In the 1990s, Uganda was globally seen as the African role model in the fight against AIDS. But, as recently released figures from the Uganda Aids Indicator 2011 show, it is currently the only country in East-Africa where HIV infections are on the rise. What is happening?Uganda received worldwide praise in the late 1990s when it managed to lower HIV infection rates from around 15 to 6 percent. But as the recently released figures from the Uganda Aids Indicator 2011 show, the HIV prevalence rate in Uganda increased from 6.4 percent to 6.7 percent last year and over 500,000 more Ugandans became infected with the virus over the past five years. Surprisingly, an estimated 43 percent of those new infections occur among people engaged in monogamous heterosexual relationships. It is not the young or the poor, but the married couples in urban areas who are most at risk.
Abstain, Be faithful and use Condoms
Experts say the US-backed abstinence programmes are largely to blame for this. The ‘ABC’-approach, meaning Abstain, Be faithful and use Condoms, dates back from the Bush-era and was, and still is, widely accepted in conservative Uganda. But it seems that the message ‘abstain from sex until you are married’ is a policy at odds with the patterns of sexual behaviour in the country.
“Mum is always sick because she ate a side dish,” says a billboard in Uganda’s capital Kampala. ‘Side dish’, ‘spare tire’ or ‘side mirror’ are all common terms in Uganda referring to an extra, non-regular sexual partner outside a ‘monogamous’ relationship. The terminology itself already betrays a sense of casual normality attributed to the phenomenon.
The sexual network
The government launched the ‘sexual network’ campaign two years ago, urging Ugandans to leave the sexual network in order to avoid getting HIV/AIDS. It created a buzz and got people talking, but although billboards, radio commercials and television ads all urge Ugandans to stick to one partner, statistics prove the campaign hasn’t had the desired impact yet.
“We have learned that it is very difficult to change sexual behaviour”, says Zainab Akol of the Ministry of Health. According to the minister, the government therefore wants to put more emphasis on practical intervention strategies such as male circumcision and improving accessibility to antiretroviral drugs (ARV’s).
AIDS’s changing image
Another reason for the increase in HIV infections, is AIDS’s changing image, according to Marion Natukunda, who heads the Research and Advocacy Department of the Aids Information Center in Kampala. She thinks Ugandans have become too reluctant. “A lot of people don’t regard AIDS as the killer disease it used to be back in the 1980s and1990s. Because ARV’s are now more accessible, AIDS has lost it lethal image.”
Natakunda thinks that the Ugandan government has become reluctant, too. She says the government has adopted a passive attitude regarding HIV/AIDS in recent years. “Unfortunately, HIV/AIDS is not a government priority anymore. It is gone from the government agenda. It used to be AIDS, than it became malaria, now it is nodding disease. Therefore, big international donors have taken over policies, and guidelines. The government is more on the listening than on the reactive side nowadays.”
AIDS actually kills
According to Natakunda, the Ugandan government needs to get serious. “HIV/AIDS is here and it actually kills. We need the government to focus on funding, targeting different target groups with the right message, and create accessibility in intervention strategies. We should not be only dependent on donors, because what will happen if they withdraw one day or decide HIV/AIDS is no priority anymore?”