Integrated Regional Information Networks - September 15, 2009

According to a baseline survey on HIV/AIDS carried out by the Uganda Network for Law Ethics and HIV/AIDS (UGANET) in five districts, awareness of condoms is almost universal and 80 percent of people report that condoms are affordable and accessible; however, most people only use them in new or risky sexual relationships. In all, about 600 men and women between the ages of 20 and 39 were interviewed.

Twenty percent of people interviewed said they always used a condom with a new sexual partner; another 25 percent said they only used one when they had sex with people they did not trust. Although 60 percent of people have used a condom in the past, 28 percent of sexually active people said they seldom used one.

"I think the problem is persistent use; people know how to use them correctly but using them the third and fourth time becomes difficult," said Sam Ocen, the national coordinator of Uganda Young Positives.

"With time, we gain trust with partners and stop using them," said Nelson Amuite, a banker in the capital, Kampala. "It is usually once or twice when I have a new partner."

Women who had continued their education beyond high school were more likely to use condoms, but the survey found that in general, women who buy condoms are considered to be sexually promiscuous.

Most people, the survey found, did not regard condoms as acceptable within marriage or other stable sexual relationships. Experts say this attitude is especially dangerous, as recent research shows that older people in stable relationships are now most likely to become infected with the virus.

"There is [a] need to popularize condoms and design strategies that directly address negative perceptions that are held about condom use, especially given the central role they play in prevention of HIV," said Beatrice Were, the executive director UGANET.

A 2007 Ministry of Health study on health service provision in Uganda found that although condoms were available in nine out of ten facilities offering HIV and sexually transmitted infection (STI) services, they were discussed in only half of STI consultations and offered to just 22 percent of clients.

Uganda has long relied on the Abstinence, Be faithful and use a Condom, or "ABC" HIV prevention model, which has been credited with lowering the country's HIV prevalence from over 20 percent in the 1980s to a low of 6 percent in 2000.

In response to a recent upswing in HIV prevalence, the Uganda AIDS Commission has announced its intention to craft a new national prevention strategy to target the most at risk populations; one of the first such campaigns aims to encourage married people to remain faithful to their spouses.

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