“It is no accident that HIV prevalence is five times higher among girls than boys under age 18 in Zambia,” said Janet Fleischman, Washington director for Africa Division of Human Rights Watch and author of the report. “Young girls are preyed upon by older men—including those who dare call themselves guardians or caretakers of these girls, and the government fails to protect them.”

The United Nations’ annual assessment of the HIV/AIDS epidemic, released in December, emphasized that in Africa “the face of AIDS is clearly a female face,” and noted the much higher rate of HIV transmission among girls than boys on the continent. The Human Rights Watch report tells the human story behind this disparity, detailing many ways in which girls in Zambia are vulnerable to the disease through abuse and subordination.

“Girls orphaned by AIDS face stigma and poverty and too often are unable to stay in school,” Fleischman said. “They may have no recourse but to trade sex for survival—their own survival and sometimes that of their siblings—and they are rarely able to negotiate safer sex.”

Zambia is not the only country facing this challenge, Fleischman noted. But with more than one in five adults infected and very high HIV prevalence among girls and young States’ and other donors’ development assistance agenda and HIV/AIDS programs.

women, it illustrates a situation that should be central to the United Human Rights Watch said laws against sexual violence and abuse are inadequately enforced in Zambia. The insensitive and ineffectual handling of sexual violence complaints by the law enforcement system often deters victims from reporting cases and impedes prosecution of perpetrators.

Zambia is slated to receive $93 million for AIDS programs from the Global Fund on HIV/AIDS, Malaria and Tuberculosis and $42 million from the World Bank in the next few years. Other donors, including the United States, have also given millions for anti-AIDS efforts. Little of this assistance, however, is targeted to protecting girls from sexual abuse.

Human Rights Watch urged the government of Zambia to intensify training on addressing sexual abuse for police and court officials, to strengthen victim support units of the police, and to ensure rigorous prosecution of perpetrators of these crimes.

“The improvements needed to enforce existing laws against sexual abuse are not very costly compared to many other elements of AIDS programs,” said Fleischman. “The government and donors have a chance to make a dent in the hyper-epidemic of HIV transmission among girls by making their protection a priority.”