This submission summarizes Human Rights Watch’s key concerns with Zambia’s fulfillment of its human rights obligations and commitments in the context of women’s human rights and HIV/AIDS, and outlines recommendations to Zambia.

For an elaborate analysis, outlining our concerns in detail, please see the Human Rights Watch report Hidden in the Mealie Meal: Gender-based Abuses and Women’s HIV Treatment in Zambia.

In Zambia, where 17 percent of the adult population is living with HIV/AIDS, women face grave gender-based abuses, in particular domestic violence, which hinder their ability to access or continue using life-saving HIV treatment.

Despite Zambia’s impressive roll-out of HIV treatment, the country’s health system and legal framework fail to address these barriers to women’s HIV treatment and as a result, some women living with HIV miss out on life-saving HIV treatment.

In Zambia, gender-based violence, and in particular domestic violence at the hands of husbands and intimate partners, and the fear of such violence, has a direct impact on women’s ability to start and continue using HIV treatment. Human Rights Watch’s investigation revealed that women are often beaten, slapped, shouted at, verbally abused, and raped upon discussing HIV testing and treatment, after disclosing their HIV status to their husbands, and as a result of visiting health facilities to collect antiretroviral medicine. Some women feel compelled to hide their HIV treatment, and to make up excuses even for experiencing side effects upon commencing HIV treatment. This obstructs women’s ability to access HIV testing, causes them to miss doses of HIV treatment or to miss clinic appointments to collect their medicine.

Despite high levels of sexual and gender-based violence (hereafter SGBV) in Zambia the country has no specific legislation criminalizing SGBV, and women must rely on the general Penal Code provisions on assault occasioning bodily harm. Zambia’s Penal Code has no provision for marital rape or psychological abuse.

Similarly, Zambia’s healthcare system is ill-equipped to address gender-based violence among women living with HIV/AIDS. Healthcare facilities in Zambia have no systems to detect or address SGBV, and there are no government protocols or training programs on how to address gender-based abuses in HIV treatment programs. The only two shelters in the country are run by a non-governmental organization with little funding from the government.

Although the Zambian government has established the Victim Support Unit (hereafter VSU), a special unit of the police charged with addressing a variety of abuses, including domestic violence and property grabbing (see below), lack of human and other resources undermines this unit’s ability to address gender-based abuses.

Violence against women, including domestic violence, raises a range of human rights abuses that governments have a direct responsibility to address, even where a perpetrator is not a state actor. These abuses include a woman’s rights to dignity, personal freedom, and physical integrity, as well as their right to freedom from cruel and inhuman treatment.

Tags: adult population, assault occasioning bodily harm, clinic appointments, domestic violence, health facilities, hiv aids, hiv status, hiv testing, hiv treatment, human rights obligations, impressive roll, intimate partners, legal framework, living with hiv, marital rape, penal code, s health system