Rise in HIV/AIDS Slaps Uganda in the Face

Rise in HIV/AIDS Slaps Uganda in the Face

Is 'complacent' Uganda slipping into HIV/AIDS trap again?

By Enoch Mutabaazi
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First published: June 1, 2006

Following years of a near miraculous reversal of HIV/AIDS prevalence from 30% in late 1980s to 6.2% in 2002-3 that won Uganda many international accolades, there is general fear that the country is becoming complacent and slowly slipping back into the danger zone.

According to the latest HIV/AIDS country status report carried out by The Uganda AIDS Commission for the year June, 2004 to July 2005, the country has registered stagnation in HIV prevalence from 1999 up to date, with marginal reduction or increase across the years. In 1999/00 the prevalence was 6.8%, 6.10% for 2000/01 and 6.5% for 2001/02. In 2002/3, it was 6.2% and shot up to 7.1% in 2004/5.

This stagnation is worrying many anti HIV/AIDS practitioners, prompting calls for more proactive preventive efforts if the HIV/AIDS scourge is to be halved in Uganda.

Speaking during the recently concluded Fourth Annual Partnership Forum in January 30, the Uganda AIDS commission Director General, Dr. David Kihumuro Apuuli called for tremendous efforts if Uganda is to win the war against HIV/AIDS.

"The prevalence is very high among females and in urban centers, with Kampala registering 12.5% of the prevalence among women. It is unfortunate because we are not making any headway," he said.

More confusing however, is that the Uganda HIV/AIDS sero-behavioral survey 2004/5 shows that HIV infection levels for both males and females is highest among those in age category of 30-40 years. This age bracket is presumed to be having adequate knowledge on prevention of HIV infections.

The 2004/5 country status report also confirm that Ugandan adults living in urban areas are almost twice as likely to be infected with HIV compared to their rural counterparts, yet those in urban areas are presumably more informed about preventive measures.

What seems to remain a constant is the fact that women have higher predominance of HIV infection across all age categories and regions of the country, the reason many activists have been calling for an anti-HIV/ADS strategy and policy that focuses on the vulnerability of women.

The Vice President, Prof. Gilbert Bukenya, who opened the Fourth Annual Partnership forum summarized the mood shared across by HIV/AIDS experts. "Infection is high among adults now and we must ask ourselves why," he says.

Bukenya said the issue of condom use needs to be reviewed. "The issue of condoms was politicized. Much as the religious sector is against it, I feel there are people who can't be left out. The issue must be re-addressed," he said.

Complacency a big concern

The Uganda AIDS Commission status report warns that despite the past successes Uganda has attained, a lot more efforts are needed especially in the area of prevention.

"In spite of these (previous) successes, there should be no room for complacency as figures show that the decline in the epidemic has stagnated over the last 3-4 years," warns the report sponsored by USAID. Apart from worries of general complacency in the population, several challenges still hinder a comprehensive HIV prevention strategy.

While it is generally accepted that the ABC-Abstinence, Be faithful and Condom use policy works, the Uganda government has been blamed for its recent emphasis on Abstinence and Be faithful as the lead methods of prevention. President Yoweri Museveni says that Uganda's success in reducing HIV/AIDS prevalence levels is much a result of Abstinence and Be faithful campaign than it is of condom use.

Many organizations led by Human Rights Watch (HRW) and local NGOs argue that Uganda's past success cannot be wholly attributed to behavioral change like government and religious organizations suggests.

Rebecca Schleifer, a researcher with HRW says that censorship of information about condoms in government-funded programs, myths about condoms spread by religious leaders, and restrictions on condoms hamper the fight against the AIDS pandemic.

"The clear result of restricting access to condoms would mean more lives being lost to AIDS," says Jonathan Cohen, another researcher with Human Rights Watch's HIV/AIDS Program.

However, Uganda's Presidential Advisor on HIV/AIDS, Kintu Musoke, says the Uganda government is still pursuing the ABC policy, only bringing Abstinence and Be faithful on the limelight, as this had been cast in the shadows in favour of promoting condom use. "What we are emphasising is that behavioural change is what we need most to fight HIV/AIDS," Musoke told Ultimate Media. Although the government insists on behavioural change as the key factor in HIV prevention, the 2004/05 HIV/AIDS country report indicates that only 50-55% of young men and women aged 15-19 use condoms during sex with non-regular partners. This means that over 40% of the youth aged 15-19 have unprotected sex with non-regular partners, and are at high risk of contracting HIV, the virus that causes AIDS.

Even in an environment where condoms are highly being promoted, the report also points at other key factors hindering successful prevention of HIV infection in Uganda based on the C strategy, especially the rural areas. Factors like disparities in free condom distribution at sub-counties, the unforeseen shortage of condoms, due to quality problems with Ngabo condoms that led to the failure to achieve the national target of eight condoms per sexually active person.

Worse still, the survey findings reveal that much as all the districts in the country now have some level of Prevention of Mother To Child Transmission (PMTCT) services, almost half (22) of the districts have disappointing coverage ranging from 25-50%.

"We thought we were doing well in the fight against HIV/AIDS but instead HIV/AIDS is getting on us and we are not getting on top of it," says Kihumuro referring to the current prevalence figures.

Global trend?

Kihumuro says that globally, HIV/AIDS infection had not reduced in the previous year, with over 40 million people infected, 95% of whom are in sub Saharan Africa. There are at least 1.4 million Ugandans infected with HIV/AIDS. The rise in infection is a slap in the face when Uganda was moving to another level of mitigating the effects of the HIV/AIDS pandemic by constructing an antiretroviral (ARVs) factory at Luzira, which Prof. Bukenya said will be functional by June 2006.

According to Dr. Alex Opio's situational summary, "the behavioral change remains low relative to the high levels of awareness". He says that the findings call for more vigilance in observation of the trends and that time is ripe for serious thinking on how to address the implications of the current trends.

By Enoch Mutabaazi
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First published: June 1, 2006
To learn more about Ultimate Media Consult go to www.ultimatemediaconsult.com.

Enoch Mutabaazi is a media practitioner at Ultimate Media Consult with more than six years experience in the print and electronic media. Since he majored in Broadcast Journalism at his graduate studies Mutabaazi first worked as a reporter at Uganda Television (now Uganda Broadcasting Corporation TV) before he discovered his multidimensional skills in writing and public relations at Ultimate Media Consult. He is currently the Production Executive at Ultimate Media Consult (U) Ltd and writes occasionally.