THE low government investment in reproductive health commodities has resulted in an acute condom shortage.
Contraceptives used in controlling unwanted pregnancies include condoms, injectables, pills, interuterine devices and surgical contraception equipment.
But condoms remain the most popular and cheapest means used to check STDs/ HIV and unwanted pregnancies in Uganda. According to Dr. Moses Muwonge, a reproductive health consultant, Uganda had a stock of 12 million condoms in May.
The Government imports about 20 million condoms every month. About 10 million are dispatched by the health ministry every month.
While the previous minimum stock level was six months with 12 months being the maximum, it has since been revised to four and six months, respectively because of the bulkiness of condoms.
The shelf-life of condoms is three to five years. The problem, though, is that after manufacturing, condoms are not shipped immediately.
“Sometimes they spend over 18 months at the National Medical Stores,” says Muwonge. “This reduces their shelf-life.”
Rising demand
Ugandans need over 220 million condoms annually, but only between 80-120 millions are imported.
“It means if all men were to use condoms, each would get a ration of three,” says Muwonge.
“Would this make any impact on fighting unwanted pregnancies and HIV?”
In 1993, the Government imported one million femidoms (female condoms), but only 200,000 were used.
“The remainder (800,000) expired,” says Muwonge. However, when femidoms were recently piloted in four districts, consumption rose to 100,000 in three months.
Budget
Donors fund up to 95% of the reproductive health commodities budget, which could explain the shortage. The health ministry is left guessing when the next consignment will arrive.
“What will happen when donors pull out? Where would people seek refuge?” wonders Dr. Betty Kyaddondo, the head of family health department at Population Secretariat (Pop-sec).
In the 2009/10 budget, sh15b was allocated to reproductive health commodities. Uganda needs about $12m (about sh24b) next year to address her unmet needs.
However, the Government has slashed the health sector budget. This will impact negatively on reproductive health commodities.
The contraceptive funding gap is $3m(about sh6b). The country’s five-year cost strategic plan needs $53m (about sh106b).
The Government spends over 14% of its national budget on health. Donors contribute about 35% while inter-regional NGOs meet 0.4% of the health needs of Ugandans.
Health care support falls
Mwonge says the health care package has fallen from $1.7 to $0.7 per Ugandan. “This means any person seeking medical care from public health units gets only athird of the requirement,” he says.
Uganda loses $101m (over sh202b) in unmet needs for family planning services annually. According to the 2006 Uganda Demographics and Household Survey statistics, the country’s unmet needs for reproductive health commodities stand at 41%, a drop from 52% in 1989
The survey also shows that 41% of married women do not want to have more children, 35% want to wait for two or more years before the next birth.
The United Nations Population Fund estimates that for every dollar spent on reproductive health commodities, the Government saves about $3 (about sh9000) on maternal and newborn care.
Why condoms are vital
Condoms have proved to be an effective tool in reducing teenage pregnancies, considering that over 50% of Uganda’s population is under 24 years.
Charles Zirarema, the Pop-sec chief, warns that teenage pregnancies, STDs/HIV infections will go up if condom stocks run out.
Teenage pregnancy is one of the reasons why Uganda’s maternal mortality is still high (435 deaths per 100,000 live births).
‘High population good’
President Yoweri Museveni is at the forefront of justifying the need for a high population. A high population, he argues, boosts trade.
He says such a population ensures exploitation of the natural and human resources, increased economic growth due to high production and increased profits and markets from increased demand.
However, Zirarema says for economic development to take course, such a population must have high savings and investments pattern.
“We have a crowded city (Kampala) and traffic jams because of high population growth rate,” he says. “While we may not reduce it, we must contain it.”
High population rate
Uganda’s population is about 33 million, according to the 2009 State of the UNFP World Population report. Women make up over 51% of the population with a fertility rate of 6.7 children per woman.
Ray of hope
James Kakooza, the health state minister in-charge of primary health care, says the Government will import new stocks of condoms by the end of this year. He says the shortages should not cause worry.
“Rather, people should test and know their HIV/AIDS. This is a key preventive measure.”
According to Kyaddondo, Uganda faces an uphill task in achieving the Millennium Development Goals 4 and 5 of reducing child mortality and improving maternal health, respectively.
Monday, June 14, 2010
Thursday, April 15, 2010
HIV/AIDS AND HEALTH RISKS AMONG GAY PEOPLE IN LOW INCOME COUNTRIES
Background:
HIV prevalence data suggest that men who have sex with men (MSM) in low-income are at increased risk of HIV. The aim of this article is to present information on HIV/AIDS and health risks among gay people in low income countries.
Key Words: HIV/AIDS, men who have sex with men (MSM), low income countries (LIC), HIV among gay, gay health diseases, condom use.
