Fight HIV among youths to save population

OPINION | POPULATION

By Annet Nakibuuka

Today July 11, 2018, Uganda is joining the rest of the world to commemorate the World Population Day. 

The day was instituted in 1989 by the Governing Council of the United Nation Development Programme (UNDP) and inspired by public interest in the Five Billion Day on July 11, 1987 (the estimated date on which the world's population nearly hit five billion people.)

While it originally focusses on global population issues like family planning, maternal health, gender quality, poverty and human rights, HIV silently comes along with each of these. Did you know?

The 2018 world population day theme is, ‘Family Planning is a Human Right'. Yes, but as the Governing Council aims at paying great attention towards the reproductive health problems of the community people, as the leading cause of the ill health and death of the pregnant women worldwide, other issues like HIV that affect sexuality and are hitting the population hard, are a must to address.

Celebrating this day aims at protecting and empowering youths of both gender and to offer them detail knowledge about their sexuality and delay marriages till they become able to understand their responsibilities, among other sexuality issues.

As we partner with the United Nations to commemorate this day, let us hold high, the sixth Millennium Development Goal (MDG) of combating HIV/AIDS and reverse its spread.  Ugandans, our focus should be the youths, and mostly those who are married, as these are considered to be the prime group contributing to the increasing population.

The other group (the unmarried) also actively engage in sexual activities, and this means a lot to every one of us in the country's HIV response. Along this come babies, some of whom are born HIV positive, as their parents may not have embraced the efforts to the Elimination of Mother-to-Child Transmition Strategy.

Despite the above, we should appreciate that it is a basic right of parents to be able to decide on the number and spacing of their children as stated in 1968, by the Tehran Proclamation, an International Conference that focused on Human rights and family planning. But what if these children are HIV positive?

The United Nations warns that a rapidly increasing population exacerbates existing problems, such as economic interdependency, the spread of diseases such as HIV/AIDS and various other pandemics.

Philip Njuguna, a pastor in Kenya has always said. "When the family is small, whatever little they have they are able to share. There is peace".

On the other hand, when this family is affected by HIV, even the little cannot do a miracle. For instance, the UNAIDS Fact Sheet for World AIDS Day 2017, indicated that there was only US$19.1 billion for People Living with HIV in low and middle income countries, including Uganda. These are part of the 20.9 million people worldwide, who were accessing antiretroviral therapy by June 2017. These resources are really little in consideration of HIV treatment cost.

According to the Population Council's 2016 Journal Article, ‘Annual cost of antiretroviral therapy among three service delivery models in Uganda,' the annual cost of the antiretroviral therapy per client in (USD) was $404 at Kitovu Mobile, $332 at TASO and $257 at Uganda Cares. What does this mean with a big population where majority are PLHIV.

According to Uganda AIDS Commission, the HIV prevention programmes in Uganda are yielding positive results. Despite that, the commission reports that there were 52,000 new HIV infections in Uganda in 2016, mainly among adolescents and young people, women and girls, and key populations, part of whom are married youths. UNAIDS 2017 estimates revealed a prevalence rate of 7.7% among women aged 15-47, and 5.3% for men 15-49, in Uganda.

Nevertheless, we can work toward achieving the objectives of Uganda's 2015/2016-2019/2020 prevention strategy, which aim at increasing adoption of safer sexual behaviours and reduction in risk behaviours, scaling up coverage and use of biomedical HIV prevention interventions (such as voluntary medical male circumcision and PrEP), delivered as part of integrated health care services and mitigate underlying socio-cultural, gender and other factors that drive the HIV epidemic.

Youths should also embrace condom use to hamper population and HIV risks. Data reported by UNAIDS in 2017 suggest 60% of men and 45.5% of women used a condom the last time they had higher-risk sex (defined as being with a non-marital, non-cohabiting partner). Condom use as a family planning method plays double roles; it helps avoid the uncalled for pregnancies that may result in an increased population and protects one from sexually transmitted diseases like HIV.

In addition, they ought to avoid cross generation sex as this contributes to higher risks of contracting HIV and irresponsible child bearing, since the older partner will always have another family somewhere. This increases the population, because the young girl cannot have full control of her body when dealing with an older man twice her age.

In order to achieve the above, emphasis must be put on the ‘be faithful' strategy by encouraging them to always respect and be committed to their partners, use of condoms and adherence to treatment among the discordant couples, as this can these can reduce risks of infecting their children.

Together we can achieve an AIDS Free Generation by 2030.

The writer is an HIV activist