We need to adjust HIV prevention strategies
Oct 01, 2008
Two years ago, Uganda and other 156 UN member states committed to a plan to ensure that its citizens would have access to services designed to prevent the spread of HIV by 2010. However, the goal of universal access seems unachievable, especially for developing countries.
By Liz Kobusinge
Two years ago, Uganda and other 156 UN member states committed to a plan to ensure that its citizens would have access to services designed to prevent the spread of HIV by 2010. However, the goal of universal access seems unachievable, especially for developing countries.
From a high prevalence of 18% of the population infected with HIV in the early 90s to 5% by 2000, the HIV prevalence in Uganda is now 6.4% of the adult population. The rising prevalence is a threat to the county’s success story in the fight against HIV/AIDS.
Ironically, HIV/AIDS globally received $4.6b, which is about 40% of health aid in 2006. Furthermore, funding for HIV/AIDS now often exceeds total domestic budgets. This has been at the expense of primary health care. For years, activists have given the rationale for this disproportionate spending by arguing that HIV/AIDS is exceptional: a disease of poverty, a developmental catastrophe and an emergency.
But Elizabeth Pisani, the author of the book “Wisdom of Whores; Bureaucrats, Brothels and the Business of AIDS,†defers from this argument. She notes that across several African countries like Cameroon, Uganda and Zimbabwe, HIV is lowest in the poorest households, and highest in the richest households. She adds that in many countries, more educated women are more likely to be infected with HIV than women with no formal education.
In addition, new data across Africa shows that HIV prevalence is highest among the middle classes and the more educated people.
HIV/AIDS is also a major contributing factor to children’s vulnerability. The number of children newly-infected with the virus globally continues to increase each year.
In 2006, there were over 500,000 new infections. Currently, there are about 2.3 million HIV-positive children globally. In Uganda, the increase in the number of children living with HIV is estimated at 110,000. About 20,000 of these are infected yearly through mother-to-child transmission. This has contributed to the orphan crisis in the country.
At the close of 2007, there were an estimated 1.2 million children orphaned due to HIV/AIDS. In Kampala, according to statistics compiled by African Network for the Prevention and Protection Against Child Abuse and Neglect (ANPPCAN), there are more than 12,000 child prostitutes, majority of whom are orphans. Many of these children are likely not to escape the vicious circle of HIV/AIDS.
HIV is largely a social problem because the factors that cause, promote or prevent its spread are related to people’s behaviour, their environment, beliefs, values and practices. The pandemic cannot be defeated without effective prevention. This involves combined preventive approaches like circumcision and prevention of mother-to-child transmission.
The prevention communication that resulted in the prevalence turn around in the 90s is not compelling any more. In addition, attention has been placed the availability of ARVs which make HIV seem less threatening. Furthermore, while de-stigmatisation has reduced, this is likely to be a contributor to reduction in adherence to prevention measures.
Therefore, the current prevalence patterns demand that Uganda adjusts her prevention strategies.
There is need to respond to the new HIV trends by increasing access to HIV voluntary testing facilities, increasing access to proper treatment of sexually transmitted diseases and develop a new national communication strategy for HIV/AIDS prevention.
The writer is a registered
comprehensive nurse
Two years ago, Uganda and other 156 UN member states committed to a plan to ensure that its citizens would have access to services designed to prevent the spread of HIV by 2010. However, the goal of universal access seems unachievable, especially for developing countries.
From a high prevalence of 18% of the population infected with HIV in the early 90s to 5% by 2000, the HIV prevalence in Uganda is now 6.4% of the adult population. The rising prevalence is a threat to the county’s success story in the fight against HIV/AIDS.
Ironically, HIV/AIDS globally received $4.6b, which is about 40% of health aid in 2006. Furthermore, funding for HIV/AIDS now often exceeds total domestic budgets. This has been at the expense of primary health care. For years, activists have given the rationale for this disproportionate spending by arguing that HIV/AIDS is exceptional: a disease of poverty, a developmental catastrophe and an emergency.
But Elizabeth Pisani, the author of the book “Wisdom of Whores; Bureaucrats, Brothels and the Business of AIDS,†defers from this argument. She notes that across several African countries like Cameroon, Uganda and Zimbabwe, HIV is lowest in the poorest households, and highest in the richest households. She adds that in many countries, more educated women are more likely to be infected with HIV than women with no formal education.
In addition, new data across Africa shows that HIV prevalence is highest among the middle classes and the more educated people.
HIV/AIDS is also a major contributing factor to children’s vulnerability. The number of children newly-infected with the virus globally continues to increase each year.
In 2006, there were over 500,000 new infections. Currently, there are about 2.3 million HIV-positive children globally. In Uganda, the increase in the number of children living with HIV is estimated at 110,000. About 20,000 of these are infected yearly through mother-to-child transmission. This has contributed to the orphan crisis in the country.
At the close of 2007, there were an estimated 1.2 million children orphaned due to HIV/AIDS. In Kampala, according to statistics compiled by African Network for the Prevention and Protection Against Child Abuse and Neglect (ANPPCAN), there are more than 12,000 child prostitutes, majority of whom are orphans. Many of these children are likely not to escape the vicious circle of HIV/AIDS.
HIV is largely a social problem because the factors that cause, promote or prevent its spread are related to people’s behaviour, their environment, beliefs, values and practices. The pandemic cannot be defeated without effective prevention. This involves combined preventive approaches like circumcision and prevention of mother-to-child transmission.
The prevention communication that resulted in the prevalence turn around in the 90s is not compelling any more. In addition, attention has been placed the availability of ARVs which make HIV seem less threatening. Furthermore, while de-stigmatisation has reduced, this is likely to be a contributor to reduction in adherence to prevention measures.
Therefore, the current prevalence patterns demand that Uganda adjusts her prevention strategies.
There is need to respond to the new HIV trends by increasing access to HIV voluntary testing facilities, increasing access to proper treatment of sexually transmitted diseases and develop a new national communication strategy for HIV/AIDS prevention.
The writer is a registered
comprehensive nurse