Gay youths and adults are recognized as being at high risk for HIV infections. They are 19 times more likely to be infected with HIV in low income countries around the world. Only 1 in 5 have access to the HIV prevention, care and treatment services they need and 5-10 % infections of HIV/AIDS is transmitted through gay sex. HIV epidemics and prevention needs among gay youths and adult in these countries have been relatively neglected. Compounded by limited resources, the quality and coverage of services and programs for gay youths and adults remain low, especially in contexts where the social stigma attached to male to male sex and the criminalization of this behavior is widespread as seen in Uganda today.
The urgency of adequately addressing HIV prevention needs among gay youths and adults in low income countries however has become most obvious in recent years. Gay sex behaviors have been documented in a variety of low income countries where these behaviors are most times been considered to be non-existent or illegal. Available data across LIC suggest that proportions of men who engaged in gay sex in the past year may reach 7%–8% in parts of some regions. In addition, HIV prevalence data suggest that many gay youths and adults are at markedly at increased risk for HIV infection in low income countries there fore; HIV epidemic among gay youths and adults is increasing at a higher rate. “HIV/AIDS is a disaster not only for the countries hardest hit but also for men who have sex with men wherever they live”. (World disaster report 2008)
Several studies suggest that HIV knowledge and the self-perceived risk for HIV infection is very low among gay youths and adults in low income countries. The availability of data concerning the frequency of unprotected and protected “anal intercourse” is very limited.
There are also several gay diseases apart from HIV/AIDS which affect gay youths and adults in LIC countries; these infections need greater attention because there infection rate is growing a lot in minority groups of young and adult homosexuals.
Anal genital
(Anal cancer);
Anal cancer is the result of infection with some subtypes of human papilloma virus (HPV), which are known viral carcinogens, (John R.Diggs). Anal cancer arises from the following diseases;
Chlamydia trachomatis Cryptosporidium Giardia lamblia Herpes simplex virus Human immunodeficiency virus Human papilloma virus Isospora belli Microsporidia Gonorrhea
Gay youths and adults in LIC are at greater risks of the above disease because they are not well sensitized about such infections (STDS), how to control the spread of infections and seeking treatment measures for affected individuals. Since GLBT people exists in low income countries and the number still growing, programs and treatment centers should be set up to help gay and Lesbian minority groups because they have rights for treatment and care.
If programs aren’t set up to help gay groups, the spread of such diseases above and HIV/AID epidemic will remain on a higher rate. On addition to that, gay youths and adults engage in sex out side their relationship hence getting re-infected and infecting others with new infections
METHODS OF PREVENTION AND LIVING HEATHY
Gay and Lesbian people in low income countries have a right to live health lives, getting sensitized on HIV/AIDS epidemic and access of treatment and care. The methods which can be advice for gay and lesbians minorities groups to follow are as follows;
Getting tested and have your partner tested
Gay and Lesbian youths and adults should be advised to go for HIV and other STDs tests with their partners. Testing is more important because many gay people don’t know if they are infected or not. Testing can help a couple to know ones status and getting treatment, care if found infected.
Use a condom
Many gay youths are found not to use condoms especially in low developing countries where by a big percentage of these individuals don’t have money and access to lubricants and or, some time fear going to health centers to pick condoms. In many cases, these minority groups don’t get enough sensitization on safer sex. If condoms are used careful with out using petroleum jelly, cold creams or oil, condoms can’t be weakened.
On the side of Lesbians, sex toys should be kept safe either by protecting them with a condom or cleaning them before and after every sex. Experts believe that syphilis is on the rise among gay and bisexual men because they are engaging in unprotected sex with multiple partners.
Be monogamous
Stay with one sex partner who has tested negative for HIV and other STDs and who won't have sex with anyone but you. Monthly testing should be carried out among the partners in order to get updates on each ones status. ABCD (Abstinence, Be faithful, condom use and Disclosure) methods should be also be adopted in gay communities in low income countries.
Limit alcohol and don't use drugs
Drug and alcohol abuse is common among gay youths and adults. In many cases, substance abuse is a way to cope with shame and overcome fear, denial, anxiety or even revulsion about gay sex.
A given percentage of gay people take alcohol and use drugs. Those who are under influence are more likely to take sexual risks which leads to infections of HIV and STDs. Young men and women should limit alcohol they take and those using injections for drugs should not share because there is a high risk of getting infections from one another.
Know the risks associated with sexual venues
Sexual venues such as bathhouses, sex parties and the Internet can facilitate multiple sexual partnerships and anonymous sexual encounters, as well as higher risk sexual behaviors.
Example;
A gay man named Vince, who had never before had anal intercourse without a condom, went to a sex club on the spur of the moment when he got depressed, and had unprotected sex:
"I was definitely in a period of depression . . . . And there was just something about that particular circumstance and that particular person. I don't know how to describe it. It just appealed to me; it made it seem like it was all right”, said Vince.
