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

Photogallery Strong Words Start, May End, S. African Xenophobic Attacks

President Jacob Zuma publicly condemned rise in attacks on foreign nationals but critics say leadership has been less than welcoming to foreign residents More

Video Family Waits to Hear Charges Against Reporter Jailed in Iran

Reports in Iran say Jason Rezaian has been charged with espionage, but brother tells VOA indictment has not been made public More

Video Overwhelmed by Migrants, Italy Mulls Action to Stabilize Libya

Amnesty International says multinational concerted humanitarian effort must be enacted to address crisis; decrepit boats continue to bring thousands of new arrivals daily 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.
Are Energy Needs Putting Thailand's Natural Beauty at Risk?i
X
Steve Sandford
April 17, 2015 12:50 AM
Thailand's appetite for more electricity has led to the construction of new dams along the Mekong River to the north and new coal plants near the country's famous beaches in the south. A proposed coal plant in a so-called "green zone" has touched off a debate. VOA's Steve Sandford reports.
Video

Video Are Energy Needs Putting Thailand's Natural Beauty at Risk?

Thailand's appetite for more electricity has led to the construction of new dams along the Mekong River to the north and new coal plants near the country's famous beaches in the south. A proposed coal plant in a so-called "green zone" has touched off a debate. VOA's Steve Sandford reports.
Video

Video Overwhelmed by Migrants, Italy Mulls Military Action to Stabilize Libya

Thousands more migrants have arrived on the southern shores of Italy from North Africa in the past two days. Authorities say they expect the total number of arrivals this year to far exceed previous levels, and the government has said military action in Libya might be necessary to stem the flow. VOA's Henry Ridgwell reports.
Video

Video Putin Accuses Kyiv of ‘Cutting Off’ Eastern Ukraine

Russian President Vladimir Putin, in his annual televised call-in program, again denied there were any Russian troops fighting in Ukraine. He also said the West was trying to ‘contain’ Russia with sanctions. Henry Ridgwell reports on reactions to the president’s four-hour TV appearance.
Video

Video Eye Contact Secures Dog's Place in Human Heart

Dogs serve in the military, work with police and assist the disabled, and have been by our side for thousands of years serving as companions and loyal friends. We love them. They love us in return. VOA’s Rosanne Skirble reports on a new study that looks at the bio-chemical bond that cements that human-canine connection.
Video

Video Ukrainian Volunteers Search for Bodies of Missing Soldiers

As the cease-fire becomes more fragile in eastern Ukraine, a team of volunteer body collectors travels to the small village of Savur Mohyla in the what pro-Russian separatists call the Donetsk Peoples Republic - to retrieve bodies of fallen Ukrainian servicemen from rebel-held territories. Adam Bailes traveled with the team and has this report.
Video

Video Xenophobic Violence Sweeps South Africa

South Africa, long a haven for African immigrants, has been experiencing the worst xenophobic violence in years, with at least five people killed and hundreds displaced in recent weeks. From Johannesburg, VOA’s Anita Powell brings us this report.
Video

Video Sierra Leone President Koroma Bemoans Ebola Impact on Economy

In an interview with VOA's Shaka Ssali on Wednesday, President Ernest Koroma said the outbreak undermined his government’s efforts to boost and restructure the economy after years of civil war.
Video

Video Protester Lands Gyrocopter on Capitol Lawn

A 61-year-old mailman from Florida landed a small aircraft on the Capitol lawn in Washington to bring attention to campaign finance reform and what he says is government corruption. Wednesday's incident was one in a string of security breaches on U.S. government property. Zlatica Hoke reports the gyrocopter landing violated a no-fly zone.
Video

Video Apollo 13, NASA's 'Successful Failure,' Remembered

The Apollo 13 mission in 1970 was supposed to be NASA's third manned trip to the moon, but it became much more. On the flight's 45th anniversary, astronauts and flight directors gathered at Chicago's Adler Planetarium to talk about how the aborted mission changed manned spaceflight and continues to influence space exploration today. VOA’s Kane Farabaugh reports.
Video

Video Badly Burned Ukrainian Boy Bravely Fights Back

A 9-year-old Ukrainian boy has returned to his native country after intensive treatment in the United States for life-threatening burns. Volodia Bubela, burned in a house fire almost a year ago, battled back at a Boston hospital, impressing doctors with his bravery. Faith Lapidus narrates this report from VOA's Tetiana Kharchenko.
Video

Video US Maternity Leave Benefits Much Less Than Many Countries

It was almost 20 years ago that representatives of 189 countries met at a UN conference in Beijing and adopted a plan of action to achieve gender equality around the world. Now, two decades later, the University of California Los Angeles World Policy Analysis Center has issued a report examining what the Beijing Platform for Action has achieved. From Los Angeles, Elizabeth Lee has more.
Video

Video Endangered Hawaiian Birds Get Second Chance

Of the world's nearly 9,900 bird species, 13 percent are threatened with extinction, according to BirdLife International. Among them are two Hawaiian honeycreepers - tiny birds that live in the forest canopy, and, as the name implies, survive on nectar from tropical flowers. Scientists at the San Diego Zoo report they have managed to hatch half a dozen of their chicks in captivity, raising hopes that the birds will flutter back from the brink of extinction. VOA’s George Putic reports.
Video

Video Exhibit Brings Renaissance Master Out of the Shadows

The National Gallery of Art in Washington has raised the curtain on one of the most intriguing painters of the High Renaissance. Mostly ignored after his death in the early 1500s, Italian master Piero di Cosimo is now claiming his place alongside the best-known artists of the period. VOA’s Ardita Dunellari reports.
Video

Video Sidemen to Famous Blues Artists Record Their Own CD

Legendary blues singer BB King was briefly hospitalized last week and the 87-year-old “King of the Blues” may not be touring much anymore. But some of the musicians who have played with him and other blues legends have now released their own CD in an attempt to pass the torch to younger fans... and put their own talents out front as well. VOA’s Greg Flakus has followed this project over the past year and filed this report from Houston.
Video

Video Iran-Saudi Rivalry Is Stoking Conflict in Yemen

Iran has proposed a peace plan to end the conflict in Yemen, but the idea has received little support from regional rivals like Saudi Arabia. They accuse Tehran of backing the Houthi rebels, who have forced Yemen’s president to flee to Riyadh, and have taken over swaths of Yemen. As Henry Ridgwell reports for VOA, analysts say the conflict is being fueled by the Sunni-Shia rivalry between the two regional powers.

VOA Blogs