By Malik Fahad and Davis Buyondo
Masaka-Region
Uganda, like other countries in Africa, is still struggling to achieve the global goal of ending HIV/AIDS by 2030. According to health scientists and activists, the country has remained off track due to the complacency of men and poor adherence to the available free services.
This is partially attributed to men’s inadequate involvement and responsiveness in the continuing HIV/AIDS awareness efforts intended to stop the disease.
The concern came up Thursday in a Media Science Café in Masaka city, organised by Health Journalists Network Uganda (HEJNU) under the theme ‘The role of men in the fight against HIV/AIDS in the country’.
Currently, Uganda has 1,400,000 People Living With HIV (PLHIV) of which 500000 are adult men, 840000 adult women and 88000 children. According to the Uganda Aids Commission (UAC) and USAID statistics 2021, the annual AIDS-related death stands at 17,000 people.
The key speakers emphasised the need to help the male youths and adult men understand their responsibility in eradicating HIV/AIDS in Uganda by the set timeframe.
Health scientists and activists argue that most of the available strategies are largely targeting women and children and little focus is put on men.
“We recommend bringing them on board due to their influence and power in their households, and communities,” says Dympnah Nagawa, a Senior Medical Clinical Officer who doubles as the Masaka District Quality Improvement Officer.
The rate at which HIV/AIDS is increasing is alarming yet the government and AIDS Non-Governmental Organisations (NGOs) have tried their best to offer free and accessible services.
At the moment, she noted, the HIV prevalence in Masaka has increased from 8.6% over the previous five years to 10.5% which is an obvious sign that the country is back-tracking from its protracted goals.
Despite having HIV/AIDS treatment and care services in all public health facilities, Nagawa says, the country is still slow-walking and currently at 89 percent of the second global HIV targets of 95-95-95.
The 95-95-95 UNAIDS ambitious targets are simply another pathway for ending HIV. This calls for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to start sustained antiretroviral therapy, and 95% of all people receiving antiretroviral therapy to have complete viral suppression by 2025.
Currently, Uganda has 82% of HIV-positive people on ART and 78% virally suppressed according to the UNAIDS.
Unlike women, according to Nagawa, men have poor medical-seeking behaviours that frequently obstruct health campaigns. She argues that males naturally have a tendency of putting their ego ahead of their health by assuming they can heal from any sickness on their own, which is inappropriate.
In addition, Nagawa noted the lack of awareness among men as one of the factors that have kept men far away from the HIV/AIDS fight among other diseases.
“It’s possible that men are less mindful of the health risks they encounter or are less familiar with the symptoms to watch out for. Having any sort of health issue might also reduce their likelihood of seeking medical attention,” she explains.
Another factor that may prevent men from seeking medical assistance from the available health facilities is the societal expectations where men are naturally perceived to be dominant in any situation.
“This is particularly true for problems with HIV/AIDS testing, Treatment, and mental health, where getting assistance could be viewed as a sign of weakness,” she adds.
Health officials have also reported that some HIV-positive individuals are reluctant to get treatment as well as unwilling to use condoms to prevent the virus from being spread.
A joint study by Masaka District and Babies And Mothers Alive (BAMA) indicates that while men do not find it easy to go for HIV testing and treatment, they do not encourage their wives/partners to seek HIV services due to a lack of effective awareness.
The study also found that many HIV-positive babies are continually born as a result of expectant mothers choosing to deliver with Traditional Birth Attendants (TBAs) who lack adequate knowledge and training in the prevention of mother-to-child transmission.
“This year alone, two newborn babies tested positive in January and February respectively. It was discovered their HIV-positive mothers delivered with the help of TBAs. TBAs do not test for HIV or give healthy antenatal services like health centres do,” Dr. Faith Nakiyimba, the Masaka District Health Officer (DHO) says in her message adding that the challenge can be addressed through constant public awareness.
According to Nakiyimba, it is, however, worth noting the role the media plays in disseminating HIV/AIDS information to a wider audience and assisting people to make informed choices regarding different health services.
“We thank HEJNU for equipping journalists with advanced knowledge which is vital in reporting about HIV/AIDS from an informed point of view,” she adds.
Civil Society/NGOs
If the goal to end HIV/AIDS by 2030 is to be achieved, Dick Bugembe, the Chairperson of Masaka Association of Disabled People Living with HIV/AIDS (MADIPHA), believes all stakeholders, especially men, must be fully engaged in the ongoing campaign.
While they have made an effort to use Music, Dance, and Drama to sensitise communities about HIV/AIDS, Bugembe claims it has been so disappointing to see few men attend yet women and children often show up in big numbers.
“The men ought to know the dangers of not being part of the HIV campaign. We simply encourage them to test and know their HIV/AIDS status so as to start ART and care and this has helped so many women and youths and a few men,” he recounts.
According to the leader, they have managed to debunk myths and misconceptions surrounding HIV/AIDS. Initially, he says, people would have unprotected sex with PWDs thinking they were safe but we discouraged it because they also transmit the virus like any other person without a disability.
“The MDD strategy, several communities including several People With Disabilities in Masaka region have benefited. At the moment, more than 500 PWDs know their status and are on ART,” he explains.
In addition, Bugembe urged policymakers to create more compelling HIV/AIDS initiatives that focus mostly on men because they are more likely to have several partners who they infect with the virus whereas their ART uptake and care is still low level.
Injectable HIV Drug
With a rise in infections, Uganda approved the injectable, long-lasting HIV drug (Cabotegravir) in December 2022. The country, however, became the second African country to approve the injectable drug after Zimbabwe.
Studies have indeed proven that the first non-pill HIV treatment approach is more effective than oral pills.
Ponsiano Sserwadda is the Secretary-Positive Youths In Action (POYA) under Uganda Cares, one of the AIDS Organizations that are active in Greater Masaka Region.
To attract more male youths and men in the campaign, Sserwadda believes the government needs to expedite prioritise men and the use of the injectable drug across the country mostly in places with the highest HHIV prevalence such as Kalangala, Masaka, Kyotera among others.
“The use of the injectable drug will be more effective and simply uptake of ART since most people especially men fear oral pills,” he notes.
In addition, he argues, men should be educated on proper condom use as part of the HIV campaign because most men don’t know how to use them effectively, hence putting their lives and the lives of their partners at a high risk of acquiring the virus.
“For that reason, many lose interest in using them and others use them poorly which exposes them and their partners to HIV. Neglecting men can affect the testing, treatment and viral suppression,” Sserwada adds.
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