Get vaccinated
Gay youths and adults should be advised to go for vaccination which can protect them from serious liver infections and hepatitis A and B which can be spread through Un-protected sexual acts. Hepatitis B is on a wide spread in low income countries there fore treatment and prevention measures should be emphasized to minority groups in LIC.
Remain vigilant
Gay people should know that anti-retroviral medications have reduced the number of AIDS death, but AIDS is still an illness which has no vaccine and cure. Also there is no cure for some STDS like Human papilloma virus or genital herpes; the only best way of living a health life is to protect them selves by use of condoms and getting proper treatment for curable STDs.
What should be done to maintain gay health and reduce HIV infections among gay people in Low income countries?
Human rights NGOs and other LGBT organizations in countries where homosexuality is illegal, should insist that the rights of the minorities are upheld. They need not accept the tyranny of the majority. If it’s not done, the epidemic will grow again especially in low income countries.
Leaders from low income countries where homosexuality is illegal, should support more HIV prevention targeted toward men who have sex with men and research on the extent of the epidemic among gay people. A recent study of gay sex in low income countries found that African gays are 3.8 times more likely to be HIV-positive. There is no way HIV epidemic infections could be pulled down if gay people are left un-sensitized.
Current HIV prevention efforts should be effective in reaching gay individuals. Limited research efforts in Kenya and Ghana showed that men who have sex with men do not consider themselves at risk of contracting HIV, because all of the prevention messages thus far have focused on heterosexual couples. Many MSM also have sex with women thus contributing to the risk women face. Low income countries should encourage prevention efforts among the minority groups.
Many researchers and NGO, whether publicly or privately funded should be encourage to inquire about same sex practices, their health and any other useful information which can help in building up prevention, care and treatment plans for gay youths and adults, especially most of African countries, where homosexuality is illegal.
Gay and bisexual youths and adults are more likely to smoke than are heterosexuals because of increased stress and depression due to social alienation. Smokers face many health risks, including cancer. There should be programs set up to help teach about smoking and health risks among gay people.
NGO should set up programs to carry out vaccination exercise among gay communities in a simplified way because so many gays in low income countries fear coming out due to the laws in their countries.
There is a need for printed reading materials which can be distributed to gay communities which teach on gay health, HIV/AIDS and prevention measures which can be followed to prevent or reduce infections among gay people.
Figure 1.
Comprehensive Model for HIV and Health report: Health risks and HIV/AIDS.
Form projects
with other
Organizations
to work on gay
Health and HIV/
AIDS in LIC
Fight off drug use
and smoking in
Gay communities
in LIC
NGOS in LIC,
research on
HIV rate in
Homosexuals
HIV prevention
efforts reach
Gay individuals
Leaders in LIC
Support
HIV prevention
In Gay people
GAY HEALTH &
HIV/AIDS
LOW DEVELOPED
COUNTRIES (Uganda)
“Act NOW”
NGOS Insist on
Human rights
(Gay rights)
Develop
Innovative Ideas
to fight the
Epidemic
In homosexuals
Conclusions:
Several researchers have tried to show the HIV epidemic among gay people in Low income countries and the response towards HIV, and Gay health by the governments and NGOs. Although reporting is incomplete and does not always conform to requirements, findings confirm that, in many low income countries, HIV prevention responses and Gay health in MSM need substantial strengthening.
Recommendation
The governments in low income countries should continue fighting end the epidemic and also providing the needed leadership (gay rights, access to treatment and sensitization in gay communities on gay health and HIV/AIDS) in order to free their countries off the epidemic in gay adults and youths. Prevention measures are required to lead the raising rate of HIV epidemic in Gay people.
Reference books,
a) Supplementary article by Lippincott Williams & Wilkins 2009
b) The health risk of gay sex by John R.Diggs Jr.MD
c) The report, securing Our Future: Report of the Commission on HIV/AIDS and Governance in Africa.
d) UNDP 2009. Human Development report for Africa 2009. UNDP, New York 2009
HIV prevalence data suggest that men who have sex with men (MSM) in low-income are at increased risk of HIV. The aim of this article is to present information on HIV/AIDS and health risks among gay people in low income countries.
Key Words: HIV/AIDS, men who have sex with men (MSM), low income countries (LIC), HIV among gay, gay health diseases, condom use.
Gay youths and adults are recognized as being at high risk for HIV infections. They are 19 times more likely to be infected with HIV in low income countries around the world. Only 1 in 5 have access to the HIV prevention, care and treatment services they need and 5-10 % infections of HIV/AIDS is transmitted through gay sex. HIV epidemics and prevention needs among gay youths and adult in these countries have been relatively neglected. Compounded by limited resources, the quality and coverage of services and programs for gay youths and adults remain low, especially in contexts where the social stigma attached to male to male sex and the criminalization of this behavior is widespread as seen in Uganda today.
