Ugandan women with HIV 'die faster' than men

By Gerald Tenywa & Reginah Nalunga

Ugandan women with HIV who are not on treatment die faster than their male counterparts, according to a new study by the Uganda Virus Research Institute (UVRI) and the Medical Research Council (MRC).

“The women progress to death faster than the men because they carry pregnancies and engage in sex at an earlier age than men, weakening their immune system,” said Dr. Gershim Asiki, the lead researcher and MRC’s senior scientist in charge of disease epidemiology and prevention.

The research shows that girls who acquire HIV at age 15 die at 37 years on average, compared to 42 years for men, a difference of five years.

The research has been ongoing for over 20 years in Kyamulibwa in Kalungu district.

“There is a big population that is HIV-positive and they are not getting care,” said Asiki. “The policy is that people should test for HIV, but this is not compulsory.”

However, women on anti-retroviral (ARV) drugs live longer than their male counterparts by four years, according to Asiki.

He said this is because “the women respect appointments and access specialised treatment more than the men”, adding: “If national guidelines on better healthcare are implemented, the country will gain on life expectancy.”

He was presenting research findings during a one-day symposium organised at the UVRI offices in Entebbe.

The symposium attracted researchers, development agencies, as well as medical professionals and journalists.

The Uganda AIDS Commission estimates that about 713,750, of the 1.6 million Ugandans with HIV, were on treatment by September 2014.

Uganda’s HIV/AIDS prevalence rate increased from 6.4% in 2006, to 7.3% as of September 2011, according to the AIDS Indicator Survey (AIS) report 2011, which is the latest nationwide survey. The disease is more prevalent among women than men.
 

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The prevalence rate stands at 8.3% among women, compared to 6.1% among men. Although generally more women than men have HIV, those living in urban centres are the most affected.

The 2011 survey also revealed that more women (66%) than men (45%) test for HIV. This is mainly due to the compulsory HIV testing for expectant mothers during antenatal visits to health facilities. However, AIDS-related deaths reduced by 30% in the first 10 years of the introduction of ARVs.

The number of Ugandans dying from AIDS-related infections was about 50,000 per year in the early 2000s, down from over 75,000 in the late 1980s and early 1990s.

MRC, a UK institution, set up base in Uganda in 1989 to undertake research on HIV.

The council has four centres across the country, including the one at Kyamulibwa, which was previously part of Masaka district, before Kalungu was granted district status.

Masaka is a neighbouring district to Rakai, where HIV was first reported in Uganda in the 1980s. In other research on social networks, the MRC echoed poverty as one of the drivers of HIV infections, with the risk groups being prostitutes, some of whom are willing to sleep with men without a condom in exchange for higher pay.

“We are not saying poverty causes HIV, but we are saying people who are poor found it difficult to engage in safe sex,” said Martin Mbonye, a researcher with MRC.

Another high-risk group were the fishing communities that are transient in nature or mobile as they tend to move from place to place, according to Rwamahe Rutakumwa, a researcher.

The first reported case of HIV in Uganda in the early 1980s was at Kasensero landing site in Rakai, where fishermen interact with populations from as far away as Tanzania and Burundi.

The MRC/UVRI researchers suggested that messages should target different audiences. They pointed out that the message about the use of condoms does not take into account the fact that men easily overpower women.

Condoms are a big intervention for the prevention of HIV, but this is not translated into action. For instance in Kampala, prostitutes have access to condoms, but this does not mean that they use them.

The team also pointed out that life expectancy was being undermined by lifestyle diseases, such as diabetes and hypertension.