Friday July 25 2014

Solutions to HIV have in a way contributed to its rise - experts


She was introduced to a condom by her mother when she was just 10 years old. Annet Kirabo, a resident of Makindye, a Kampala suburb, says her mother, who has depended on a bar to provide for the family in a one-roomed house they have called home since birth, was scared that her customers would one day defile her daughter.

Two years later, her suspicion came true. At 12, the first born of four children became pregnant and was reluctant to inform her mother. But as months went by, her mother noticed body changes and asked if she was pregnant and who was responsible. To her surprise, it was one of her frequent customers whom she had trusted for years.
“My mother was shocked to learn that I was pregnant at 12 and by someone she knew well. It was a betrayal. She had given me a condom when I was little but I was only asked to keep it and not told what its use was,” Kirabo said in a frustrated tone.

“I learnt later that it was to guard me against getting pregnant in case I slept with a man. But the worst blow was to learn that I had also contracted HIV. The information I had was that it kills.”

The teenage mother, however, has something to celebrate. Her mother, though disappointed, encouraged her not to miss any of her antenatal visits and this paid off when she delivered a healthy baby girl from hospital.

The results of the 2011 Uganda Aids Indicator Survey (UAIS) indicated that 7.3 per cent of adults aged 15 to 49 years in the country were infected with HIV up from 6.4 per cent in 2005.
National Drug Authority’s executive secretary, Gordon Sematiko warns that if the current attitude towards HIV goes unchecked especially among the youth, the prevalence is likely to go even higher.
The worrying thing is that interventions to curb the pandemic have ended up causing it to go up in a number of cases.

The arrival of ARVs
Sematiko explained that the introduction of antiretroviral treatment and other alternative measures like circumcision in the fight against HIV have partly contributed to the rise of the epidemic.

“To me, circumcision was diversionary. This is because people think once they are circumcised, they can’t get sick and thus are not using condoms. We expect to have HIV vaccine trial in Uganda.

There are many people waiting, saying that once we get the vaccine, many will forget to protect themselves,” Mr Sematiko said in an interview.
According to Ms Vastha Kibirige, Ministry of Health condom focal person, many people fear pregnancy than they do contracting HIV/Aids.

As a result, they have shied away from the national HIV prevention of ABC+ approach going in for unprotected sex because they know they will get treatment.
This has also been experienced at Uganda Network of Aids services organisations with their everyday interactions with the community. Unaso Executive Director, Mr Bharam Namanya: “There is a lot of complacency as people think they can go for unprotected sex and get treatment once they are infected with HIV.”

A stands for abstinence; B= Be faithful; C= Condom use; and the Plus (+) refers to other proven interventions for reducing HIV transmission such as elimination of mother to child transmission of HIV and Safe Male Circumcision.

Mr Patrick Muinda, Ministry of Education’s assistant commissioner in-charge of communication and information faults Kirabo’s mother for giving her a condom at an early age.

He explained that although the ministry uses the national ABC strategy to fight HIV, they only encourage abstinence in schools.

“There is no reason such a parent can give for giving a minor a condom. It was very wrong of her. As a ministry, we can’t tell a child to be faithful or use a condom; to who? We insist on abstinence and call upon parents to train the child in a way that they should grow,” Mr Muinda explained.

Reduction in condom use
Ms Kibirige also says the number of condom use has reduced. She cites the National Condom Programming Strategy 2013/15 where there was a sharp decline in the quantity of condoms procured from 143 million in 2010 to about 82.1 million in 2011 although it increased to 87.2 million pieces in 2012.

“Condom use has completely reduced which is very alarming because people are going for unprotected sex,” Ms Kibirige explained.

She said that as the ministry, they are trying to move away from their old way of distributing condoms to health centres after it was discovered that few men seek health services in hospitals.

Instead, they have opted to take them to areas where it is expected that sex takes place.
However, this has come with challenges.

For instance, Ms Kibirige said that there are many people who don’t know how to use the condom while some men defend their actions for not using them saying the condom sizes are small for them and will burst.

There are other people who discourage the use of condoms because they believe that they are meant for sex workers and that they encourage immorality.
At least 20 million condoms are needed every month. Ms Kibirige reported that they received fewer condoms than what was required.

“Condoms that we receive are not enough. Last year, we received 200 million condoms yet we needed 280 condoms.” However, she says, there has been a general improvement. “We had a shortfall of 80 million condoms. We have come from far. There is a time when we didn’t want to say the word condom,” Ms Kibirige noted.

She said that each condom costs at least US 3cents.
There is a growing concern that some individuals are living recklessly because of the various interventions in the fight against HIV/Aids.

Experts warn that although there is need to find the cure for the epidemic, it should be used to spread the scourge.