Uganda strives for a generation free from HIV

Kakaire Kirunda thinks the only way to stop the spread of HIV among teenagers is to treat them like adults.

Against a soothing instrumental background, a group of female friends discuss the hazards of sugar daddies on a popular Ugandan radio show:

Mary: Let me tell you about this friend of mine. A few months ago she told me mbu [that] she met this nice guy with a lot of money. Yes he was married but he treated her like a queen, took her to all the nice clubs, and bought her a really cool phone. Even the expensive clothes, he bought. Now yesterday she came to me crying, her world is falling a part. She has just found out that she is pregnant.

Kate: And the nice man?

Mary: He is not interested. He is tired of her. But that is not the worst part; she is also infected with HIV.

Kate: Girls! The gifts, the nights out, the cash, can never be worth your life and future. Older men are taking advantage of you and putting you at risk of HIV infection in exchange for these bu [small] things. This practice is called cross-generational sex. Respect yourselves, do what I do. Say no to sugar daddies…

Uganda wants an HIV-free generation and, to help to achieve this, the government has begun an onslaught against so-called cross-generational sex. The practice is defined as young people, especially girls, entering into sexual relationships with people who are more than ten years older.

Catchy as it is, I believe this media campaign is in danger of overlooking an inconvenient truth – young people are not contracting HIV simply because they have sex with older people, they are also at risk of transmitting HIV to one another.

It's all very well telling young people to 'say no to sugar daddies'. But any campaign that ignores the fact that many young people have sexual relationships with each other is likely to fail. Young people will continue to contract HIV unless they talk honestly to their sexual partners about their HIV status (whatever their age).

What's more, there are many thousands of young people in Uganda and across the globe who are HIV positive as a result of contracting the virus at birth. They still want to exercise their right to loving relationships and even to have children.

Gone are the days when most infants infected with HIV died within the first two years of life. The advent of antiretroviral therapy has seen many living to adulthood – in 2006, Uganda’s longest-surviving person born with HIV turned 23 years old, thanks to these life-saving medicines.

Significant numbers of these adolescents have registered with support organisations in Uganda. By the end of last year TASO (The Aids Support Organisation) had on its books nearly 5,000 10- to 19-year–olds who have been living with HIV since infancy. The Mildmay Centre just outside Kampala had over 600 young people, while the national referral hospital in Mulago had over 500.

During a media dialogue organized by the Mildmay Centre and the Uganda Aids Commission earlier this year Dr Ivy Kasirye, a paediatrician at the Mildmay Centre, admitted that dealing with the adolescents is complicated.

"We all know what adolescents are like. The fact that they also have a package of HIV with them makes it a hard situation," she said. "As is natural, they become experimental, they have natural desires. So one of the biggest challenges we have is handling sexuality in our adolescents."

The Population Council and its partners, using funds from the United States Agency for International Development, has just completed the first study to address the reproductive health needs of adolescents born with HIV in Uganda. The results are troubling.

Of its sample of more than 700 10- to 19-year-olds, many are dating - 39 per cent are in a casual relationship – and others desire to love and be loved. Fair enough. But more than half of these young people say they are afraid of disclosing their HIV status.

Furthermore, three in five of those who are sexually active said they did not use any protective method the first time they had sex. A similar proportion of those in a relationship have never discussed their HIV status with their current partner, while two-thirds do not know the status of their current partner.

I spoke to one 17-year-old living with HIV who gets treatment from a TASO centre in eastern Uganda. He told me: "I am in a sexual relationship but I have not yet told my status to my partner whose sero-status I am not aware of. I am afraid to tell her. What if she rejects me?"

Unless he uses protection not only can he transmit the virus to his partner, but he is also in danger of becoming re-infected with another strain of HIV if his partner is also HIV positive.

Many teenagers, including those living with HIV, are hesitant to discuss their sexual behaviour with their service providers. The study found that counselling by service providers in Uganda is often inadequate.

The young people surveyed felt that they were being lectured and not given a chance to discuss their own views. Indeed, sometimes providers talk to parents or guardians rather than the child. Counsellors often warn youngsters against sex, relationships or dating. The emphasis is on abstinence until marriage for all young people – regardless of their HIV status.

It seems clear that further interventions are needed to realise the dream of an HIV-free generation in Uganda. The Population Council’s research points to a dearth of appropriate information and advice for positive teenagers. They need to be equipped to negotiate their lives at this pivotal time – to make informed choices and to balance responsibility with their sexual desires.

Comments

[Erick Kabendera]

Kakaire, as usual, all feature writing rules observed; like the human face and strong analysis skills. It is clear in the story that you know the subect well and you read before writing.

[Bessie Manda]

Kakaire, your writing does not only show that you know what you talking about, but helps a reader to read on. The way it starts with a dramtised part will make any person want to read more and know what the writer is talking about. Keep up the good work.

[OTIENO MICHAEL JACKSON]

IAM a student at Kampala International University and a proud member of the human species. Iam organizing a forum on cross generational sex back home in kenya on 23rd December 2007. I would like to know how i can get some assistance like, literature materials, shirts, caps and any other assistance. One East Africa one society.

[Paul B]

Kakaire this is the typical story in our country. I have heard and supported a couple of people who thought they had found Angels (albeit commercialization of their bodies- to please so and so or settle down or make quick bucks from ABC or he/she bought me car etc and then let go etc). Our country is bleeding to death through this pandemic.Let's not stop at putting up the large bill boards but further targeted action should be used. This could include regular seminars say in Secondary schools, Universities because our kith and kin are getting infected by marauding Sugar daddies and Sugar mummies. There is no such a thing as something for nothing, I cant buy you a car for nothing. All human or animal activities are results of objectives which MUST be achieved.
As for the 17 yr old, he needs counseling support to open up otherwise his world will surely crumble as she finds out.

[Kyanjo Erimiah]

Hi there im a graduate student carrying out a thesis study on HIV AMONG ADOLOSCENTS ,IM REQUESTING FOR CURRENT STATISTICS OF ADOLOSCENTS LIVING WITH HIV/AIDS IN UGANDA, KINDLY AVAIL THEM TO THEM

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I don't agree upon the view presented in this article.I hope to see better constructed reports in the future.I think that at some point in time someone became lazy or maybe just time constrained and only prepared a slightly more detailed version of a presentation and this caught on like wild fire and unfortunately became acceptable since it cut the time to complete the briefing and presentation in half.

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