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Married People are Key to HIV prevention Strategies

Uganda is internationally praised for controlling and managing the HIV/AIDS pandemic. However, recent studies indicate that new infections now occur among marrieds, who exhibit ignorance of the way the virus is transmitted. Care providers and policy makers are concerned about this new trend and argue that solutions must be found urgently.

In its effort to address the issue, Uganda compiles two-yearly national HIV progress reports, which it presents to the United Nations General Assembly.

The latest report submitted in January 2008, shows that most new infections are among people aged between 30-34 years and 40-45 years.

Another report released in July by UNAIDS, the UN agency for AIDS, indicates that married couples aged 30 and above have a higher risk of contracting HIV/AIDS than singles. For a long time, sexual and mother-to-child transmission had been the highest sources of new infection.

Other challenges in the fight against HIV/AIDS have been raised by health workers who say testing and treatment of couples in Uganda is still low.

Usually, couples test and receive HIV treatment separately for fear of judgment by either party. Some only test once before marriage. Pregnant women who test HIV-positive find it difficult to disclose their status to their partners.

These factors teach us great lessons. We should continue emphasising that the main form of HIV transmission is sexual in all prevention efforts.

Additionally, there is urgent demand for strategies to address high HIV infection among marrieds. It is no longer viable to simply target the young people and advise them to get married to avoid HIV infection. In any case, extra-marital sexual relations are on the increase. Moreover, many married people think that the youth, especially those in school, are HIV-free. This leads to inter-generational sexual relationships, ignoring the possibility of getting infected by young people. We must also stop viewing domestic servants, especially those from villages, as safe. We cannot tell one’s HIV status by physical appearance or age.

There is also the need for all to test for and get HIV counselling. This reduces the risk of an individual becoming infected. The ones already infected can receive care and support and avoid transmitting the virus.

Unfortunately, although testing services have been available since 1988, a study in 2005 showed that only 15% of adults have tested for HIV. Moreover, about 80% infected adults are not aware of their status.

Couples ought to also test for HIV?regularly during marriage. This has many implications but adherence to all HIV care and support strategies demands the knowledge and active involvement of all partners in a sexual relationship.

As simpler approaches to HIV/AIDS prevention are applied, Uganda is faced with more challenging issues surrounding the disease. Groups like fathers’ and mothers’ unions, religious leaders, cultural and traditional leaders should create a platform to discuss AIDS issues among marrieds.

Men, who culturally are expected to take leadership in sexual relationships, should take the lead in initiating their partners to test for HIV.

There is also need for more supportive health systems that integrate reproductive health, family planning, male involvement and HIV/AIDS programmes. Otherwise we are simply prolonging the war on AIDS