THE War-torn Gulu and Amuru districts have about 27,000 people living with HIV/AIDS and a prevalence rate of 8.2%. Of these, 12,000 are children, writes Raymond Baguma

JANE Acana, (not real name) 17, was in primary school in 2003, when she tested positive to HIV, the virus that causes AIDS. When Acan sat for P.7 in 2005, she thought continuing to secondary level was useless, since she was going to die anyway. “But I decided against it when I realised there were many students who are sick and are in school.”

“I was sickly when I was taken to Gulu Hospital. I told my guardian, who is my elder brother, about the results. But he just kept quiet. I had expected him to talk but he did not. Maybe he thought that I had been sleeping around,” she says.

Acana is a peer educator with Health Alert, a local NGO in Gulu, and in S.3 in a school in Gulu town. She says most HIV-positive students keep their sero-status a secret for fear of being stigmatised. “For me at school, they do not know that I am living with HIV,” she adds.

Francis Omony is the general secretary of the peer club. He is in S.5 at Koch Goma SS. He was bold enough to go public about his status. He does not mind his identity being disclosed since his sero-status is known, he says. But going public was not easy for Omony, 17, who first learnt about his HIV status in 2004 when he was in S.1.

“I was admitted to Lacor Hospital. I had a swelling on the neck and it was operated. They asked me to test me and I accepted. I was found positive. I did not eat for three days,” he recalls.
“Many students might be having HIV but they do not come out. There is a lot of stigma in the schools and there is need to sensitise the community,” he adds.

He is also concerned that the youth in Gulu are engaging in casual sex, commonly referred to as “conning,” and thereby exposing themselves to HIV. The students also smoke during school functions. Oftentimes, they go in pairs. .
“One day, some students at my school stigmatised me and they were expelled. But I complained to the school administration about their dismissal, and they were recalled,” he says.

Health Alert is funded by Save the Children in Uganda (SCiU) to support 1,116 young people living with HIV/AIDS, enabling them to receive HIV testing, ARV treatment and support. The project also aims at reducing HIV prevalence in children in Gulu.

Under the programme, the children have been trained to carry out peer education about HIV/AIDS, which they in turn pass on to fellow children and help to fight stigma.

Edmund Kertho, the SCiU HIV/AIDS programme coordinator, says the three -year-old project also provides Prevention of MOther-to-Child Transmission (PMTCT) services to HIV-positive expecting mothers as well as supplementary feeding to their new-born babies.

Francis Obutu, the Health Alert coordinator, says some HIV-positive students change schools as a result of the stigma, which affects their academic performance and creates a gap in follow-up on ARV treatment at schools.
Acana says: “Taking medicine at school is hard because of the stigma when other students see you swallowing the medicine.”

There is also a challenge in adhering to the ARV regimen for the school-going children, who wake up early to go to school and at times forget taking their medication.

Obutu adds that the HIV prevalence among adolescents in Gulu district is on the increase because there are few organisations promoting behaviour change to the adolescents. Health Alert had initially planned to cater for 750 beneficiaries under the project but there is an increase in the number of children in need of ARVs.

The Gulu district education officer, the Rev. Vincent Ochen-Ocheng, says the education department has observed risky behaviour especially among students. He said it was worse among those residing in private hostels, who were not beingsupervised by matrons. The department recommended that schools take over the running of the hostels.

Cleopatra Apiro, an HIV-positive adolescent, says boys insist on having sex with her. “Even if you tell them you are positive, they insist. Others say ‘no matter what, I shall sleep with you.’”
While Health Alert provides counselling services to HIV-positive adolescents about the dangers of re-infection and transmitting HIV through unprotected sex, there are increasing numbers of pregnancies among older HIV-positive adolescents.

Florence Amito, a nurse with Health Alert, says: “There was a girl who told her healthy boyfriend that she had HIV. The boy did not believe and he insisted. She gave in. Later, when the boy realised that she was serious and found her taking ARVs, he was scared and has not gone for an HIV test. The boy is also in Senior Five. The other students do not believe.”

Omony says although they wish the Government could provide special care to HIV-positive students, care should not include special diets, since this would set them apart from other students and cause stigmatisation.