The urgency of adequately addressing HIV prevention needs among gay youths and adults in low income countries however has become most obvious in recent years. Gay sex behaviors have been documented in a variety of low income countries where these behaviors are most times been considered to be non-existent or illegal. Available data across LIC suggest that proportions of men who engaged in gay sex in the past year may reach 7%–8% in parts of some regions. In addition, HIV prevalence data suggest that many gay youths and adults are at markedly at increased risk for HIV infection in low income countries there fore; HIV epidemic among gay youths and adults is increasing at a higher rate. “HIV/AIDS is a disaster not only for the countries hardest hit but also for men who have sex with men wherever they live”. (World disaster report 2008)
Several studies suggest that HIV knowledge and the self-perceived risk for HIV infection is very low among gay youths and adults in low income countries. The availability of data concerning the frequency of unprotected and protected “anal intercourse” is very limited.
There are also several gay diseases apart from HIV/AIDS which affect gay youths and adults in LIC countries; these infections need greater attention because there infection rate is growing a lot in minority groups of young and adult homosexuals.
Anal genital
(Anal cancer);
Anal cancer is the result of infection with some subtypes of human papilloma virus (HPV), which are known viral carcinogens, (John R.Diggs). Anal cancer arises from the following diseases;
Chlamydia trachomatis Cryptosporidium Giardia lamblia Herpes simplex virus Human immunodeficiency virus Human papilloma virus Isospora belli Microsporidia Gonorrhea
Gay youths and adults in LIC are at greater risks of the above disease because they are not well sensitized about such infections (STDS), how to control the spread of infections and seeking treatment measures for affected individuals. Since GLBT people exists in low income countries and the number still growing, programs and treatment centers should be set up to help gay and Lesbian minority groups because they have rights for treatment and care.
If programs aren’t set up to help gay groups, the spread of such diseases above and HIV/AID epidemic will remain on a higher rate. On addition to that, gay youths and adults engage in sex out side their relationship hence getting re-infected and infecting others with new infections
METHODS OF PREVENTION AND LIVING HEATHY
Gay and Lesbian people in low income countries have a right to live health lives, getting sensitized on HIV/AIDS epidemic and access of treatment and care. The methods which can be advice for gay and lesbians minorities groups to follow are as follows;
Getting tested and have your partner tested
Gay and Lesbian youths and adults should be advised to go for HIV and other STDs tests with their partners. Testing is more important because many gay people don’t know if they are infected or not. Testing can help a couple to know ones status and getting treatment, care if found infected.
Use a condom
Many gay youths are found not to use condoms especially in low developing countries where by a big percentage of these individuals don’t have money and access to lubricants and or, some time fear going to health centers to pick condoms. In many cases, these minority groups don’t get enough sensitization on safer sex. If condoms are used careful with out using petroleum jelly, cold creams or oil, condoms can’t be weakened.
On the side of Lesbians, sex toys should be kept safe either by protecting them with a condom or cleaning them before and after every sex. Experts believe that syphilis is on the rise among gay and bisexual men because they are engaging in unprotected sex with multiple partners.
Be monogamous
Stay with one sex partner who has tested negative for HIV and other STDs and who won't have sex with anyone but you. Monthly testing should be carried out among the partners in order to get updates on each ones status. ABCD (Abstinence, Be faithful, condom use and Disclosure) methods should be also be adopted in gay communities in low income countries.
Limit alcohol and don't use drugs
Drug and alcohol abuse is common among gay youths and adults. In many cases, substance abuse is a way to cope with shame and overcome fear, denial, anxiety or even revulsion about gay sex.
A given percentage of gay people take alcohol and use drugs. Those who are under influence are more likely to take sexual risks which leads to infections of HIV and STDs. Young men and women should limit alcohol they take and those using injections for drugs should not share because there is a high risk of getting infections from one another.
Know the risks associated with sexual venues
Sexual venues such as bathhouses, sex parties and the Internet can facilitate multiple sexual partnerships and anonymous sexual encounters, as well as higher risk sexual behaviors.
Example;
A gay man named Vince, who had never before had anal intercourse without a condom, went to a sex club on the spur of the moment when he got depressed, and had unprotected sex:
"I was definitely in a period of depression . . . . And there was just something about that particular circumstance and that particular person. I don't know how to describe it. It just appealed to me; it made it seem like it was all right”, said Vince.
Get vaccinated
Gay youths and adults should be advised to go for vaccination which can protect them from serious liver infections and hepatitis A and B which can be spread through Un-protected sexual acts. Hepatitis B is on a wide spread in low income countries there fore treatment and prevention measures should be emphasized to minority groups in LIC.
Remain vigilant
Gay people should know that anti-retroviral medications have reduced the number of AIDS death, but AIDS is still an illness which has no vaccine and cure. Also there is no cure for some STDS like Human papilloma virus or genital herpes; the only best way of living a health life is to protect them selves by use of condoms and getting proper treatment for curable STDs.
What should be done to maintain gay health and reduce HIV infections among gay people in Low income countries?
