News / Africa

In Uganda, HIV Infections on the Rise

Jolly Nyamigisha, 40, a Ugandan woman living with HIV/AIDS waits to receive antiretroviral drugs from the Infectious Disease Institute (IDI) at the Uganda referral hospital, Mulago, near the capital Kampala, (File).
Jolly Nyamigisha, 40, a Ugandan woman living with HIV/AIDS waits to receive antiretroviral drugs from the Infectious Disease Institute (IDI) at the Uganda referral hospital, Mulago, near the capital Kampala, (File).

After a wildly successful campaign against AIDS in the 1990s, Uganda is now the only country in East Africa where the AIDS rate is actually rising.  Some people attribute this to a Bush-era abstinence-only approach to AIDS prevention, a policy at odds with patterns of sexual behavior in Uganda. 

Uganda was once a shining example of successful AIDS prevention, when, in the 1990s and early 2000s, it managed to slash its infection rate from around 15 percent to 6 percent.  But for the past five years, infections have once again been on the rise, leading many people to question what went wrong.

Exact statistics on mounting infection rates are not due to be published until next year. But on December 1, World AIDS Day, the Ugandan government launched a new HIV Prevention Strategy to address the worrying trend.

Changing sexual behaviors

Zainab Akol of the Ministry of Health says that one of the reasons for the rise is complacency, but she admits that attempts to change people’s sexual behavior were not very successful.  She says that in the future, Uganda intends to focus more on medical and educational methods to prevent transmission and treat those who are already infected.

“We are talking about scaling up anti-retroviral treatment, we are talking about male circumcision, we are talking about scaling up HIV counseling and testing.  We now understand that it’s very difficult to deal with sexual behavior," Akol explained. "We hadn’t understood.  We thought people would just hear the threat and develop fear, but we now see that fear doesn’t work all the time.”

Abstinence-only backfires

Many experts blame the rising infection rate on a communication strategy that promoted abstinence only until marriage, without encouraging the use of condoms.  This was the message of the American-funded PEPFAR, which stands for President’s Emergency Plan for AIDS Relief.

Established in 2003 under former U.S. President George W. Bush, PEPFAR has provided hundreds of millions of dollars in funding for Uganda’s AIDS programs.  Its focus on abstinence was eagerly adopted here, where the message fit in well with a culture of conservative Christianity.

But now, with the rate of new HIV infections rising fastest among married couples, this strategy seems to have backfired.  Asia Russell, of the advocacy organization Health GAP, says that PEPFAR’s approach has expanded in recent years to include encouraging condom use.  But, she adds, the U.S. government still funds programs focusing on abstinence.

“About 46 percent of new infections in this country are between married, co-habitating people in stable relationships.  And yet, if you drive around Kampala you see many billboards that communicate that marriage protects people.  That’s false information," Russell said. "It’s wasteful, and it’s harmful.  Meanwhile, we all know of facilities where people can’t get free condoms.  We’re concerned that some of these messages still find their way into the community, and still receive investments from the U.S. government.”

Moralistic approach not a solution

Leonard Okello, of the International HIV/AIDS Alliance in Uganda, says the problem is that using moral values such as marriage to fight the spread of HIV has given married people a false sense of security.  With Uganda’s widespread culture of marital infidelity, he says, abstaining can still put you at risk.

“If you adopt a more moralistic approach, you get these problems.  I think we need to recognize that it is not just about morals.  Even abstinence has its limitations, because not everybody is abstaining. They go to church, wed this one and only wife and one and only husband, and then lead a traditional polygamous life.  It seems to be an acceptable norm,” Okello stated.

But, Okello explains, even being faithful is not always safe.  He was married for eight years to a woman who was HIV positive, a situation, he says, that the abstinence-only message fails to address.

“My wife was HIV positive, and I was HIV negative. I was faithful to my wife.  She got HIV infected earlier, but we didn’t know.  By remaining faithful, I was actually at risk.  So it doesn’t necessarily mean being faithful is safe," he noted. "Those are the realities we did not know then.  When PEPFAR was pushing very much the abstinence agenda, we forgot that the epidemic was changing rapidly.”

AIDS activist Rukia Nansubuga, who is HIV positive herself, says that one of the main obstacles to controlling the virus among married couples is simple fear of disclosing your status to your spouse.

“When a woman comes out to be tested, she fears to disclose to her partner.  Once the woman declares that 'I’m HIV positive,' then that’s the end of the marriage," Nansubuga said. "When I disclosed and my husband knew my status, he abandoned me.  Now I’m a single mother living with HIV/AIDS, with seven children.”

More resources needed

Increasing medical interventions and treatments in Uganda just became more difficult, as the Global Fund to Fight AIDS, Tuberculosis and Malaria announced last month that no new funding would be available until 2014.

Russell says that in order to bring infection rates down, Uganda will have to commit more of its own resources to the struggle.  She also hopes the current crisis will re-galvanize the country’s leadership, including President Yoweri Museveni, because over the past several years, she says, political will has begun to slip.

