be addressed. Communities need to be empowered to recognize and act upon signs of abuse. Governments, schools and communities should enhance programs to keep girls in school and in a safe environment. Traditional counselors and healers should be encouraged to incorporate AIDS education into their work, and cultural practices that put girls at risk of HIV infection should be stopped.
This is an important moment for Zambia and for the international struggle against HIV/AIDS. Recent studies have indicated a reduction in HIV prevalence among young adults in Zambia, reportedly due to sexual behavior change, including increased condom use. However, progress in reducing new cases will be stalled if the abuses that put girls at risk of infection are not addressed. In addition, significant resources are being made available for HIV/AIDS programs in Zambia through the Global AIDS Fund as well as through bilateral donors and the World Bank. International and national policymakers should muster the political will and take the steps necessary to break this cycle of abuse and transmission and must make protection of girls' human rights a central part of their anti-HIV/AIDS strategies. Allowing girls to suffer in silence not only perpetuates serious human rights violations; it ensures that the HIV/AIDS epidemic will continue on its destructive course.
 Human Rights Watch interview, Lusaka, May 22, 2002.