Human rights NGOs and other LGBT organizations in countries where homosexuality is illegal, should insist that the rights of the minorities are upheld. They need not accept the tyranny of the majority. If it’s not done, the epidemic will grow again especially in low income countries.
Leaders from low income countries where homosexuality is illegal, should support more HIV prevention targeted toward men who have sex with men and research on the extent of the epidemic among gay people. A recent study of gay sex in low income countries found that African gays are 3.8 times more likely to be HIV-positive. There is no way HIV epidemic infections could be pulled down if gay people are left un-sensitized.
Current HIV prevention efforts should be effective in reaching gay individuals. Limited research efforts in Kenya and Ghana showed that men who have sex with men do not consider themselves at risk of contracting HIV, because all of the prevention messages thus far have focused on heterosexual couples. Many MSM also have sex with women thus contributing to the risk women face. Low income countries should encourage prevention efforts among the minority groups.
Many researchers and NGO, whether publicly or privately funded should be encourage to inquire about same sex practices, their health and any other useful information which can help in building up prevention, care and treatment plans for gay youths and adults, especially most of African countries, where homosexuality is illegal.
Gay and bisexual youths and adults are more likely to smoke than are heterosexuals because of increased stress and depression due to social alienation. Smokers face many health risks, including cancer. There should be programs set up to help teach about smoking and health risks among gay people.
NGO should set up programs to carry out vaccination exercise among gay communities in a simplified way because so many gays in low income countries fear coming out due to the laws in their countries.
There is a need for printed reading materials which can be distributed to gay communities which teach on gay health, HIV/AIDS and prevention measures which can be followed to prevent or reduce infections among gay people.
Figure 1.
Comprehensive Model for HIV and Health report: Health risks and HIV/AIDS.
Form projects
with other
Organizations
to work on gay
Health and HIV/
AIDS in LIC
Fight off drug use
and smoking in
Gay communities
in LIC
NGOS in LIC,
research on
HIV rate in
Homosexuals
HIV prevention
efforts reach
Gay individuals
Leaders in LIC
Support
HIV prevention
In Gay people
GAY HEALTH &
HIV/AIDS
LOW DEVELOPED
COUNTRIES (Uganda)
“Act NOW”
NGOS Insist on
Human rights
(Gay rights)
Develop
Innovative Ideas
to fight the
Epidemic
In homosexuals
Conclusions:
Several researchers have tried to show the HIV epidemic among gay people in Low income countries and the response towards HIV, and Gay health by the governments and NGOs. Although reporting is incomplete and does not always conform to requirements, findings confirm that, in many low income countries, HIV prevention responses and Gay health in MSM need substantial strengthening.
Recommendation
The governments in low income countries should continue fighting end the epidemic and also providing the needed leadership (gay rights, access to treatment and sensitization in gay communities on gay health and HIV/AIDS) in order to free their countries off the epidemic in gay adults and youths. Prevention measures are required to lead the raising rate of HIV epidemic in Gay people.
Reference books,
a) Supplementary article by Lippincott Williams & Wilkins 2009
b) The health risk of gay sex by John R.Diggs Jr.MD
c) The report, securing Our Future: Report of the Commission on HIV/AIDS and Governance in Africa.
d) UNDP 2009. Human Development report for Africa 2009. UNDP, New York 2009
Monday, March 22, 2010
MODULE 2 LESSON 1
Which key populations were you assigned?
Young people
What are some issues that contribute to HIV infections among people from this group?
Uganda has greatly suffered the consequences and impacts of HIV/AIDS for the past decades since 1980s. The country has lost and is continuing to lose the most energetic and productive youths at the time when they begin to contribute to their families and national development. HIV prevalence rates among young people especially girls is higher. In a study carried out, girls are six times more infected than boys of the same group. There is still high increase in HIV affection numbers of youths in Uganda due to the following reasons;
Ø Young people of age 15-19 years are at a disadvantage and vulnerable to inter-generational sex which leads to exploitation and they lack skill of negotiating safer sex.
Ø Young people especially girls are at greater risk of being prone to rape and other form of abuse like forced marriage to grown up men, widow inheritance where by most of these men are already infected.
Ø Youths from rural areas are predominately illiterates; they have little or no idea on safer sex control methods. Also their parents find it difficult to counsel and guide their children. Young people from rural areas usually engage in early sex hence an increase in infection rate especially in rural areas.
Ø Girls and boys engage in use of drugs where by there is use of NON-sterilized materials like injections by many youths hence bringing the spread of HIV with in that community.
Ø Young boys and girls who engage in early relationships which results in early sex practices tend to have more casual partners for sex, hence leading to increase in infection rates, this is the same with gay and lesbian youths.
Ø There is also peer pressure among the adolescents and youths where by they tend to copy risky behaviors such as girl/boy relationship which leads to early sex.
