Article 1
The HIV/AIDS Epidemic
The first AIDS case was diagnosed in 1981 in the United States of America and the disease has since spread to epidemic proportions around the world. According to the November 2005 epidemiological update, UNAIDS estimates that globally 40.3 million children and adults are living with HIV/AIDS while 4.9 million new infections and 3.1 deaths occurred in the year 2005 alone. There are regional variances in HIV prevalence globally. Sub Saharan Africa, where Uganda lies, bears the heaviest burden of the epidemic accounting for 28.5 million children and adults (about 64%) of those living with HIV/AIDS globally while about 97% of the AIDS related deaths in 2005 alone occurred in this region.
In Sub-Saharan Africa, HIV is mainly transmitted through heterosexual intercourse. Variances in sexual behaviors across cultures, age groups, and gender usually influenced by culture and social, economic circumstances impact on HIV on HIV spread as well as prevention interventions. Similarly, poverty, underdevelopment and illiteracy contribute to the spread of HIV in the developing world yet HIV/AIDS is also observed to aggravate the poverty situation, hindering development efforts and eroding gains in various areas.
HIV/AIDS epidemiological trends in Uganda
Uganda was among the first hard hit countries. The first HIV/AIDS case was identified in the country along the shores of Lake Victoria in 1982. Superstitions and witchcraft characterized the initial response from communities amidst lack of clear government response to HIV/AIDS. Consequently, the epidemic progressed very fast to all parts of the country initially concentrating in urban and semi-urban centres.
By end of 1992, the national prevalence rate was estimated at 18.3% with some centres registering rates above 30%. This was followed by a period of steady decline in prevalence rates from the mid 1990s to 2000 to around 6%, attributed to favourable prevention policies. The country has since experienced stabilizing prevalence rates over the last four years with threats of increases in some parts of the country.
The 2004 National HIV/AIDS sero and behaviour survey by the Ministry of Health Surveillance Unit put the national adult prevalence rates at 6.4% which is within the expected range from estimates based on antenatal surveillance. The survey revealed regional, rural/urban, and gender variations in HIV prevalence. The Kampala, central, and North-central regions registered the highest infection rates at around 9% while the West Nile region was at 2.5%. Overall infection rates in urban areas were at 10.7% compared to 6.4% in rural areas while the infection rate amongst urban women was almost twice as high (13%) compared to women in rural areas at 7%.
The Ministry Of Health estimated over 940,000 HIV/AIDS-related deaths since the onset of the epidemic in the country by end of 2001. The Ministry of Health also estimated the national HIV prevalence rate (pooled antenatal figures) at an average of 6.2% of the total Ugandan population by end of 2002 while new infections were estimated at 70,170 cases, new AIDS cases at 73,830 and AIDS deaths at 75,290 in 2002 alone.
Information from Uganda Aids Cmmission
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Article 2
This article was posted to this blog and we thought it would be a better idea to highlight it here as posted especially because of the message embedded within:
Can we achieve an HIV free generation?
Globally, about half of those newly infected with HIV each year are under the age of 25. As international youth leaders gather to discuss HIV among other issues at the Commonwealth Youth Forum in Entebbe, Kakaire A. Kirunda spots shortcomings in Uganda’s attempts to achieve an HIV-free generation. Against a soothing instrumental background, female friends in a popular radio spot on several local radio stations discuss the hazards of sugar-daddies.
“Mary: Let me tell you about this friend of mine. A few months ago she told me mbu [that] she met this nice guy with a lot of money. Yes he was married but he treated her like a queen, took her to all the nice clubs, and bought her a really cool phone. Even the expensive clothes, he bought. Now yesterday she came to me crying, her world is falling a part. She has just found out that she is pregnant.
Kate: And the nice man?
Mary: He is not interested. He is tired of her. But that is not the worst part; she is also infected with HIV
Kate: Girls! The gifts, the nights out, the cash, can never be worth your life and future. Older men are taking advantage of you and putting you at risk of HIV infection in exchange for these bu [small] things. This practice is called cross generational sex. Respect yourselves, do what I do. Say no to sugar daddies. Cross generational sex stops with you.”
