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

    Native Americans Ask: What About Our Water Supply?

    They say they have been facing a dangerous water contaminant for decades - uranium – but the problem has received far less attention than water contamination by lead in Flint, Michigan

    Pakistan's President Urges Nation Not to Celebrate Valentine's Day

    Mamnoon Hussain criticizes Valentine's Day, which falls on Sunday this year, as a Western import that threatens to undermine the Islamic values of Pakistan

    Mother of IS Supporter: Son Was Peaceful, 'Role Model'

    Somali-American Abdirizak Mohamed Warsame pleaded guilty Thursday to charges of conspiring to provide material support to Islamic State militants

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

    By the Numbers

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Two-thirds of World Faces Water Shortagei
    X
    February 12, 2016 7:31 PM
    Four billion people — or two out of every three on the planet — do not have enough water to meet their basic needs. That is far greater than previously thought, according to a new study that presents a more accurate picture of the problem. As VOA's Rosanne Skirble reports, the findings will help policymakers and the public craft solutions to address the threat.
    Video

    Video Two-thirds of World Faces Water Shortage

    Four billion people — or two out of every three on the planet — do not have enough water to meet their basic needs. That is far greater than previously thought, according to a new study that presents a more accurate picture of the problem. As VOA's Rosanne Skirble reports, the findings will help policymakers and the public craft solutions to address the threat.
    Video

    Video Gateway to Mecca: Historical Old Jeddah

    Local leader Sami Nawar's family has been in the Old City of Jeddah for hundreds of years and takes us on a tour of this ancient route to Mecca, also believed to be the final resting place of Adam's wife, Eve.
    Video

    Video New Technology Aims to Bring Election Transparency to Uganda

    A team of recent graduates from Uganda’s Makerere University has created a mobile application designed to help monitor elections and expose possible rigging. The developers say the app, called E-Poll, will make Uganda's democratic process fairer. From Kampala, VOA's Serginho Roosblad reports.
    Video

    Video As Refugees Perish, Greek Graveyards Fill

    Aid workers on the Greek island of Lesbos say they are struggling to bury the increasing number of bodies of refugees that have been recovered or washed up ashore in recent months.  The graveyards are all full, they say, yet as tens of thousands of people clamor to get out of Syria, it is clear refugees will still be coming in record numbers. For VOA, Hamada Elrasam reports from Lesbos, Greece.
    Video

    Video Russia Bristles at NATO Expansion in E. Europe

    Russian Foreign Minister Sergei Lavrov is meeting Friday with the head of NATO after the Western military alliance and the United States announced plans for the biggest military build-up in Europe since the Cold War. Russia has called NATO's moves a threat to stability in Europe. But NATO says the troop rotations and equipment are aimed at reassuring allies concerned about Russia as VOA's Daniel Schearf reports from Moscow.
    Video

    Video To Fight Zika, Scientists Target Mosquitoes

    Mosquitoes strike again. The Zika virus outbreak is just the latest headline-grabbing epidemic carried by these biting pests, but researchers are fighting back with new ways to control them. VOA's Steve Baragona takes a look.
    Video

    Video Mosul Refugees Talk About Life Under IS

    A top U.S. intelligence official told Congress this week that a planned Iraqi-led operation to re-take the city of Mosul from Islamic State militants is unlikely to take place this year. IS took over the city in June 2014, and for the past year and a half, Mosul residents have been held captive under its rule. VOA's Zana Omar talked to some families who managed to escape. Bronwyn Benito narrates his report.
    Video

    Video Scientists Make Progress Toward Better Diabetes Treatment, Cure

    Scientists at two of the top U.S. universities say they have made significant advances in their quest to find a more efficient treatment for diabetes and eventually a cure. According to the International Diabetes Federation, the disease affects more than 370 million people worldwide. VOA’s George Putic reports.
    Video

    Video NATO to Target Migrant Smugglers

    NATO has announced plans to send warships to the Aegean Sea to target migrant smugglers in the alliance's most direct intervention so far since a wave of people began trying to reach European shores.
    Video

    Video Russia's Catholics, Orthodox Hopeful on Historic Pope-Patriarch Meeting

    Russia's Catholic minority has welcomed an historic first meeting Friday in Cuba between the Pope and the Patriarch of Russia's dominant Orthodox Church. The Orthodox Church split with Rome in 1054 and analysts say politics, both church and state, have been driving the relationship in the centuries since. VOA's Daniel Schearf reports from Moscow.
    Video

    Video Used Books Get a New Life on the Streets of Lagos

    Used booksellers are importing books from abroad and selling them on the streets of Africa's largest city. What‘s popular with readers may surprise you. Chris Stein reports from Lagos.
    Video

    Video After NH Primaries All Eyes on South Carolina

    After Tuesday's primary in New Hampshire, US presidential candidates swiftly turned to the next election coming up in South Carolina. The so-called “first-in-the-South” poll may help further narrow down the field of candidates. Zlatica Hoke reports.
    Video

    Video Smartphone Helps Grow Vegetables

    One day, you may be using your smartphone to grow your vegetables. A Taipei-based company has developed a farm cube — a small, enclosed ecosystem designed to grow plants indoors. The environment inside is automatically adjusted by the cube, but it can also be controlled through an app. VOA's Deborah Block has more on the gardening system.
    Video

    Video Exhibit Turns da Vinci’s Drawings Into Real Objects

    In addition to being a successful artist, Renaissance genius Leonardo da Vinci designed many practical machines, some of which are still in use today, although in different forms. But a number of his projects were never realized — until today. VOA’s George Putic reports.