“One feature that distinguished the response in this country is Museveni and other high-profile leaders speaking in an extraordinarily committed way to the fight against HIV.  That changed over the last few years.  I think people noticed a silence, and noticed more stigmatizing language about people with HIV coming out of statehouse,” Russell noted.

Both Russell and Okello agree that with the treatments available and enough information, an HIV-free generation is within reach.  But it remains to be seen whether Uganda can summon the political commitment and resources to make it happen.

Photo Gallery: World AIDS Day

You May Like

Multimedia Social Media Documenting, Not Driving, Hong Kong Protests

Unlike in Arab Spring uprisings, pro-democracy protesters in Hong Kong aren't relying on Twitter and Facebook to organize, but social media still plays a role More

Bambari Hospital a Lone Place of Help in Violence-Plagued CAR

Only establishment still functioning in CAR's second city is main hospital More

This forum has been closed.
Comments
     
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
The Legacy of Jimmy Carter: The Preacher from Plainsi
X
October 01, 2014 10:45 AM
It is common in the United States to see tourists flock to sites associated with America's presidents. Some are privately owned and others are run by the National Park Service or the National Archives -- but most have helped draw business and people into the towns and cities where they are located. As VOA’s Kane Farabaugh reports, there is one particular presidential hometown that is unique in what it has to offer those who make the trip.
Video

Video The Legacy of Jimmy Carter: The Preacher from Plains

It is common in the United States to see tourists flock to sites associated with America's presidents. Some are privately owned and others are run by the National Park Service or the National Archives -- but most have helped draw business and people into the towns and cities where they are located. As VOA’s Kane Farabaugh reports, there is one particular presidential hometown that is unique in what it has to offer those who make the trip.
Video

Video Hong Kong Protests Draw New Supporters on National Holiday

On the 65th anniversary of the founding of Communist China, Hong Kong protesters are hoping to stage the largest pro-democracy demonstration since the 1989 Tiananmen protests. VOA's Brian Padden visited one of the protest sites mid-day, when the atmosphere was calm and where the supporters were enthusiastic about joining what they are calling the umbrella revolution.
Video

Video India's PM Continues First US Visit

India's prime minister is on his first visit to Washington, to strengthen political and economic ties between the world's oldest and the world biggest democracies. He came to the U.S. capital from New York, the first stop on his five-day visit to the country that denied him an entry visa in the past. From Washington, Zlatica Hoke reports Modi seemed most focused on attracting foreign investment and trade to increase job opportunities for his people.
Video

Video Malaysia Struggles to Stop People Joining Jihad

Malaysian authorities say militant groups like the so-called "Islamic State" have used social media to entice at least three dozen Malaysian Muslims to fight in what they call "jihad" in Syria and Iraq. As Mahi Ramkrishnan reports from Kuala Lumpur, counterterrorism police are deeply worried about what could happen when these militants return home.
Video

Video Could US Have Done More to Stop Rise of Islamic State?

President Obama says airstrikes against Islamic State militants in Syria will likely continue for some time because, in his words, "there is a cancer that has grown for too long." So what if President Obama had acted sooner in Syria to arm more-moderate opponents of both the Islamic State and the Syrian government? VOA State Department Correspondent Scott Stearns reports from the United Nations.
Video

Video Treasure Hunters Seek 'Hidden Treasure' in Central Kenya

Could a cave in a small village in central Kenya be the site of buried treasure? A rumor of riches, left behind by colonialists, has some residents dreaming of wealth, while others see it as a dangerous hoax. VOA's Gabe Joselow has the story.
Video

Video Ebola Patients Find No Treatment at Sierra Leone Holding Center

At a holding facility in Makeni, central Sierra Leone, dozens of sick people sit on the floor in an empty university building. They wait in filthy conditions. It's a 16-hour drive by ambulance to Kailahun Ebola treatment center. Adam Bailes was there and reports on what he says are some of the worst situations he has seen since the beginning of this Ebola outbreak. And he says it appears case numbers may already be far worse than authorities acknowledge.
Video

Video Identifying Bodies Found in Texas Border Region

Thousands of immigrants have died after crossing the border from Mexico into remote areas of the southwestern United States in recent years. Local officials in south Texas alone have found hundreds of unidentified bodies and buried them in mass graves in local cemeteries. Now an anthropologist and her students at Baylor University have been exhuming bodies and looking for clues to identify them. VOA’s Greg Flakus has more from Waco, Texas.
Colonel Steve ‘Spiros’ Pisanos left Greece and came to the U.S. to learn to fly. He flew fighters for the Allies in World War II, narrowly escaping death multiple times.Colonel Steve ‘Spiros’ Pisanos left Greece and came to the U.S. to learn to fly. He flew fighters for the Allies in World War II, narrowly escaping death multiple times.

AppleAndroid