HIV/AIDS in Uganda

Last week I gave an HIV/AIDS Education Workshop at the primary school for the staff. It was something they had requested as they felt the need to educate their pupils more in this area. In fact, it’s actually an area I needed more education about before Peace Corps too. I watched Philadelphia in school, I knew some of the history of it in the U.S. (mostly thanks to Rent), I knew that HIV/AIDS was "bad in Africa" (and that’s probably one of the world’s most general statements ever), but I didn’t know much more than that. It seemed like a far-off, ancient problem - in my fairly sheltered American life, I had never even met anyone who had HIV or AIDS. Coming to Uganda, that all changed. Peace Corps provided me with the most thorough education on this subject that I had ever received, an education that seemed much more relevant and needed as I began to get to know more co-workers, students, and friends for whom HIV/AIDS had intimately, awfully, impacted their lives.

Uganda actually was considered a success story in sub-Saharan Africa when it came to HIV/AIDS, reducing the rate from up to 30% in the 1990s to 6.4% in 2006. Much of this has been credited to an extensive education program in the 90’s using the ABC approach: Abstinence, Be Faithful, Use Condoms. However, HIV prevalence has been on the rise again since 2006. Approximately one in 10 women now become HIV positive by their late 30s and for men, about one in 10 are infected by their early 40s. This is in part due to the government’s shift, somewhat under pressure from foreign countries like the U.S., towards abstinence-only programs during the 2000’s. Some health experts also blame the increasing rate of infection on “AIDS-fatigue,” a general complacency and reduction in safe sex that began once Uganda started to be lauded as a victor in the battle against HIV/AIDS.

Right now, 1.4 million people in Uganda are living with HIV, and, despite the nation’s early success in combating HIV/AIDS, there are 1.1 million children that have been orphaned by this epidemic. Many of my own pupils are part of this statistic. They live with extended family, adults who find it difficult to pay for their own children’s school fees, uniforms, and meals, not to mention doing the same for other young relatives, but nevertheless take them in.

Working to educate youth about HIV/AIDS is extremely important in Uganda, not only because HIV/AIDS is more prevalent here, but also because the median age is 15 (15!). With so many youth and so few adults, accurate facts and means of prevention can slip through the cracks and be replaced by rumors and misconceptions. HIV/AIDS and sex education are clearly urgently needed right now; only 39 percent of young people aged 15 to 24 know all the necessary facts about how HIV can be prevented. National prevention and treatment efforts also need to be supported, requiring a de-stigmatization of those living with HIV. Stigma and discrimination against people with HIV is still common in many rural areas, so even those who know their or their children’s positive status are reluctant to seek help for fear of “outing” themselves or their family members. The passage of the HIV and AIDS Prevention and Control Act in Uganda, which sanctions forced disclosure and criminalizes transmission, attempted transmission, and “behavior that might result in transmission,” is only continuing to add to this problem.

In Peace Corps, and at my school, Ugandans and PCVs are continuing the fight from the ground up, working with people who can help affect some of the most change: teachers. In fact, a quarter of the people who are living with HIV in Uganda right now are a part of the school system - students or staff. At the workshop last week, we refreshed the basics, talked about incorporating literacy into HIV/AIDS education, discussed how gender roles can affect the spread of HIV/AIDs, detailed how to care for people with HIV, and played a lot of games and activities that the teachers can do with their pupils. During the games and activities, such as Jeopardy, foot races, Big Books, and play-acting, we also did some myth-busting. And man, are there some wildly inaccurate myths out there (and probably in the States too, unfortunately): condoms cause cancer; virgins can’t have HIV; having sex with a virgin will cure you; when an HIV+ mother breastfeeds, the baby dies; HIV can be transmitted by mosquitoes; washing out with Coca-Cola after sex will prevent you from being infected; HIV can be passed by kissing; America has a secret cure for HIV/AIDS; America invented HIV/AIDS (oh, conspiracy theories!). 

The teachers got extremely competitive during the final Jeopardy review!

One of the pre-assessments, where the average score was 70; everyone scored 100 or 95 on the post-assessments.

Doing a "Can Transmit" and "Cannot Transmit" activities sort - it's not every day that you get to explain to your coworkers the definition of pre-ejaculate in English...

Overall, I like to think the workshop was a success – the pre- and post-assessments on HIV/AIDS I gave out showed drastic improvement, and the teachers were excited (and very competitive!) while practicing a variety of ways to educate their pupils on HIV prevention, treatment, and care. I’m looking forward to seeing the teachers use their new skills to give the kids an opportunity to play and learn at the same time. It is just a start, and a small one at that, but it's one I was proud to be asked to be a part of.

There is a saying in Tibetan, "Tragedy should be utilized as a source of strength." No matter what sort of difficulties, how painful experience is, if we lose our hope, that's our real disaster.

- Dalai Lama