Wealthy Ugandans stalked by HIV
Posted by African Press International on February 17, 2007
*”A NEW study by the Ministry of Health has put a fresh twist to HIV/Aids prevalence in Uganda. It shows that it is highest among richer Ugandans.
However, some HIV/Aids experts are already viewing the sensational findings suspiciously.
The study, called The Sero-Behavioural Survey, says; “the data shows a gradual increase in HIV with wealth. The rates rise from four per cent among those with (the lowest income) to nine per cent among those with (the highest income).”
This spike, according to the study, is occasioned by an 11 per cent HIV prevalence among wealthy women.
The study, whose data was compiled between 2004-05, also contains significant findings regarding marital status.
“Those who are widowed are by far the most likely to be HIV infected. Almost one third of women and men who have been widowed are HIV positive, compared with around six per cent of those who are currently married.”
The findings, released late last year, also bring out large differentials in HIV infection by ethnic group. “The Batoro are the most affected by the epidemic, with 15 per cent of adults infected. Rates are also high among the Langi (nine per cent) and the Baganda (eight per cent).”
The lowest levels are found among the Karimojong (two per cent) and the Lugbara/Madi (three per cent).
The statistics were largely generated through an HIV sentinel surveillance, a system that relied on data collected from 25 sites around the country, representing a wide geographical and demographic range. Of these sites, 24 are based in anti-natal clinics, while one is located in an STI referral clinic.
The report contains no substantial explanations of its findings. And it does not attempt to explain, for instance, why the rich, the widowed and Batoro, among others, are falling prey to HIV more than others. Daily Monitor could not get a comment from the architects of the report. However, Dr Kihumuro Apuuli, the Director Uganda Aids Commission (UAC), yesterday shed some light on the findings relating to wealth.
He told the Parliamentary Accounts Committee that wealthy communities had free access to whatever they needed and as a result many of them had become victims of the scourge.
“These people have a higher disposable income than the poor. They can go out there and do whatever they want and in the process some of them have contracted the disease,” Dr Apuuli said.
Ms Beatrice Were, who runs Action Aid Uganda, is highly sceptical of the survey’s conclusions. She said when the findings were originally presented, Ministry of Health officials stated that wealthy women had a surprisingly high prevalence because they were more likely to travel, and while travelling there was a tendency to have high-risk sex with relatively anonymous partners (strangers).
Ms Were believes that the ministry’s methodology was inadequate and that the findings require further scrutiny before they can be taken seriously.
In particular, she pointed to the fact that no concrete definition of wealth was cited in the study.
She further said if wealthy women in fact had the highest prevalence rate in the country, it was because gender inequalities exposed them to higher risk, not because their wealth promoted high-risk sexual behaviour. Ms Were has long argued that women are more vulnerable to HIV infection because men are more likely to have extra marital affairs. So in essence they bring the virus home.
Another HIV expert, speaking to Daily Monitor anonymously, called the findings regarding wealth “counter-intuitive.”
Dr Apuuli also offered the parliamentary committee a discouraging assessment of the threat of HIV in Uganda. He said the government should increase HIV/Aids funding to curtail the spread of the virus. He warned that if Uganda obtained all the money it needed [about US$1.7 billion] to combat the disease, about 400,000 deaths and more than 450,000 new infections would be registered by 2012.
“We are likely to lose more than 600,000 lives and more 800,000 people are likely to get infected within a space of five years if we don’t get enough funds to fight the scourge,” Dr Apuuli said. Dr Apuuli said people were having more multiple partners than two years ago.
Quoting statistics from the UAC’s Impact Modeling Study, Dr Apuuli said 60 per cent of the HIV/Aids infections occurred outside marriage while 20 per cent of married women had extra-marital partners.”*