Ø Young people and youth experience a secondary growth spur and development of sexual characteristics. These development coupled with the culture perceptions of being “grown ups” tempts adolescents to experiment with sex which increases their exposure to HIV.
How are these issues connected to human rights?
Young people at risk of HIV infection or already infected may choose not to access health care, prevention and education services for fear of being stigmatized by health care and service providers because they are illiterate about their rights especially youths from rural areas. This is also seen in gay youths because they can’t disclose out their sexuality in order to get proper treatment and prevention measures because being gay is illegal in Uganda.
To young men and women, HIV/AIDS-related stigmatization and discrimination threaten them to attend HIV prevention and care programs. They create a climate that negatively impacts on effective prevention by discouraging individuals from coming forward for testing, and from seeking information on how to protect themselves and others, thus deepening the adverse impact of living with HIV/AIDS and continuous engagement in un-protected sexual intercourse with many partners.
What are some issues that affect access to HIV treatment, care and support among people from this group?
Young men and women have a belief that HIV prevention programs’ and resources available in their communities/areas, are not aligned with the HIV prevention needs they want. In rural communities, health care access is very poor, there is marked variation in access both with in and between districts.
Young people face a lot of discrimination and stigmatization in their communities and from some places where they hope to receive treatment and care. HIV positive youths are normally blamed why they did engage in early sex (adult acts) so this pushes them away from visiting healthy centre for treatment and care.
Criminalization and stigmatization of certain sexual practices like commercial sex work in young girls and boys can contribute to the person’s vulnerability to HIV and their inability to access services and information regarding HIV/AIDS.
Many young people in developing countries luck financial support to access HIV treatment and care because some centers tend to charge for services hence making them un able to access service because they don’t have funds and pay jobs. Reports show that it’s higher in young people in rural areas and un-employed youths in developing countries.
How are these issues connected to human rights?
Ø Several countries have policies that interfere with the accessibility and effectiveness of HIV related measures for prevention and care. Examples include laws criminalizing consensual sex between men.
Ø There is no development of international rights framework which ensures that human rights are interpreted by all relevant international institutions to embrace the needs and concerns of young people and HIV/AIDS.
Ø The allocation of resources to rights education programmes in rural areas is not invested in by governments. Reports show that educating the rural and urban poor on sexual issues often requires expensive and time-consuming face-to-face methods.
Ø Facilitation of access to affordable drugs is not available to young people and youths and there is no equal access to treatments service and care to young individuals in developing countries especially to young people in rural and poor urban settlers.
Ø Establishment of rules for protection and regulation of home based care, and care to young people in schools is not programmed for. This can be a very easy way for young people to access treatment and care services freely.
Young people
What are some issues that contribute to HIV infections among people from this group?
Uganda has greatly suffered the consequences and impacts of HIV/AIDS for the past decades since 1980s. The country has lost and is continuing to lose the most energetic and productive youths at the time when they begin to contribute to their families and national development. HIV prevalence rates among young people especially girls is higher. In a study carried out, girls are six times more infected than boys of the same group. There is still high increase in HIV affection numbers of youths in Uganda due to the following reasons;
Ø Young people of age 15-19 years are at a disadvantage and vulnerable to inter-generational sex which leads to exploitation and they lack skill of negotiating safer sex.
Ø Young people especially girls are at greater risk of being prone to rape and other form of abuse like forced marriage to grown up men, widow inheritance where by most of these men are already infected.
Ø Youths from rural areas are predominately illiterates; they have little or no idea on safer sex control methods. Also their parents find it difficult to counsel and guide their children. Young people from rural areas usually engage in early sex hence an increase in infection rate especially in rural areas.
Ø Girls and boys engage in use of drugs where by there is use of NON-sterilized materials like injections by many youths hence bringing the spread of HIV with in that community.
Ø Young boys and girls who engage in early relationships which results in early sex practices tend to have more casual partners for sex, hence leading to increase in infection rates, this is the same with gay and lesbian youths.
Ø There is also peer pressure among the adolescents and youths where by they tend to copy risky behaviors such as girl/boy relationship which leads to early sex.
Ø Young people and youth experience a secondary growth spur and development of sexual characteristics. These development coupled with the culture perceptions of being “grown ups” tempts adolescents to experiment with sex which increases their exposure to HIV.
How are these issues connected to human rights?
Young people at risk of HIV infection or already infected may choose not to access health care, prevention and education services for fear of being stigmatized by health care and service providers because they are illiterate about their rights especially youths from rural areas. This is also seen in gay youths because they can’t disclose out their sexuality in order to get proper treatment and prevention measures because being gay is illegal in Uganda.
To young men and women, HIV/AIDS-related stigmatization and discrimination threaten them to attend HIV prevention and care programs. They create a climate that negatively impacts on effective prevention by discouraging individuals from coming forward for testing, and from seeking information on how to protect themselves and others, thus deepening the adverse impact of living with HIV/AIDS and continuous engagement in un-protected sexual intercourse with many partners.
