Complacency, ignorance, vulnerability driving fresh HIV infections among women

Catherine Nansikombi, 27 years old and single, says she does not want to be committed to any man. So she has very brief relationships. However, whenever she asks the man she is going to sleep with to wear a condom, it is not because she is afraid of catching HIV. “It’s because I am afraid of getting pregnant. Nowadays, HIV has become like malaria. As long as you take your medication on time, you can live as long as any other person.”

Besides not caring about whether the man she is sleeping with has HIV, Nansikombi does not care if the man has another spouse because culture dictates that a man can have as many women as he can take care of. “This whole get-off-the-sexual-network campaign is not useful at all; cultural norms still prevail.”

It is beliefs such as these among women that have frustrated the HIV fight thus putting the HIV prevalence rate amongst women at 7.7 per cent (8 out of every 100 women ), while their male counterparts are at 5.6 per cent (6 out of every 100 men), according to research findings released by the Ministry of Health on March 15.

Polygamy, mixed messages, complacency
According to Dr Alex Opio, the commissioner for health services and national disease control at the Ministry of Health, the campaign against sexual networks is working. Topics rising on Women’s Day recently however included the prevalence of polygamy and how it is contributing to the spread of the HIV virus. This conclusion was being based on Ministry of Health reports that there is a shift in the prevalence of HIV/Aids from the young unmarried to the married couples between 35 to 49 years.

Besides married couples, the recent findings indicate that HIV is higher among the uneducated women, urban wealthier class of women, widows, residents of the post conflict northern Uganda region and sex workers but the prevalence is mostly high among the married women.

Leticia, a 19-year-old sex worker at Bwaise says that most men who seek her services do not want to use condoms. “I am afraid of getting pregnant and contracting HIV but I have come to learn that using a condom is not my choice. Most men do not want to use condoms. When I insist that a man wears a condom, some of them beat me. So I do not even know my status and I am afraid to check because I might be positive.”

The survey also indicates that comprehensive knowledge about prevention and transmission of the disease was very low at 34 per cent for women and 41 per cent for men. This meant that most of the messages were either not reaching the people or were misinterpreted.

This is true in relation to the recently launched programme by government of male circumcision to reduce the spread of HIV. Some women, mostly the uneducated, have misinterpreted it. A woman who would only identify herself as Nalongo in Makindye says, “As long as my husband is circumcised, there are chances that I will not contract HIV because the adverts say it reduces infection by 60 per cent.”

However, one man, James Mugume, a secondary school teacher, was not in agreement, saying, “I got circumcised a few months back but I don’t think that it will prevent me from contracting HIV. I still take precautions. I am aware that women are more infected than the men and I think it’s because wearing a condom has now turned out to be a choice of the man not the woman.”

Just like Mugume, Agume Mukumamu a casual labour also believes that women are more infected so he always uses a condom whenever he is to sleep with someone else other than his wife. Meanwhile, besides ignorance and the misinterpretation of HIV messages by the women, there is a failure to incorporate all the sectors in the fight against the spread of HIV.

Dr Lydia Mungherera the Executive Director Mama’s Club, says, “The success we made in the 1980s was due to the unity everybody had.

We developed a multi sectorial fight against HIV, which led to the reduction in the prevalence of the disease. But now the fight has only been left to the Ministry of Health, which is a very small sector to fight an issue affecting the whole country.” Dr Mungherera also adds that while initially people were scared of contracting HIV, they have nowadays relaxed. “It is because they know they can get treatment and no one will know that they are sick.”

Women ignorant of the situation
In the meantime, while statistics show that women are more infected than their male counterparts, most women know otherwise. In a survey conducted on 30 women of various social classes by this Newspaper, 28 insisted that men are more infected than the women.

Their defense was that the men are more promiscuous than the female. For the two that agreed that women are more infected, their explanation was that a man contracts the virus from one woman and spreads it to the other five or more he sleeps with.

What does this mean to the fight against HIV?
Dr Henry Bukenya a general practitioner at Mulago referral Hospital says that such a high prevalence rate of HIV among the women indicates that if no intervention is done at all levels of the health services, “We shall have high cases of mother to child transmission thus increasing the rate of new borns with HIV.” Speaking at the launch of the preliminary report on the Uganda AIDS indicator survey in March, the Minister of Health, Dr Christine Ondoa, said such rates of prevalence show a serious need for action, “The country is not doing well in trying to contain the disease, this calls for more resources to be allocated to interventions to see that the prevalence among both women and men comes down.”

Dr Mungherera on the other hand advises that the government embraces new methods of prevention and also ensure that massive informative programmes about the new methods are launched across the country. She adds, “Preventive programmes like Abstinence, Be faithful and use of condoms (ABC) plus male circumcision are good programmes but people have not yet understood them properly.”

She therefore calls upon government to go down into the communities where the people live and educate while encouraging the positive ones to come out publically, which will reduce on the spread of the infection. The Queen of Buganda also advised that unhealthy cultural beliefs like polygamy should be abandoned as a way of reducing the prevalence of the disease among married couples.