Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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New Vision (Kampala) - October 28, 2002
Joan Mugenzi
According to estimates from UNAIDS/WHO based on surveillance data for pregnant women, Uganda's HIV prevalence declined in major urban areas from about 30% in 1990 to 14% in the late 1990s, and in non-urban areas from 13% in 1992 to about 8% in the late 1990s.
"Uganda's successful reduction of HIV prevalence rates during the 1990s resulted from progress on all three fronts of its behavioural-change; prevention strategy of delaying sexual initiation among young people, reducing the number of sexual partners and promoting condom use among people who are sexually active," the AGI analysis reveals.
AGI's Director of Government Affairs, Susan Cohen, draws on the new analysis to illustrate that an integrated approach, which is being adopted by countries worldwide, shows the most promise for slowing the spread of HIV.
To better understand the cause of the decline in Uganda, AGI analysed data from nationally representative Demographic and Health surveys in 1988 (of reproductive age women) and 1995 and 2000 (of women and men) in Uganda to identify changes in sexual activity, multiple sexual partnerships and condom use.
According to AGI's research, condom use among unmarried women rose from negligible levels in 1988 to 24% in 2000. Condom use also rose sharply among unmarried men, from 39% in 1995 to 57% in 2000.
Reduction in the number of sexual partners also contributed to reducing exposure to HIV risk.
The proportion of unmarried sexually active women who said they had more than one sexual partner within the past year declined from 10% to 4% between 1995 and 2000. Among unmarried men, the proportion remained steady at about 25%.
In 2000, fewer adolescents (especially young women) reported ever having had sex than in the prior survey years, indicating that delayed sexual activity was a moderately important contributing factor in reducing HIV infections. However, among those who were sexually experienced, there was no increase in abstinence.
Research findings in Uganda are not any different from AGI's.
According to the recently launched HIV/AIDS surveillance report-June 2002, a survey on STD/HIV/AIDS behavioural surveillance carried out in Kampala, Jinja and Lira revealed that people had embraced behavioural-change practices.
When the respondents in these areas were asked to cite the specific preventive practices against HIV/AIDS, 69% of women and 83% of men cited condom use while 84% of women and 91% of men cited limiting the number of sexual partners.
Cohen says that the Ugandan government's programme has been comprehensive, encouraging abstinence, but also providing information about and support for condom use among those who are sexually active.
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