Taxi drivers, fisher folk, young people out of school and sex workers are among the most at risk of HIV and Mildmay Uganda is tackling the issue with a three-year project.
Few bicycle and motorcycle taxi drivers, known as ‘boda-boda’, use condoms according to a recent study into the behaviour of those most at risk of HIV in five Ugandan communities.
The study, published in May by HIV care and treatment charity Mildmay Uganda, reveals that 67 per cent of boda-boda riders did not use a condom in their last sexual encounter. This was followed by fisher folk (63 per cent), young people out of school (42 per cent) and sex workers (31 per cent).
Sixty per cent of the fisher folk had more than three sexual partners while 20 per cent had had more than seven in the last six months.
Mobilising prevention, care and treatment
Mildmay Uganda executive director Dr Barbara Mukasa says the purpose of the study was to help reduce new HIV infections among those most at risk by mobilising HIV prevention, care, treatment and referral services. It is part of Mildmay’s three-year project for populations most at risk in five sub counties of Wakiso District: Bussi, Wakiso Town Council, Makindye Sabagabo, Nangabo and Nansana Town Council.
The study was based on a representative sample of 240 respondents (60 sex workers, 60 boda-boda riders, 60 fisher folk and 60 young people out of school).
As well as providing an insight into the behaviour of people in these groups, it found that there is lack of comprehensive counselling skills at antenatal care, inadequate public education about HIV and AIDS and confusing messages from health authorities and non-governmental organisations.
“As a country we have more male condoms but at the same time there is low involvement of men. Who is using those condoms? Does that explain why we have high infections?” Mukasa asked. “We need to have female condoms and teach women how to use them.”
Promoting safer sex
Mildmay Uganda’s project aims to increase risk perception and adoption of safer sexual behaviours and practices among 40,150 people in the five sub counties by March 2016. It is funded by the Civil Society Fund.
In most Ugandan communities, stigma remains strong and people are reluctant to disclose (or even learn) their HIV status. In a focus group set up by Mildmay in Wakiso Town, couples discussed issues such as trust in a sero-discordant relationships (where one partner is HIV positive and the other is HIV negative).
“At first, I thought it was impossible to trust others, including my husband,” said one woman. Sitting close by, Saïd Mayanja nodded his head in understanding. He and his wife, Zaituni, found that mistrust was an enormous contributor to in‐home aggression and the biggest obstacle to couples being able to confront jointly their sero‐status.
Through this project, and several others in the country, Mildmay hopes to increase demand for HIV prevention and care services. It also aims to strengthen district and community level co-ordination for the delivery of comprehensive HIV prevention and care in the targeted communities.
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