HIV infections are on the rise once again
in Uganda. Anne Awori-Osinde gives some insight into why
this is happening
Amid
all the shouting, singing and celebrating around the slogan: Stop Aids, Keep
the Promise, the rate of HIV infections in Uganda is steadily climbing again,
mostly in grassroots communities and especially among women.
In the early days of Uganda’s epidemic, condom use was good. But now
condom use has dropped off while the national supply has rapidly dwindled.
PN has covered the reasons behind the national condom shortage in a previous
edition (PN129). What I wanted to know was why men and women were shunning
condoms.
Ugandan men have been, and are still, controllers of sex. This means women
must always wait till the men are in the mood and ready to have sex. In rural
communities women are still their husbands’ slaves.
Traditionally and culturally, in the family, men hold the power and this situation
is proving resilient to change. Normally it is a taboo for a woman to say
“I want sex” or to show any sign of interest in it. But a man
is allowed to demand sex at any time, day or night.
In the same tradition, women can never say no to a man’s demands. That
is what she is told by her relatives when she is prepared for marriage. Even
today it is a man’s choice whether to use a condom, never a woman’s.
A man can have as many women as he can afford to keep but a woman is to have
only one man.
Here at the Grassroots Women’s Development Organisation (GWODEO) in
Jinja we decided to ask people in our local communities why they didn’t
use condoms.
This is what they told us:
Women said:
“We do not use condoms because my husband says condoms are for those
who are not married and prostitutes. He also said that if I insist he will
leave me and go to other women or if I don’t trust him I should pack
my things and go back to my parents.”
“He told me that he no longer needed his first wife; that they had divorced.
I was convinced and married him. After I delivered a baby he started to sleep
out or come back very late. A friend told me he had reinstated his relationship
with his first wife who had been going with drug users. I was shocked, so
I went to my parents to seek advice but they told me that it was too late.
They blamed me for getting married to a man who had another wife. I returned
to my husband but I am not happy. If I tell my husband to use a condom, he
just quarrels. If I try to abstain, he beats me. So I have nothing to do but
to wait for death. I am fearful because the man who befriended my co-wife
is HIV positive, a drug user and they have become involved in drug trafficking.”
“I didn’t know his first wife had died of Aids; but when I was
told, I confronted him. That was the beginning of my bad days.
When I suggested I got a medical test he said that would be the end of our
marriage. One day, while he was in Nairobi, I went to be tested and I was
found positive with a very low CD4 count. There is no way I can tell him I
am positive so I have to get secret treatment.”
“I asked my cousin why she was unfaithful to her husband she said: ‘My
husband has two more wives and I am the third, how can I be sure that the
two are faithful? I do not want to be killed innocently’.”
Another unfaithful wife said: “I have five children who are supposed
to go to school, eat well and be dressed. My husband has been jobless for
over five years now. What do you expect me to do if there is someone who is
willing to cater for those in exchange for sex?”
A young widow complained: “My current husband blames me for infecting
him with HIV. I lost my first husband in 2002; he left me with three children,
a house and enough property to sustain us. I was prepared to bring up my children
without another man.
“However, my in-laws gave me an ultimatum: either re-marry one of my
brothers-in-law or leave my children and vacate the home. I had no choice
but accept and stay in the home. We have had two children. Recently my new
husband fell very sick and on testing he was found positive. Why am I to blame
when they did not want to listen to me?”
Men
said:
“We use condoms with new partners. Then after having sex more than once,
women always agree to have unprotected sex. It is not always easy to use a
condom in case of a stolen sexual relationship, such as hurried sexual intercourse.
Another case is a rape. Here you have no time to put on condom.”
Another man who is HIV positive said he did not use condom because he wanted
to get a baby. He also said he did not want to have sex with positive women
because he was not sure if a positive man and positive woman could have a
negative baby. So he did not want to waste his time and did not want to get
“more HIV”.
“I have lived with HIV for more than ten years now. I have lost two
wives, but I don’t want my current wife to know my status.”
“We go for young girls. We fear older women because most of them are
HIV positive, expensive and very demanding. Young girls are always available,
safe, cheap and less demanding.”
Young people said:
“We use condoms when girls tell us that they are not in their safe days,
for fear of impregnating them. Most guys no longer fear HIV since we can live
with it. We only fear to become parents at an early age and harassment by
the girls’ parents.”
“I want to abstain but I have to live like other girls. I need education,
feeding and clothing which my parents can’t afford. I have no alternative.
I have heard about ABC but that is only for the daughters of the rich people.
I sometimes offer to do a piece of work for rich men, but they always refuse
and prefer sex.”
Reading these comments it is hard to see how HIV can be eliminated
from these communities. People’s common experiences are the driving
forces behind the spread of HIV: poverty, cultural and traditional norms,
illiteracy and ignorance.
Many rural Ugandan families live below the poverty line; even the smallest
income means survival. Girls are forced into sex at an early age in order
to contribute to their family income, and school fees. Unmarried men defile
young girls and children because they cannot afford expensive sex workers.
Young men are forced to cohabit with widows to benefit from their dead relatives’
properties. All these are done because they need to survive.
In communities where cultural traditions are strictly observed domestic violence
and promiscuity are commonplace. In many rural homes polygamy is seen as a
symbol of a man’s status. This coupled with poverty means there is never
enough to go around in the family, leading to conflicts, mistrust and extra-marital
relationships.
Where illiteracy is high and the flow of information hampered by bad roads
and poverty, government prevention messages fail to reach many. This creates
a gap between the urban and the rural communities. Condoms given out in rural
areas go to people not sensitised to the messages and often end up being used
by children as balloons.
Some religious sects make matter worse by preaching that HIV can be cured
through prayers. Their followers then go back to their communities and spread
HIV. ARVs have even made some believe that the Aids epidemic is over. Sadly,
of course, it is not.
To enable people in rural communities to deter the spread of the epidemic
all those concerned must observe unity, co-operation, consideration and understanding.
• Anne Awori-Osinde is a founder of Grassroots Women’s Development
Organisation (GWODEO), a self-help and empowerment group that works in rural
communities affected by HIV and poverty
