In Zambia, as in most African societies, a marriage is considered incomplete without children. That is why mother and father are called by their child's name (e.g. bana Bwalya, meaning 'mother of Bwalya'). It is the woman who suffers most when the marriage is childless, as she is called all sorts of humiliating names. At funerals, some clans will stick a maize cob into a deceased woman's vagina so that the "spirits" will not come back to trouble other people's children. Family pressure mounts as relatives push for the couple, especially the woman, to seek medication. If that fails, the relatives intervene in the marriage and ask the woman to leave, to pave the way for another --fertile-- woman.

Should people living with HIV/AIDS (PLWHAs) engage in sexual affairs? Do they have a right to have children? PLWHAs say that they are as human as any other person and have the same sexual and reproductive rights and wishes: having children is one of the fundamental rights of every individual.

"It is clear that people, HIV-positive or not, have sex and produce children, but no one wants to talk about it. In Zambia it is a taboo to discuss sex in public, even more so sex between PLWHAs," says Winstone Zulu, co-ordinator of the Network of Zambian People Living with HIV/AIDS (NZP+) and one of the first --and few-- Zambians who came out openly about their HIV status. "When it comes to sexual and reproductive rights, PLWHAs must take responsibility, both to protect themselves and reduce risks for others, including their unborn babies," says Zulu. After ten years of serious consideration, Zulu has decided to try and have a child. A drug trial has allowed him access to anti-retroviral drugs for some time now. His wife will start taking them soon too, so that they can try out to have a child without a high risk of transmission to the child.

Clement Mfuzi, a PLWHA and an outreach worker, says that society cannot start deciding on other people's sexual behaviour. At the NGO he worked for, PLWHAs were asked not to have any sex at all. "It is easy to tell people not to have sex, but how can you monitor this? What angered me most, is that it is possible for PLWHAs to have safe sex. People should be given options so that together they can make informed decisions on what to do." Mfuzi says. "There is a general belief that PLWHAs should not have children. I used to follow all prescriptions, such as no sex , no children, no alcohol. But after I lost my job --for no other reason than being an HIV/AIDS advocate-- I wanted to do the opposite of what I was told to do. I had this strong desire to die as an African man with children of my own. We decided to have children, although my wife and I knew I was HIV-positive," Mfuzi says. However, he believes that if PLWHAs decide to have children, they must consider their children's future, such as the possibility of them becoming orphans and that they can be infected with HIV. "Rights go hand in hand with responsibility," says Mfuzi. It took him and his wife four years before they decided to have children: they now have two visibly healthy children aged three and two years.

Fred Mubitelela, a 26-year old PLWHA with two wives, says that people like him are human too and have a right to sex and having children. He has lost two children and does not intend to have any more. He has instead adopted a child. Mubitelela advises people to protect themselves with condoms. Similarly, Matthews Miti, a PLWHA and outreach worker, says PLWHAs have a right to have children, but need to consider the risks for the children, themselves and the mother during delivery. "I don't think I would have children now because they could be born HIV-positive. I have seen how children suffer pain," says Miti. He has a 9-year old child, born in 1991, seven years before he tested HIV-positive. He says, however, that there is no harm in having children, as long as measures to protect both the mother and child at delivery are taken.