Complacence is the leading cause of increasing HIV prevalence

 

Dr. Raymond Byaruhanga, the AIC director

LAST Sunday, the Aids Information Centre(AIC) celebrated 20 years of providing voluntary counselling and testing (VCT). Elvis Basudde talked to Dr.Raymond Byaruhanga, the executive director. Below are the excerpts.   AIC has provided VCT services in Uganda for 20 years, what have been your experiences? AIC like any other NGO, has equally scored success and met challenges. We started on a very high note in 1990 because many people were in need of services and financial resources were available and many donors had interest, so we took off comfortably. Over time, we expanded throughout the country despite the challenges since this meant more financial resources.

In 2001, the branch in Kampala bore five other branches around the country. We established three more branches in 2003 and our clientele has grown to more than two million people.

Our biggest challenge is the increasing number of people in need of services yet we are unable to reach them in their localities.

Despite that, we have been able to disseminate HIV prevention messages, reduce stigma and improve on disclosure in many parts of Uganda.We are happy we have been able to achieve much in that area.

 

Is it true HCT does not cause behaviour change?
HCT does change behaviour. We offer two types of HCT; the provider initiated, where the health worker provides information saying one needs to know his or her HIV status and the VCT which is client initiated.

This is where a client comes seeking to know his or her status.

By the time a client takes a decision to know his HIV status, it means he or she is seeking change. The biggest issue we discuss during HIV counselling is to identify the risk and manage it with the client. We discuss and advise the client on how to manage their life.

 

With all the measures and strategies put in place, why is HIV still a big problem in Uganda?
True, HIV/AIDS is still a big problem. However, we are also proud of the success we have achieved over the years. Uganda’s HIV prevalence rate was one of the highest at about 40%. AIC staged sensitisation campaigns on prevention and risk management, reducing the prevalence to 6%.

In the last decade, the prevalence has been stagnant and this is mainly attributed to complacence. People have realised HIV is not a killer disease. In addition, there is now low dissemination of HIV prevention messages.

HIV counselling and testing has not been put at the forefront for people to know their HIV status and change behaviour.

Much emphasis has been put on treatment, with less emphasis on prevention.
We know prevention is better than cure, the more you prevent the better.
Emphasising treatment alone without reinforcing prevention leads to stagnation and in some areas, escalating figures.

For example, there is an increase in HIV prevalence, especially in fishing communities and the army. This is mainly attributed to inadequate HIV prevention services.This does not necessarily mean we have done nothing in the last decade, it is because people have become complacent. That is why our theme for our celebrations stipulates the need to do more on prevention.

 

Do you offer HCT services to prisoners?
According to the studies we have undertaken, prisoners comprise the biggest percentage of HIV vulnerable populations in Uganda. Many prisoners go to jail when they are already HIV-positive.

The poor conditions in the prison exacerbate their health, developing into AIDS and that is why it appears like there are so many people with AIDS in prison compared to the outside population.

However, some prisoners come to prison when HIV-negative. They contract the virus in prison due to various risk factors they are subjected to. For example, they spend a long time without having sex, forcing men to have sex with fellow men

 

Which interventions do you have for the other high risk groups?
Other high risk groups include the Police, the army, commercial sex workers, fishing communities, truck drivers and married people.We hope to use knowledge as one of our most outstanding intervention. Equipping these people with knowledge on HIV prevention will make a breakthrough.

Knowledge of their HIV status is also important. We believe the moment you know your own status, you will get into care if positive and you will want to live negatively if found negative. We also provide them with prevention services like condoms.
We also bring them together into groups to discuss among themselves other interventions they can consider apart from condoms.

We have also started the medical male circumcision. It has been proven that medical male circumcision, used with other interventions, prevents HIV by 60%

 

It is said HIV is more prevalent in couples. How is AIC responding to this?

Couples are a new group at risk because we have lost our moral commitments by engaging in infidelity, commonly known as side dish. It is important that couples know their HIV status together. This will make them change their behaviour and to confide in each other.

 

What is your message to the public?
On behalf of the board of trustees of AIC and the staff, we would like to thank our patron, President Yoweri Museveni for the moral support, especially in every message he sends out to the people of Uganda on on HIV prevention.

I would also like to appreciate our partners, who have supported us financially and technically.Our clients and members of AIC, too, have also contributed to our activities, we appreciate their role.

We implore all people to realise that knowledge is power. Knowing your HIV status, as an individual and as a couple will enable you change your behaviour and certainly determine your destination.