More than 130,000 people who live in 42 fishing villages along Uganda’s shores of Lake Victoria have an HIV-infection rate that is three to four times higher than the national average in this country of 36 million people.
Uganda has been aggressive in combating the HIV virus for more than 30 years.
The IOM studied the fishing communities in six Uganda districts. When they examined the level of knowledge of HIV and the attitudes and practices of people in the communities, they found the high HIV prevalence was caused by many inter-related factors, said Dr. Natalia Gitu, IOM’s chief medical officer in Kampala.
Gitu said the IOM study and several previous reports describes the mobility and lifestyle of the fishermen - “The fact that they have every day, new cash, that flows in their business, and it’s associated with drinking alcohol, and engaging themselves in unprotected sex.”
“These are the factors that our studies confirm that lead to increased prevalence of HIV among fishermen,” she said of a community in which condom use if low.
Cultural attitudes lead to unprotected sex
The doctor said that while a large majority of men and women in the fishing communities are aware of the risks of contracting HIV, they most likely do not use protection due to cultural attitudes: They live and work in the face of high risk.
“The profession of fishermen is considered to be very risky,” said Gitu.
“They can lose their lives while they are fishing, and they don’t value their life.” So, the challenge is to work with existing attitudes.
“The intervention should be appropriate to the local culture. And we believe that any intervention should be tailored specifically to the fishing community based on their culture, on their attitudes, on their beliefs,” she said.
For example, the IOM medical chief explained that the women of these fishing communities depend very heavily on the fishermen who provide them with jobs. As a result the women feel they have no choice but to do what the men want them to do.
“In the fishing community, traditionally they believe that women can be shared by the men - women belong to the community,” she said.
“For example, when people engage themselves in unsafe sex, only 37 percent of men report that they use a condom and only 13 percent of women. So the use of condoms in fishing communities is very low and that is also a big contribution to the spread of HIV,” noted Gitu.
Having access to treatment was another big factor in the spreading of the disease.
Most of the fishing communities are located in remote parts of the country, and traveling to obtain healthcare is a real challenge. More than 80 percent reported seeking treatment when they felt the symptoms of sexually transmitted diseases, but health facilities are far away from these villages.
“Sometimes they have to travel two hours to go to the health facility,” she said. “Therefore, bringing health services closer to fishing communities will definitely benefit men and women,” Gitu said.