Sunday, July 1, 2012

Why multiple sexual partners are driving up new HIV infections and a national emergency in Uganda

Ugandans are still reeling from last week’s bombshell of a revelation by Health Minister Dr Christine Ondoa that HIV/AIDS prevalence in Uganda has risen from 6.4% in 2005 to the current 7.3% in Uganda primarily driven by an increase in multiple sexual partnerships.

The findings are from a 2011 Uganda AIDS indicators survey conducted between February and September 2011 which interviewed an astonishing 11,340 households.

Concurrent sexual partnerships or a situation where an individual is having more than one sexual partner at the same time is the leading driver of new HIV infections in Uganda- according to the Uganda AIDS Commission.

 ‘'Have you ever seen a man who does not cheat? Tell me if yours doesn't cheat .All men cheat. But we make sure we do not have kids with those women we sleep with'’ celebrated Ugandan musician, Bebe Cool, was quoted in a Sunday Vision interview with journalist Carol Kasujja, in the May 6th 2012 edition, when asked to comment on rumours that his wife had left him over alleged infidelity.

The non-regular sexual partners are often called names: 'spare tire', 'side dish', 'away match', 'side mirror.’.etc.

The very choice of names betrays Ugandans' social acceptance of casual sex. It is only in Uganda that you will hear people refer to sexual intercourse as 'playing sex’. It is like a simple, casual game. Some kind of harmless fun. But it isn't fun.

Ironically, it is married couples or people in stable relationships who are driving up new HIV infections but also who are at a higher risk of HIV infection in Uganda because of reckless sexual behaviour. Married couples in Uganda have more unprotected sex than younger, single people. Married couples' aversion to condoms is legendary. ’'condoms don't belong in a marital bed' ‘one couple says defiantly.

A few weeks ago I listened in to a lively Saturday morning health talk show on Radio One where this was the topic of debate. Why are Ugandans partial to 'side dishes' to use the tongue-in-chick reference to extra marital sex?

And the panelists were not short of answers. '’Women lose sexual appetite as they grow older, yet mens' libido's don't wane with age so a man has to look out for it'’ a middle aged male caller volunteers.

‘’sometimes we women are in our periods and during such times; men should not be made to wait'’ a female caller volunteers. Ugandans are clearly socially accepting of marital infidelity. Although that is usually skewed in favour of the male gender.

In many Ugandan traditional societies, a man can be culturally granted divorce on account of a wife's infidelity although the reverse is not as easily accepted.

Cheating used to be a preserve for men. But not anymore. 'We now also have the money. When I know my man has a 'side dish', I also revenge and get a young man to satisfy my needs. These days we don't depend on men for money. We have our own money'’ says Namukasa Jane, 43(Not real name).

Statistics from Uganda AIDS Commission shows that males still cheat more than females although the latter are catching up fast.

Last year ,Dr Raymond Byarugaba,Head of the AIDS Information Centre (AIC)announced that new annual HIV  infection rates are set to reach 150,000 new cases compared to 120,000 the  year before up from 100,000 cases in years previous.

Uganda’s rising new HIV infections are out of step with declining global trends even in countries such as worse-hit countries such as South Africa and Botswana registering a 25% reduction in new HIV infection rates according to UNAIDS.

Ironically, Uganda was renowned for taming run away HIV infections in the 1990s making the recent spike in new HIV infections a  national emergency.

With donors scaling down funding for the HIV/AIDS treatment and new patients being turned away at AIDS treatment centres because of donor funding caps, increasing new HIV infections mean that  HIV treatment efforts are being hopelessly outpaced by new infections.

Michel Sidibe, the UNAIDS boss blames the rise in new HIV infections on ‘complacency’. It now seems that Uganda has to revert to the aggressive prevention programming favoured in the 1990s with Ugandans waking up to drums and hearing the messages of ‘love carefully’ .

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