The HIVAids epidemic in Zambia, says Dr Frida Sakala Kazembe, impacts disproportionately "on women of reproductive age, young people (15-24) and skilled and economically productive groups". Aids cases peak in the 20-29 age range for females and in the 30-39 age range for males. To Dr Kazembe, these data "suggest a noteworthy transmission from older men to younger women."

Surveys show "higher proportions of women infected in both urban and rural areas," she adds. "A significant number of Aids cases has been reported among young children, and virtually all of these children were infected by their mothers through prenatal transmission." Also serious is the growing number of orphans left behind by mothers who have died of Aids.

Dr Kazembe was speaking at a panel discussion on HIV/Aids at the end of March in Lusaka, Zambia's capital. The discussion was organized by the United Church of Zambia and the Reformed Church in Zambia together with our Department of partnership of women and men.

The HIV/Aids epidemic puts a huge strain on the struggling Zambian economy. An already impoverished social system is overburdened by the huge demand for health care, child welfare and other services. In many homes, grandparents are left to care for orphans; in other cases adolescent children are forced to take responsibility for the household.

Women are multiply disadvantaged in the pandemic, Dr Kazembe says. Wives take care of their sick husbands, but most women when sick themselves are abandoned by their husbands and family. Widows "may lose what little that has been left behind by their husbands, through property grabbing by their husbands' relatives."

Some churches are active in caring both for people living with HIV/Aids and for Aids orphans, but there is still a lot to be done. "The church has had to cope with infected religious workers as well as infected and affected members of the congregations," Dr Kazembe notes. The ABC formula ("Abstain, be faithful and condomize") has not been very effective in dealing with HIV/Aids, especially where gender roles and expectations disempower women.

The churches must take a leading role in addressing questions of sexuality, service to people living with and dying of Aids, ethical issues relating to confidentiality, and support for families affected by Aids.

Women are at special risk of infection because they often have less control over when, where and whether sex takes place. Economically they depend on their husbands or partners, and are frequently prey to violence at their hands - an outrage that the churches must publicly condemn.

Cultural expectations about what it means to be a man place men in an oppressive role and deprive them of many of God's gifts - caring, nurturing and the ability to give up power and share in an equal partnership with women. They also encourage irresponsible sexual behaviour in men which puts them and their partners at increased risk.