‘When I found out my status, I was devastated. I even thought of aborting the baby. I was living with my husband but I was afraid of telling him,’ says Mary, a mother of five who lives in Jinja, southern Uganda. ‘It is easier for a woman to live with a man who is positive. But for a negative man to live with a positive woman, it is never easy.’ Women living with HIV are at greater risk of violence. Involuntary and coerced sterilisation and forced abortion among women living with HIV has been reported in at least 14 countries, according to UN Women
In the Kamalanga compound, in the Zambian capital Lusaka, a young mother carries water. Research suggests physical and sexual violence puts women at greater risk of HIV, and that women living with the virus may experience violence as a result of their status. Among Zambian women aged 15-24 who have never been married or had a partner, about a third have experienced physical or sexual violence in the past year, according to UNAids
‘Martha’ helps her grandmother sell coal at a market outside Lusaka. She has never attended school. Girls in Zambia are less likely than boys to finish school, and more likely to become sexually active at a younger age. As a result, HIV prevalence is higher (11.2%) among younger women than younger men (7.3%) aged 20-24, according to Zambia’s National Aids Council. Aids is a leading cause of adolescent deaths in sub-Saharan Africa
‘When I found out that I was pregnant, I wasn’t too happy because I have had children but they passed away and it was very painful,’ says Nokuthula, 27, who lives in a rural village in South Africa, near the border with Swaziland. In September 2013, she gave birth to a son, Knowledge, who died the following year. This is the fourth of her children who hasn’t survived a third birthday. Last year, an estimated 160,000 children became infected with HIV, according to UNAids
Photograph: Karin Schermbrucker/Unicef
Siblings share a moment on the banks of the Luapula river, Kasenga, Democratic Republic of the Congo. An estimated 13.4 million children have lost one or more parents to Aids, according to UNAids. More than 80% of these children live in sub-Saharan Africa. Children orphaned by Aids, or those living with sick caregivers, face an increased risk of physical and emotional abuse compared with other children, including orphans
‘My husband was an alcoholic. Last year he left me for another woman. Now, I am trying to raise five children with no financial support. He doesn’t even visit his children and he lives down the road,’ says Cynthia from Mpumalanga, in the east of South Africa. Only 35% of children in South Africa grow up in homes with both parents
‘I encourage other mothers to keep breastfeeding their babies, even though it’s hard. They will see their babies are healthier if they do,’ says Nonhlanhla, a nursery school teacher, in Polokwane City, South Africa. She is HIV positive and took precautions when pregnant to ensure her baby would be born negative. In order to breastfeed for as long as possible, she expresses by hand every morning. South Africa is home to the world’s biggest HIV epidemic, but the country has made progress. Since 2010, new HIV infections have decreased by 49%, according to UNAids
Two girls play together during sunset on the banks of the Luapula river. Mother-to-child transmission is the most common way in which children become infected with HIV. However, west and central Africa also have high levels of underage and forced marriage. In 2015, 42% of girls in west and central Africa were married before they turned 18
Photographer Karin Schermbrucker spent a decade travelling with Unicef, documenting the courage of such women