Education key to reducing HIV infections among adolescents

Apr 02, 2024

Teenage pregnancy remains a major health and social concern in Uganda, with 24% women aged 15-19 having started childbearing (UDHS 2022). Child marriage and teenage pregnancy increase girls’ risk to sexually transmitted diseases, including HIV and AIDS, cervical cancer, gender-based violence (GBV), less years of school, persistent and enduring inequalities, social stigma and isolation.

Dr Nelson Musoba

Admin .
@New Vision

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OPINION

By Dr Nelson Musoba

This year on March 8, Uganda joined the rest of the World to commemorate International Women’s Day in Katakwi district. The chief guest was President Yoweri Kaguta Museveni.

The national theme was: Accelerating Gender Equality through Women Economic Empowerment.

Education is a critical factor in ensuring economic empowerment of girls and women. In line with this, the Government has been providing universal primary education for the past 25 years and universal secondary education for the past 15 years.

Research has shown that completion of primary and secondary education is protective, especially for girls. Staying longer in school protects them against early marriage, teenage pregnancy, early sexual debut, gender-based violence and HIV infection. Education also equips girls with the knowledge and skills necessary to contribute significantly to their families, communities and nation at large.

According to the Uganda Bureau of Statistics, while primary school enrolment increased from 2.5 million in 1997 to 8.6 million in 2023, completion of primary and (or) secondary education remains low, especially among girls. Out of every 10 children enrolled in primary, only six complete Primary Seven. There is still less than 50% access to and completion of secondary education by girls aged 13-18.

Net secondary school enrolment is at 27% (24% rural and 43% urban). The net enrolment rate for girls stands at 21% and the percentage of girls enrolled is 47.8% of the national enrolment in secondary schools. Transition from primary to secondary is at 68.5%.

Uganda has the highest rate of teenage pregnancy in sub-Saharan Africa, with over 24% pregnancies among teenagers registered every year.

Teenage pregnancy remains a major health and social concern in Uganda, with 24% women aged 15-19 having started childbearing (UDHS 2022). Child marriage and teenage pregnancy increase girls’ risk to sexually transmitted diseases, including HIV and AIDS, cervical cancer, gender-based violence (GBV), less years of school, persistent and enduring inequalities, social stigma and isolation.

The latest UDHS shows that 17% of women and 6% of men experienced sexual violence, while 44% of women and 39% of men experienced physical violence. Wife beating is widely accepted and tolerated in Uganda. The majority of perpetrators of violence are intimate partners.

The 2023 Annual Police Crime report reveals alarming figures; 14,681 cases of domestic violence and 14,846 sex-related crimes.

Despite the high prevalence of violence against women and girls in Uganda, only 32% of women and 31% of men sought help to end the violence or get a service, of which 57% of women and 40% of men sought it from their own families (UDHS, 2022).

Violence against women and girls continues to threaten the gains that the country has made in ensuring gender equality and equity. Violence against women and girls remains not only a critical issue of national concern, but also a gross violation of fundamental human rights with severe long-term negative impacts on the physical, sexual, mental wellbeing of the survivors, family and community.

The Government has put in place policies aimed at addressing structural barriers that address violence against women and girls. These include the Penal Code Act (2007), Children’s Act Amendment (2016), Domestic Violence Act 2010, prohibition of Female Genital Mutilation Act, 2010, trafficking in Persons Act, (2010).

There are policies such as the Uganda Gender Policy (2007), the National Policy on Elimination of Gender-Based Violence in Uganda (2016), and the Guidelines for Establishment and Management of Gender-Based Violence Shelters in Uganda. The implementation of these policies needs to be fast-tracked in order for Uganda to achieve the 2030 targets.

President Museveni, in June 2017, launched the Presidential Fast Track Initiative (PFTI) for ending AIDS as public health threat in Uganda by 2030. The PFTI has five key objectives

  • Engage men in HIV prevention to close the tap on new HIV infections, particularly, among the adolescent girls and young women
  • Accelerate implementation of test and treat and attainment of 90-90-90 targets among men and young people. This has been updated to 95:95:95
  • Consolidate progress on elimination of mother to child transmission on HIV
  • Ensure financial sustainability for the HIV response
  • Ensure institutional effectiveness for a well-coordinated multi-sectoral response

Whereas the overall number of new HIV infections has reduced over the years, Uganda still registers more than 140 new HIV infections daily. Adolescent girls and young women aged 15-24 account for most of these new infections estimated at 19,000 of the 52,000 annual infections.

In June 2022, UNAIDS, UNESCO, UNFPA, UNICEF, UNWOMEN, together with the Government of Uganda, launched the Education Plus Initiative. A high-profile level political advocacy drive to accelerate actions and investments to prevent HIV, reduce teenage pregnancy, gender-based violence, early marriage and poverty among adolescent girls and young women. The aim of this is to empower adolescent girls and young women, achieve gender equality in Sub-Saharan Africa with secondary education as the entry point.

This initiative intends to reposition Education Plus within the HIV/AIDS response at the centre of a resilient, sustainable, integrated and person-centered approach to health and tackling gender inequalities in Uganda.

On World AIDS Day 2023 in Rakai, and on International Women’s Day 2024 in Katakwi, during his speeches, the President urged parents to keep their children in school because it helps them not only to gain knowledge, but also protects them from acquiring HIV.

With a few years left to 2030, a renewed multi-sectoral approach needs to be utilised in addressing the structural drivers that prevent adolescent girls and young women from thriving and achieving their full potential.

As a country we need to:

  • Abandon harmful practices that perpetuate gender inequalities. We need to promote positive social norms, values and practices and transform negative norms, beliefs and practices at all levels.
  • Provide adolescents and young women with an enabling environment, information, knowledge that they need and social support. This will not only grant them the economic autonomy that they deserve, but also ensure their control over their sexual reproductive health.
  • Mainstream GBV prevention and response in legislation, policies, programmes and strategic plans, budget framework papers, ministerial policy statements of ministries, departments and agencies, local governments and private sector organisations, including review of laws and policies with the aim of strengthening GBV prevention and response.
  • Ensure compliance with the laws that promote gender equality and provide the necessary support systems for women to thrive in various economic sections.
  • Promote decent work and productive employment for all women and men, including investing in appropriate technologies to reduce the burden of unpaid core work.

Our collective responsibility and efforts will ensure that women and girls attain their full potential and enjoy their rights.

The writer is the Director General, Uganda AIDS Commission in partnership with UNAIDS

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