By Jennifer Austin
RECENT data presented by the Ministry of Health at a Uganda Aids Commission conference revealed interesting details about the prevalence of HIV infection among various groups within Uganda.
The data, presented by Dr. Alex Opio, was compiled from ante-natal clinics and sero-behavioural studies and the Uganda AIDS Indicator Survey.
Population-wide HIV infection rates have decreased dramatically since the peak of 18% in 1992.
However, over the last three to four years, the prevalence rate has stagnated at between 6% and 6.5%, according to data collected at ante-natal clinics.
A recent Ministry of Health population-based sero-survey showed an average national prevalence for people aged between 15 and 49 of 7.1%.
The infection rate is consistently higher for women than men, with the national average prevalence among women at 8.1% and at 5.8% for men.
The research also showed that the AIDS epidemic is most widespread in an older population.
A common assumption is that young, single people are at the highest risk and, consequently, many programmes are targeted at the youth.
However, the data shows that women in their early 30s and men between the ages of 35 and 45 years actually have the highest infection rates.
Discordance, where only one partner is infected with HIV, is also extremely high.
The data shows that 48% of couples in which at least one partner is infected are discordant, meaning even some people in faithful, monogamous marriages could be at risk.
Infection rates among ethnic groups and religions also showed some distinct variation.
Further research into the underlying causes of the variations is needed to help in developing effective programmes tailored to better meet the needs of specific groups.
According to the data presented, Muslims have the lowest prevalence rate at 5% and Anglican/ Protestants have the highest prevalence rate of 7.1%.
Larger differences were found among ethnic groups in Uganda, with Batoro showing a prevalence of 14.9% at one extreme and the Karimojong having a prevalence of just 1.7%.
Lugbara/Madi people were the next lowest with a prevalence of 2.7%. All other identified ethnic groups had infection rates of 5% or higher.
Though the data itself is informative, more ethnographic studies and research needs to be done to link the distribution to specific causes so that the information can be used to guide the creation of programmes and strategies to continue to reduce HIV/AIDS.
Other factors that one would expect to show clear trends such as education and wealth, did not. HIV prevalence does not show a clear decrease as education increases, as many would expect.
Those with secondary education or above do have the lowest prevalence, but individuals who have completed primary school have a higher infection rate than those who have not.
The survey showed that behavioural change is low, even with rising awareness levels. This indicates that not only education and knowledge about HIV/AIDS, but other factors such as perceptions and attitudes about HIV/AIDS prevention and treatment determine people’s actions.
External factors such as social pressures and norms leave individuals, most commonly women, unable to assert themselves, leading them to do things that they know to be unhealthy, high risk behaviour.
Also contrary to common expectation, the data show that women in the highest income group have the highest infection rate. Men and women in the lowest income group have the lowest infection rates.
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