What are some issues that affect access to HIV treatment, care and support among people from this group?
Young men and women have a belief that HIV prevention programs’ and resources available in their communities/areas, are not aligned with the HIV prevention needs they want. In rural communities, health care access is very poor, there is marked variation in access both with in and between districts.
Young people face a lot of discrimination and stigmatization in their communities and from some places where they hope to receive treatment and care. HIV positive youths are normally blamed why they did engage in early sex (adult acts) so this pushes them away from visiting healthy centre for treatment and care.
Criminalization and stigmatization of certain sexual practices like commercial sex work in young girls and boys can contribute to the person’s vulnerability to HIV and their inability to access services and information regarding HIV/AIDS.
Many young people in developing countries luck financial support to access HIV treatment and care because some centers tend to charge for services hence making them un able to access service because they don’t have funds and pay jobs. Reports show that it’s higher in young people in rural areas and un-employed youths in developing countries.
How are these issues connected to human rights?
Ø Several countries have policies that interfere with the accessibility and effectiveness of HIV related measures for prevention and care. Examples include laws criminalizing consensual sex between men.
Ø There is no development of international rights framework which ensures that human rights are interpreted by all relevant international institutions to embrace the needs and concerns of young people and HIV/AIDS.
Ø The allocation of resources to rights education programmes in rural areas is not invested in by governments. Reports show that educating the rural and urban poor on sexual issues often requires expensive and time-consuming face-to-face methods.
Ø Facilitation of access to affordable drugs is not available to young people and youths and there is no equal access to treatments service and care to young individuals in developing countries especially to young people in rural and poor urban settlers.
Ø Establishment of rules for protection and regulation of home based care, and care to young people in schools is not programmed for. This can be a very easy way for young people to access treatment and care services freely.
Monday, March 15, 2010
THE HIV/AIDS EPIDEMIC IN UGANDA
Uganda has been one of the countries hardest hit by the AIDS epidemic over the past 25 years. From only two known HIV/AIDS cases in 1982, the epidemic grew to reach a cumulative two million infections by the end of 2000, and it’s estimated that these, around half of them have since died.
It has been estimated that HIV/AIDS has had a direct impact on at least one in every ten house holds in the country, including the 884,000 HIV/AIDS orphans (UNAIDS, 200). The Uganda AIDS commission (UCA, 2001) gives similar, but slightly different figures, with a cumulative total of 2.2 million people infected with HIV since its onset, of which about 800,000 people are estimated to have died of AIDS, about 1.4 million people were then estimated to be living with HIV/AIDS, of whom 100,000 were children under 15 years. The UAC gave much higher figures of over 1.7 million children orphaned by AIDS. The risk of mother to child transmission of HIV (MTCT) was estimated at 15-25% (UCA, 2004)
HIV EFFECTS TO GIRLS/WOMEN AND BOYS/MEN IN UGANDA
Both genders are affected by HIV/AIDS at the house hold level where social- economic factors combine with socio- cultural and factors variables to influence prevalence. It’s the house unit that carries the greatest burden of poverty, inequality which interacts with the epidemic at the house hold level to continue a dangerous down ward cycle towards greater indigence.
The epidemic deepens poverty among the already poor through loss of income and medical care costs, which absorb up to one third of house hold income.
Children schooling is disrupted especially among girls because they are sent to take care of the affected HIV positive relatives. On addition to this, it also brings a strain of growing extended family network as households often send their children to live else where most often with relatives.
The epidemic brings a spirit of borrowing and selling of house hold assets for treatment of the positive family individuals and all house hold savings and income, becomes the most important sources for covering treatment costs,
The epidemic also affects intergenerational transmission of knowledge and it imposes a greater burden on the elderly while reducing their economic security which could look after their children to become economically productive adults.
The epidemic more so affects the married partners in cases where one partner is found positive and another negative (discondent situations ) , hence bringing up miss understandings, break ups, violent attacks to the affected individual especially if a woman is found negative.
HIV epidemic is the leading cause of mental disturbances and madness to the affected positive individuals because they think of dieing any time, think about how they will live their children, wives/husbands and other relatives.
On business side, HIV epidemic reduce on labor productivity and increased absenteeism because positive individuals my some time get on and off sickness which hinders them from coming to work for some days.
On the side of education, positive students tend to decline in their performance at schools because of much worries and little concentration on school programs.
