In a country such as Zambia, or indeed Sub-Saharan Africa, with generalized epidemics, it is critical that prevention of new infections 
becomes the cornerstone of the response if Millennium development goals and Universal access are to be reached. This will only be achieved if all people make it their business to know their status and act to prevent the further spread of HIV, therefore VCT is a pre-requisite to universal access. Counselling and testing should not just be defined as voluntary counselling and testing, but should include provider initiated counselling and testing and as an entry point for PMTC and ART as well as an entry point to engage men around Sexual Reproductive Health (SRH). To maximize its utility and as a mechanism to reach men, VCT should be linked to these services.
In a country such as Zambia, or indeed Sub-Saharan Africa, with generalized epidemics, it is critical that prevention of new infections becomes the cornerstone of the response if Millennium development goals and Universal access are to be reached. This will only be achieved if all people make it their business to know their status and act to prevent the further spread of HIV, therefore VCT is a pre-requisite to universal access. Counselling and testing should not just be defined as voluntary counseling and testing, but should include provider initiated counselling and testing and as an entry point for PMTC and ART as well as an entry point to engage men around Sexual Reproductive Health (SRH). To maximize its utility and as a mechanism to reach men, VCT should be linked to these services.
Although there has been significant progress, treatment scale-up has not kept pace with actual needs. This is so because of various obstacles, these include the inability of women to have equal access to prevention, care, treatment and support. Women need to feel safe in their quest to know their status, safe to seek and take treatment and this can only be possible when men plan their role in ensuring scale up to VCT, thereby removing these obstacles.
There is need to develop, implement and scale up prevention efforts for men. These should aim to motivate men and women to talk more openly about sexuality, Reproductive health and HIV, thereby facilitating a more open and inclusive joint approach to counseling and testing.
This is a difficult area for couples but let us remember that in Sub-Saharan Africa, “couple testing” has reduced HIV amongst serodiscordant couples (Allen at all 2003). Providing serodiscordant couples with improved prevention and treatment services and tools can greatly reduce HIV transmission. As well as contribute to the successful implementation of PMTC programmes.
Zambia is committed to attaining the Millennium Development goals by 2015 I will specifically refer to goal No 4: Reducing infant mortality. The high infant mortality can be successfully addressed through a comprehensive scale-up of prevention strategies that can almost eliminate mother-to-child transmission. This can best be achieved if couples/ partners worked together to achieve this. Couples need to support each other in VCT. We all know that women have been victimized by their male partners, be they husbands or partners on declaring their HIV status especially if they are HIV positive. They have stayed away from reaching available services for fear of reprisals and lack of choices, so it makes perfect sense for men to provide the necessary leadership and support and take themselves and their partners for VCT. It is tragic that in this day, only 2 out of 3 HIV positive women do not receive anti-retroviral drugs and other services to prevent mother-to –child transmission.
Again with reference to goal No 5:
[1]Women account for about 50% of all people living with HIV and for more than
[2]60% of infections in Africa. Greater access to anti-retroviral drugs is effective in improving the health of women through programmes that combine PMTC and continuing treatment to improve and maintain the health status of women. Women can only take full advantage of these services with and when they have full partnership and support of their male partners. This is not an option, it is a responsibility which men must increasingly face up to.
Historically, since the beginning of the epidemic, women have taken the lead in all aspects of the response. Time has now come for shared responsibility; issues of sexual reproductive health can no longer be left to women only. These are issues that must surely be addressed by both men and women.
[1] Report on the Global Aids epidemic- UNAIDS 2008
[2] Report on the Global Aids epidemic- UNAIDS 2008
