26 November 2012

Uganda: Batooro Lead in HIV Prevalence

Photo: Patrick Jaramogi/New Vision
Florence Nansubuga, 43, and Nakku Florence, 45, have been living with HIV for 17 years.

Of all the ethnic groups in Uganda, the Batooro have the highest HIV prevalence rate. According to the latest Uganda AIDS indicator survey, 13% of the Batooro sampled had HIV, compared with the national average of 7.4%.

The Banyankore, Acholi, the Bakiga and the Baganda all had a prevalence of 9%. Those with the lowest prevalence were the Karimojong at 3%, Lugbara and Madi at 4%.

All the other tribes including Iteso, Langi, Basoga, Bagisu, Sabiny, Japadhola, Banyoro, Alur have their infection rates ranging between 6% and 7%.

The survey was conducted by the health ministry and development partners in 2011. It was conducted on a nationally representative sample of 12,153 women and 9,588 men aged 15-59, as well as about 10,000 children between zero to four years. The survey involved individual interviews and blood sample analysis.

Overall, the HIV prevalence among Ugandan adults has risen from 6.4% in 2004/05 to 7.3% in 2011/12. The report estimates that 130,000 people become infected with HIV annually.

While the survey does not give reasons why some tribes have higher prevalence than others, there are indications that culture might play a role.

Growing up in Fort Portal, Dr. Kihumuro Apuuli, the director general of the Uganda AIDS Commission (UAC), knew about the traditional phrase 'omusaija tayangwa', which implies that a woman should not say no to a man's sexual advances. This, he says, might be partly responsible for the high prevalence of HIV in the area.

Today, he says, the prevalence is being compounded by commercial sex workers who are flooding the region because of oil exploration.

"If you want to know how bad it is, go to Hoima and Fort Portal at night. It is crazy. Everyone is coming here, because they think this is where the money is," says Apuuli.

He added that many tribes have the traditional practice of having multiple women, which encourages the spread of HIV.

"The problem with African men is that they think the more women the more prestige, which is wrong and worrying," says Apuuli.

According to the UAC chairman, Prof Vinand Nantulya, the number one enemy for every adult Ugandan is a 'side dish' or multiple partner relationships. He says close to 90% of new infections in adult's occurred in those who engage in multiple sex relations.

"You here statements like 'why worry. HIV/AIDS is not cancer. You just live with it like blood pressure. But clearly this is only denial of the truth," stresses Nantulya.

On Karamojong, Apuuli says the infection rates have been relatively low because of the difficult conditions in the region. However, he notes that with the infrastructure development in the region, the infection rates are going up.

"People are beginning to go there, and the population is getting exposed," says Apuuli.

Nantulya urges adults to take HIV tests so they can know their status. "If you test negative you should continue to lead a lifestyle of self-restraint. Avoid relationships

with people whose status you do not know. Ensure that when tempted to engage in sex, use a condom. But remember that condom use is not foolproof," says Nantulya.

Christine Ondoa, the health minister, says the results demonstrate indisputably that HIV infection remains a significant health problem for Uganda.

"For this reason, the report should serve as a call to action for all stakeholders. Let's use it as a resource to inform the process of planning and policy formulation as well as the monitoring and evaluation of HIV and AIDS programmes," Ondoa says.

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