Fw: [LGBTI_health_africa] UGANDA NOW TO INCLUDE HOMOSEXUALS IN HIV PROGRAMMES
Subject: UGANDA NOW TO INCLUDE HOMOSEXUALS IN HIV PROGRAMMES
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In an incredible change of heart, the Uganda government has listed homosexuals as a target for HIV/Aids programming in a new five year National HIV Prevention Strategy for Uganda 2011-2015.
The policy document which Behind the Mask has seen will run under the theme: "Expanding and Doing HIV Prevention better." The policy development process is spearheaded by the Uganda Aids Commission (UAC), with consultations of various stakeholders including Civil Society.
Until recently, the UAC had publicly stated that they had no funds for targeting homosexuals in HIV programming. "Gays are one of the drivers of HIV in Uganda, but because of meagre resources we cannot direct our programmes at them at this time," Dr Kihumuro Apuuli, (pictured) the Director General of UAC was quoted saying in 2008.
However, some have suggested that the UAC was being influenced by Christian born again movements who were lobbying Uganda's First Lady, Janet Museveni, a born again Christian herself, not to recognize gays in any policy document. The UAC was established by an act of Parliament, and is directly under President's Office.
The National HIV Prevention Strategy sets forth opportunities and guidance for intensified efforts to significantly stem new HIV infections. Its vision builds on that of the National HIV/Aids Strategic Plan(NSP), of a Uganda where new HIV infections are rare, and where everyone, regardless of age, gender, ethnicity or socio‐economic status has uninterrupted access to high quality and effective HIV prevention.
"The overall goal of the strategy is to reduce new HIV infections by 30percent based on the baseline of 2009 which would result in 40percent reduction of the projected number of new HIV infections in 2015," the policy text reads in part.
Ms Hasifa Nakiganda, an LGBTI lobbyist with Uhspa Uganda welcomed the contents of the draft policy. She said Uganda's burying its head in the sand over homosexuals was setting a bad example, because Uganda was a reference country when it came to the best management of HIV/Aids. "So by denying homosexuals universal access to HIV programming, Uganda is sending a bad signal to other countries struggling with the HIV pandemic," Ms Hasifa said. Uhspa Uganda petitioned the Ugandan Parliament pleading for homosexuals Right to Health and HIV programming inclusion.
Uganda has only one policy that recognizes homosexuals as a target for health service delivery- the National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights. But homophobia prevents gays from accessing public health services.
The new NPS policy aligns with the National Development Plan for Uganda and the, the Second National Health Policy, and the Health Sector Strategic and Investment Plan (HSSIP) (2010-2015). It will contribute to attainment of Universal Access, as per the UNGASS- United Nations General Special Session Country Progress Declaration of Commitment on HIV/Aids and MDG (Millennium Development Goals) 5, 6, and 7 targets; calling for increased focus, coordination and collaboration to comprehensively scale‐up HIV prevention efforts and align them to the drivers of the epidemic.
Ms Nakiganda said the policy recognition will help in distributing resources to gay HIV programmes.
In Uganda MSM and Transgender communities are not recognized as a contributing source to the HIV epidemic, despite emerging data that they are. Some of the factors listed as driving the epidemic include behavioural factors, social cultural, socio-behavioural, economic and geographic factors. These include higher risk sex (which include non-martial sex, extra- marital sex, non-consensual sex, commercial sex, transactional sex, intergenerational sex and sex for survival), mother to child transmission, HIV discordance and non-disclosure, poverty, early marriage, glorification of non-marital sex, multiple sexual partners, stigma, discrimination and Sexually Transmitted Infections (STI) prevalence.
New Infections are found highest among co-habiting/married/widowed groups at 42percent. Despite these governmental statements, various studies attempting to assess prevalence amongst MSM have indicated that they are an important driver of the Ugandan epidemic.
The Crane Survey, that began in May 2008 and ended in April 2009, assessed various most at risk populations, including men who have sex with men in Kampala with the overall goal of informing policy makers and planners of HIV/Aids prevention, intervention programs.
There were major challenges in the implementation of the survey after the arrest and abuse of gay rights activists in May 2008 and arrests of men who were allegedly gay in September 2008. Sampling stopped at that point and barely recovered later. Despite the extreme hostile and homophobic environment, the survey managed to reach 290 participants.
According to the study, STI prevalence (including HIV) stood at 22.1percent. HIV prevalence was found to be 13.2ercent; 45percent did not know their HIV status. A substantial proportion of the men had fathered children (29percent), while 31percent had ever married; 44percent had ever lived with a female partner, and 16ercent were presently living with a female partner.
There was poor knowledge on HIV risk of anal sex with 38ercent indicating that it is more likely to get HIV through sex with a woman. An Additional 10percent felt it was less important to use condoms for anal sex compared to vaginal sex. This finding collaborated an earlier study of gay and bisexual men in Kampala where unprotected receptive anal intercourse (URAI) was associated with people identifying as gay, being younger and having had an HIV test in the past six months.
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