HIV/Aids; pray and also preach condom use

Author: Nicholas Sengoba. PHOTO/NMG

What you need to know:

It is time to seriously prioritise the teaching of the proper and consistent use of condoms

Many years ago Uganda had a vibrant newspaper called the Weekly Topic. It was edited by Philip Wafula Oguttu and featured the likes of Charles Onyango-Obbo plus the late Ogen Kevin Aliro and Richard Olooya Tebere. Topic was a ‘leftist’ newspaper which courted a lot of controversy even in the most unlikely of places.

One time they fell out with a section of Christian soldiers of Uganda over a prominently placed front page advert. The advert cautioned readers thus; ‘the Bible may save your soul but this, will save your life.’ ‘This’, was the picture of a packet of condoms. The religious were saying that HIV/Aids was a warning from God and that it was time for the people to leave their evil ways. Condoms were encouraging people to sin!

The height of the HIV/Aids pandemic in Uganda was a very scary period. Acquiring HIV/Aids was a death sentence. It was a common sight to see people losing weight almost overnight which gave the condition the label slim or siriimu. Other victims lost their hair while some presented with oral thrush and black spots. For some there were huge dark patches and long lesions that went round organs like the neck and arms, in belt like fashion hence the name kisipi. Stigma was as high as the sky. If one got infected people would abandon them for fear of infection and also because they had ‘sinned’.

What had been assumed initially to be a disease of poor people from the provinces like Rakai, started visiting the urban areas where it was thought to be the preserve of prostitutes. Then it went into homes of duly married religious couples. Then it went into schools and all sections of society, including high-ranking government officials and religious leaders.

There was hardly any known treatment. What was later developed on the market like AZT from the USA and KEMRON from Kenya was out of reach for most people. The prominent voices in those days; the likes of Dr Alfred Okware worked overtime on radio and television teaching about the new condition. Much as there was a lot of emphasis on abstinence and being faithful, the proper use of the condom took center stage because people were having sex. A medical doctor once said that if one woke up in the morning intending to abstain but ‘felt weak’ and could not be faithful to their partner it was safer for them to fall in sin with a condom so as to have another chance at trying out abstinence and being faithful instead of dying.

Looking at the statistics, Uganda has made very gigantic strides since the first cases of the Acquired Immune Deficiency Syndrome (AIDS) were reported around 1982. For instance, the Joint AIDS Review 2022/2023 indicates that the prevalence of HIV among those between 15 and 49 years has reduced from 18 percent in 1985 to 5.1 percent in 2022. But there is a devil in the details. There are about 54,000 new infections every year. About 50 percent of these new infections are among teenagers. In the earlier years it was mainly the older folks who were at risk. What helped in the past was mainly communication and the condom. Because of fear attached to the new disease, people were hungry to know as much as possible about the killer. When the drum was sounded after news bulletins in all languages on the single Radio Uganda and Uganda television stations it found many open ears. They did it as a public service. Now the myriad of stations will only allocate time for money, not free public service.

Secondly, back in the day, there were many visible examples of the devastating disease in the community for one to fear for their lives. These days because of the development in the field of medicine and antiretroviral treatment, it is difficult to tell who has the virus so many may not take it seriously. Many believe that ARVs eradicate the disease so they don’t fear to acquire it.

The other, of course, is the religious aspect. Uganda loves to pride itself as a very religious country whose national anthem is a prayer, (Oh, Uganda may God uphold thee.) Never mind that the composer of that anthem went to his grave crying that he was not paid for his composition.  Because we are ‘religious’, there is a tendency to bury our heads in the sand and pretend that people are not having sex outside of marriage or that prayers will stop them from doing so. They end up frowning at teaching about safer sex and condom usage.

The reality is that in Uganda today there are so many people who are partly or wholly dependent on sex for their existential (survival). They have devised many ways. The inbox on social media is a convenient place to initiate transactions. A mere mention of ‘I am bored’ or ‘this weather is too cold for me’ may be viewed as a declaration of availability. In some cases young people rent apartments and offer massage and sex for a fee in a safe environment.

A young lawyer told me that the Uganda Revenue Authority is missing out on revenue because they have not paid attention to the sex trade in the country. Many young people have so many more demands today than in the past which they and their parents, for those in school, cannot afford. Sometimes it is as mundane as a warm fried meal in an upscale restaurant. They may need tuition or a well furnished apartment or hostel. An expensive smart phone. An occasional hairdo combined with a pedicure and manicure plus spa treatment which is captioned ‘self-love’ on social media. Then the designer clothes and shoes plus the holiday to Dubai plus a presentable car.

Because one man or woman or ‘sugar parent’ may not afford all these things, there is a tendency to spread out (no pun intended) by having several partners to bear the cost. Each may have invested in other relationships too, from where they get additional ‘sexual healing’. This creates a web and could probably explain why 36 percent of the 54,000 new HIV infections are among adolescent girls and young women.  

Many times the one paying comes with their conditions which may include unprotected sex. One researcher claimed that the aversion for condoms in some cases was that the girls didn’t like the men and were not physically ready for them when they demanded for sex. Using the condom became akin to rubbing metals without lubrication. At times they said sex is ‘sweeter’ without a condom! Before we think about treatment, it is important to face the reality of prevention at the most common point where the virus enters the body - the private parts. So as we preach abstinence and being faithful, we have to face the reality that people are having a lot of sex outside this realm.  It is time to seriously prioritise the teaching of the proper and consistent use of condoms.

Twitter: @nsengoba