Aids fight: New approaches needed to reduce the scourge

Thus, in order to curb HIV prevalence, Uganda needs to take a serious look at infection trends and behaviour to identify why this rise may be occurring and how to remedy it.

Uganda is often cited as a rare example of success in a continent facing a severe HIV/Aids crisis. The country is seen as having implemented a well-timed and successful HIV/Aids prevention campaign, which has been credited with helping to bring the prevalence rate from around 15 per cent in the early 1990s down to around 5 per cent in 2001.

Sadly, Uganda is at an important crossroad in her nearly 30-year long struggle with the HIV/Aids epidemic and prevalence has increased, especially amongst the young people who constitute over 70 per cent of the population. After a dramatic reduction in HIV occurrence, following an early comprehensive HIV/Aids prevention campaign, there is evidence that the number of people living with HIV in the country is on the increase and majorities are youth.

The reasons for this increase have been attributed to the government’s shift towards abstinence - only prevention programmes - a general complacency or ‘Aids fatigue’ and a suggestion that Anti-retroviral drugs have changed the perception of HIV/Aids from a death sentence to a treatable, manageable disease.

The epidemic is also a gender issue because it affects men and women differently. The prevalence rates are higher among women with young women being at a greater risk of contagion. Young girls are more vulnerable to HIV/Aids because of intergenerational sex, discrimination, sexual violence, cultural beliefs and limited access to information.

In Africa, women’s vulnerability to HIV/Aids is rooted in the existing strong gender inequalities in the distribution of resources, which leaves women economically dependent on their male sexual partners and hence lack of control over their sexuality and fertility which renders them vulnerable to poverty, violence and sexual coercion.

HIV/Aids has claimed many lives as a result of limited sensitisation, limited knowledge about prevention, limited access to health services and stigma; which have all obstructed many from accessing treatment. Many people have been involved in careless sexual relationships; extra-marital relations and premarital sex.

However, others have faced sexual violence, including rape, defilement and human trafficking, all being the leading causes of the spread of HIV/Aids. The impact of HIV is felt most acutely among poorer households, especially those headed by women with little resources with which to cushion the economic burden. Research shows that HIV/Aids affects the most productive members of society and reduces household income by to 80 per cent.

The approach used to fight HIV/Aids has been named the “ABC” approach; firstly, encouraging sexual Abstinence until marriage, advising those who are sexually active to Be faithful to one partner and finally, urging Condom use, especially for those who have more than one partner. Thus, in order to curb HIV prevalence, Uganda needs to take a serious look at infection trends and behaviour to identify why this rise may be occurring and how to remedy it.

Already existing policies on treatment and care need to be implemented more comprehensively. In particular, attention should be paid to supporting and expanding the provision of home-based care and strengthening referral systems to other health facilities and complementary services, in addition to increasing equitable access to antiretroviral treatment to those in need.

Additionally, there is need for sensitisation, provision of information, awareness creation and community mobilisation of people about the prevention and involvement in HIV/AIDS health activities. There is need to eliminate gender inequalities in distribution of resources, basically to reduce the vulnerability of women to poverty, violence and sexual coercion.

There is a need to sensitise parents to support boy and girlchild education without any discrimination. Poverty reduction initiatives should be put in place to increase the household income and reduce men and women’s vulnerability to HIV/Aids. Other strategies should include; openness through intensive education about the epidemic, voluntary counselling and testing (VCT), STDs treatment and control and provision of “life skills”.

Ali is a student of community-based rehabilitation at Kyambogo University.