Zambia has similar health programmes to Zimbabwe yet the neighbouring country has managed to supply ARVs to 80 percent of people needing them thereby achieving universal access. Zambia sometimes has drug stockouts and patients get two weeks supplies instead of a month's supply when stocks are low.
Kunyima Lifumbela, who is the Programmes Manager of National Zambian People Living with HIV (NZP+), speaking on the sidelines of the just-ended XIX International Aids Conference in Washington, DC, said their education system needs to refocus as children who were born HIV positive are now getting into adolescence and have unmet needs.
"Our school curricula looks at children in school as if they are all HIV negative. They do not speak for those children who were born HIV positive. A decade ago these children were young but today they are young adults and have to have their needs met.
"As NZP+ we are saying break down barriers. You cannot talk prevention only without taking in care and support for these children who were born HIV positive. We cannot pretend that all the children in school are HIV negative," said Lifumbela.
Lifumbela added that children living positively should be understood if they missed classes as they had to collect drugs especially when there are stockouts.
She said the school environment was not conducive to children living positively and at times some of them ended up withdrawing from sporting activities because they do not want to endanger their mates.
"A child should not be forced to disclose their HIV status. In the event that a child prefers certain sports, say, athletics from rugby, school heads ought to understand that the child does not want to endanger their mates since some sporting activities end up in injury," she said.
She also said the family environment was not conducive in some instances where orphans are looked after by relatives.
"We have situations where an orphan has their HIV status made public knowledge by a relative. That child is not ready to face the backlash. You even have some parents asking their children not to play with that HIV positive child because someone was reckless and chose to disclose a minor's status. It is discriminatory and being an orphan is hard enough without anyone adding unwanted disclosure which ends with stigma from the community," said Lifumbela.
Minors are not expected to be sexually active but when one is HIV positive, people point fingers. Some even say the minor engaged in sexual activity yet the child could have gotten it through mother to child transmission.
"It is not their making that these children were born HIV positive. Society must understand that and give the children equal opportunities as their counterparts. The same guardians who disclose an adolescent's HIV status do not disclose their own status. Some of them have never been tested so how do they go about discriminating when they have never been tested?" she said.
Lifumbela said her organisation was working with the chiefs who are community leaders in educating them on the rights of the children.
"Chiefs are community leaders and are influential in their areas so we have engaged them as we seek to have children born positive get space and a conducive environment be it at home, school or in the community," she said.
Zimbabwe is in a similar position as the children who were born HIV positive are now young adults and are even ready to start families. Lily, from Mufakose, Harare, said she is lucky as she grew up in a community that fostered acceptance of positive living.
"I lost my parents a decade ago and grew up under the care and support of my uncle. In my community there are support groups for people living positively and this has greatly helped me. I did not need to go out and announce that I was HIV positive. Joining a group of people in a similar situation has helped me a lot," she said.
"My uncle, although HIV negative, is a member of the support group and has been there for me. He has made my association with other children born positive possible and he does not discriminate," said Lily.
She said she is a peer educator in her community and at school and fully understands that it is possible to have an HIV free baby even if one is positive.
"I have learnt of the prevention of mother to child transmission and I will get a partner from our positive circles when I am ready to settle down," she said.
She said with PMTCT HIV positive women were now able to have babies and even breastfeed.
"Taking ART is good as it reduces the chances of one passing the virus to your partner. I am on medication and my chances of passing the virus to the baby will be minimised when the time comes. I will give birth to an HIV free baby unlike my mother," she said.
In Zimbabwe the Elizabeth Glaser Foundation working in conjunction with the Ministry of Health and Child Welfare has over 700 sites nationally where PMTCT is offered to registered mothers.