HIV Rate Rises In Uganda After AIDS Prevention Strategies Shifted Focus Abstinence-Only Policies

Think Progress | by Amanda Peterson Beadle | August 3rd, 2012

Widowed by AIDS in Uganda

Uganda had seen a sharp decrease in the nation’s AIDS rate, but after its decline in the 1990s inspired public health strategies to fight HIV infections, a new study shows that Uganda and Chad are the only two African nations where the number of AIDS cases is rising.

The HIV infection rate in Uganda grew from 6.4 percent in 2005 to 7.3 percent in 2012. But at roughly the same time, the United States spent about $1.7 billion to fight AIDS in Uganda through the President’s Emergency Plan for AIDS Relief (PEPFAR), which teamed up with faith-based groups in 2003 and emphasized abstinence. Instead of continuing Uganda’s decreasing number of HIV infections, the survey shows that the public health campaigns, including the PEPFAR-sponsored “Get Off the Sexual Network” message,may have backfired:

On one hand, 90 percent of Ugandans today acknowledge sexual fidelity in a relationship as a health imperative, according to the survey results; on the other hand, roughly 25 percent of married men said they had multiple sexual partners.

The survey found that 75 percent of Ugandans were knowledgeable about condoms in sexual health but that fewer than 8 percent of married men who were having sex outside their marriage were using condoms.

Uganda’s hard-line approach toward homosexuality, which is outlawed here, also fuels the spread of AIDS, experts say. One report indicated that one-third of the male respondents who had sex with other men said they had previously been married to women and fathered children. Fewer than half use condoms.

Pepfar’s founding policies barred partnering with organizations that did not condemn prostitution, and called for 33 percent of financing to be spent on abstinence and fidelity programs.

“If you have an environment that stigmatizes them, then don’t expect people to use condoms,” said Canon Gideon Byamugisha, a religious leader and AIDS activist in Uganda. Byamugisha told the New York Times that the country has “confusing” messages in its fight against HIV/AIDS.

When Congress reauthorized PEPFAR in 2008, the program dropped a directive topromote abstinence until marriage; however, it still emphasizes abstinence and fidelity. In his 2013 budget, President Obama requested $6.4 billion for PEPFAR.

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