TARGET:
Many young people are increasingly falling prey to HIV/Aids after years of successful battles against the disease.
Uganda wants an HIV-free generation and to help to achieve this, the government has begun an onslaught against so-called cross-generational sex. The practice is defined as young people, especially girls, entering into sexual relationships with people who are more than ten years older. Catchy as it is, I believe this media campaign is in danger of overlooking an inconvenient truth – young people are not contracting HIV simply because they have sexual relations with older people, they are also at risk of transmitting HIV to one another.
It’s all very well telling young people to ‘say no to sugar daddies’ but any campaign that ignores the fact that many young people will continue to have sexual relationships is likely to fail. The fact is that young people will continue to contract HIV unless they talk honestly to their sexual partners about their HIV status (whatever their age).
What’s more, there are many thousands of young people across Uganda and across the globe who are HIV positive as a result of contracting the virus at birth and they want to exercise their right to loving relationships. Research indicates that gone are the days when most infants infected with HIV died within the first two years of life. The advent of antiretroviral therapy has seen many people who would have died, living to adulthood as long as they access the life saving medicines.
Many of the adolescents who now know their status are seeking to become sexually active and even to have children. In 2006, the oldest surviving of these young people born with HIV in Uganda turned 23 years old, thanks to antiretroviral therapy. The latest statistics showed there were significant numbers of adolescents registered at support organizations in Uganda.
At the end of 2006, The Aids Support Organization (Taso) had registered 4,696 ten to nineteen-year-olds living with HIV since infancy. The Mildmay Centre had over 600 young people, while the Pediatric Infectious Disease Clinic at the national referral Hospital in Mulago had over 500 young people.
During a media dialogue organized by the Mildmay Centre and the Uganda Aids Commission this year, Dr Ivy Kasirye, a paediatrician at the Mildmay Centre said dealing with the adolescents was complicated. “By the nature of the fact that they are adolescents and we all know what adolescents are, and the fact that they also have a package of HIV with them is a hard situation,” she said. “As it is natural, they become experimental, they have natural desires. So one of the biggest challenges we have is handling sexuality in our adolescents.”
The Population Council and its partners, using funds from the United States Agency for International Development has just done the first ever study addressing the reproductive health needs of adolescents born with HIV in Uganda. This research focused on the lives of these adolescents and is subsequently developing the first generation of tools to assist those providing them with care and support. But the research produced worrying results.
It was a sample of 732 people in the 10-19 age group. And it shows that many are dating and others desire to love and be loved, which are genuine rights. But problem comes in when results indicate that 39 percent of these young people are in a casual relationship yet 51 of the entire study sample are afraid of disclosing their HIV status.
Further to this, 61 percent of the sexually active surveyed said they did not use any protective method during first time sex. And it also emerged that 62 per cent of those in a relationship have never discussed their HIV status with their current partner, while 67 percent do not know the status of their current partner.
A 17-year-old teenager living with HIV who gets treatment from one of the TASO centers in eastern Uganda said: “I am in a sexual relationship but I have not yet told my status to my partner whose sero status I am not aware of. I am afraid to tell her. What if she rejects me?” Unless he uses protection, not only can he transmit the virus to a partner but he is also in danger of becoming re-infected with another strain of HIV if his partner is HIV positive. Many teenagers, including those living with HIV are hesitant to discuss their sexual behavior with their service providers. The research found that counseling by service providers in Uganda is often inadequate. The young people surveyed felt that they were being lectured and not given a chance to discuss their own views.
The Population Council (PC) research further found that the counselors also often warn against sex, relationships or dating, with sometimes, providers talking to parents or guardians rather than the child. Strong emphasis is being put on abstinence until marriage for all young people regardless of their HIV status. To this, more interventions are needed to realise the dream of an HIV free generation in the country. An analysis of PC’s research indicates that there is obvious need to avail information to positive teenagers and handy support to enable them negotiate vital aspects of their lives, avoid infection of others and self-re-infection. This information would also enable them understand their sexuality as they grow and make informed choices and be able to balance responsibility with sexual and reproductive desires.
Panos Features
