Condoms are supplied free in many places around the world, but a limited supply at fishing sites in Uganda, is fuelling the spread of HIV in fishing communities.
The lack of free condoms means some fishermen do without them, while others re-use them.
With high rates of alcoholism and paid sex in fishing communities, such as in Buikwe district, these unsafe sexual practices are greatly hindering government efforts to curb the spread of HIV.
Low condom use
According to John Musisi, 38, a fisherman at Nalumuli fishing site, alcoholism leads to risky behavior.
“Since paid sex is easily accessible and condoms are in short supply and expensive, at times I opt not to use them,” he explains.
Senyonjo Mugalu Kizito, a fisherman at Kigungo fishing site, says that St Francis Hospital in Nkokonjeru and the government health center 3 in Buikwe district, where free government condoms are available are far away and the supply is short. “Condoms are available at the local drug shops and clinics, but priced highly. A pack of three which should cost 500 Ugandan shillings goes for double the price – equivalent of almost half a dollar,” Kizito says.
According to Yowakimu Kaana, chairman of Buweera Beach Management Unit, the government should introduce a schedule for free condom distribution.
High HIV rates among fishermen.
A 2013 IOM report estimates that HIV infection rates among fishing communities in six districts in Uganda are almost 3-4 times higher than the national average.
The population size is approximately 130,000 and the majority of fishermen are not aware of the risks of HIV, the report says. High HIV prevalence rates in these communities are the result of a complex interplay of factors including vulnerabilities such as high mobility and failure of HIV prevention programmes to address their knowledge, attitudes and practices.
Betty Mirembe, the proprietor of a private clinic at Kigungo landing site, said: “Many of these fishermen do not use condoms due to their scarcity.” She added that she sells a pack at 1,000 Uganda shillings due to the high transport costs involved.
Partnerships crucial to ensure services
“Government should partner with local NGOs to distribute condoms among people especially in remote areas,” suggests Joseph Mwavvu a volunteer with local NGO African Social Development and Health Initiatives. Fishermen cannot easily access free condoms at the hospital and health centre due to the high transport costs, he admits.
According to Buikwe district chairman Mathias Kigongoa, a new partnership with NGO Uganda Health Management Group will help distribute condoms to fishermen within the district at a low price. Under the partnership, fishermen are to be informed more about the effectiveness of condoms.
Also, Dr Asuman Lukwago a permanent secretary in the Ministry of Health says that the government has partnered with the US government to address high HIV rates among the most at risk populations in the country, such as fishermen.
According to Dr Lukwago, this will involve reminding fishermen about the effectiveness of condom use and condoms will be distributed to them. Dr Lukwago also plans to work with Uganda Aids Control Programme to draw up strategies for how fishermen can best be helped.
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