The epidemic also cause an increased number of people getting infected every day because HIV positive individuals gain hearts of no mercy and they start spreading to others with a say “I DON’T DIE ALONE”
It has been estimated that HIV/AIDS has had a direct impact on at least one in every ten house holds in the country, including the 884,000 HIV/AIDS orphans (UNAIDS, 200). The Uganda AIDS commission (UCA, 2001) gives similar, but slightly different figures, with a cumulative total of 2.2 million people infected with HIV since its onset, of which about 800,000 people are estimated to have died of AIDS, about 1.4 million people were then estimated to be living with HIV/AIDS, of whom 100,000 were children under 15 years. The UAC gave much higher figures of over 1.7 million children orphaned by AIDS. The risk of mother to child transmission of HIV (MTCT) was estimated at 15-25% (UCA, 2004)
HIV EFFECTS TO GIRLS/WOMEN AND BOYS/MEN IN UGANDA
Both genders are affected by HIV/AIDS at the house hold level where social- economic factors combine with socio- cultural and factors variables to influence prevalence. It’s the house unit that carries the greatest burden of poverty, inequality which interacts with the epidemic at the house hold level to continue a dangerous down ward cycle towards greater indigence.
The epidemic deepens poverty among the already poor through loss of income and medical care costs, which absorb up to one third of house hold income.
Children schooling is disrupted especially among girls because they are sent to take care of the affected HIV positive relatives. On addition to this, it also brings a strain of growing extended family network as households often send their children to live else where most often with relatives.
The epidemic brings a spirit of borrowing and selling of house hold assets for treatment of the positive family individuals and all house hold savings and income, becomes the most important sources for covering treatment costs,
The epidemic also affects intergenerational transmission of knowledge and it imposes a greater burden on the elderly while reducing their economic security which could look after their children to become economically productive adults.
The epidemic more so affects the married partners in cases where one partner is found positive and another negative (discondent situations ) , hence bringing up miss understandings, break ups, violent attacks to the affected individual especially if a woman is found negative.
HIV epidemic is the leading cause of mental disturbances and madness to the affected positive individuals because they think of dieing any time, think about how they will live their children, wives/husbands and other relatives.
On business side, HIV epidemic reduce on labor productivity and increased absenteeism because positive individuals my some time get on and off sickness which hinders them from coming to work for some days.
On the side of education, positive students tend to decline in their performance at schools because of much worries and little concentration on school programs.
The epidemic also cause an increased number of people getting infected every day because HIV positive individuals gain hearts of no mercy and they start spreading to others with a say “I DON’T DIE ALONE”
Thursday, March 11, 2010
Uganda men who have sex with men(MSM) "A Bridge group for HIV Transmission"
The number of newly-diagnosed AIDS cases among homosexual men in Uganda is continuing to increase. While substantial amounts of data have been gathered on HIV related behaviours and infection rates in “straight” by different researchers and NGOs, less is known about “rates and practices” especially among homosexual teenagers and young adults. There are a considerable number of youths and adults who continue to engage in unprotected anal and virginal receptive intercourse with different partners every month.
Unprotected anal and Virginal sex is the highest risk behaviour for HIV transmission among gay youths and adults. In many societies of Uganda, MSM also have sex with women. Bisexual men represent an important “bridge” group between a sub-population at high risk for infection and the general population at lower risk for infection. Investigation of sexual risk behaviour of MSM is of great importance in order to prevent HIV transmission increase in Uganda.
Approximately 7% of the younger men in schools and 18% of the men over 22 years of age are already infected with HIV. There for aggressive HIV risk reduction programs to homosexuals are needed in schools and existing networks in the gay community.
MSM in Uganda fear to be identified so they end up also having sex with women to hide their sexuality to society and community members. Through the process of cross sexual intercourse with men and women, HIV infection between sub-population and general population is taking place because there is no use of condoms to all partners. Gay youth who engage in anal sexual intercourse tend not to use condoms since they are not well sensitized on how to use condoms in anal sex and gay health information. So transmission of HIV is bridged between people practicing anal and virginal sex.
Conclusion: A large part of MSM in Uganda have sex both with male and female partners thus promoting the risk of HIV bridging between men who have sex with men (MSM) and the general Population.
How infections can be prevented?
Unprotected anal and Virginal sex is the highest risk behaviour for HIV transmission among gay youths and adults. In many societies of Uganda, MSM also have sex with women. Bisexual men represent an important “bridge” group between a sub-population at high risk for infection and the general population at lower risk for infection. Investigation of sexual risk behaviour of MSM is of great importance in order to prevent HIV transmission increase in Uganda.
Approximately 7% of the younger men in schools and 18% of the men over 22 years of age are already infected with HIV. There for aggressive HIV risk reduction programs to homosexuals are needed in schools and existing networks in the gay community.
MSM in Uganda fear to be identified so they end up also having sex with women to hide their sexuality to society and community members. Through the process of cross sexual intercourse with men and women, HIV infection between sub-population and general population is taking place because there is no use of condoms to all partners. Gay youth who engage in anal sexual intercourse tend not to use condoms since they are not well sensitized on how to use condoms in anal sex and gay health information. So transmission of HIV is bridged between people practicing anal and virginal sex.
Conclusion: A large part of MSM in Uganda have sex both with male and female partners thus promoting the risk of HIV bridging between men who have sex with men (MSM) and the general Population.
How infections can be prevented?
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