All around the world, we still face enormous challenges related to curbing the spread of the disease, as well as dealing with the debilitating consequences on the potential of individuals and communities to participate fully in sustainable development initiatives. Reflecting on the theme of this year’s AIDS Day- “Universal Access and Human Rights”, we are all called to think and act upon the existing gaps in accessing services and information related to the spread and effects of HIV AIDS. We hope to curb new infections and help to protect those who are already infected and affected against societal stigma and discrimination.

My experience in Uganda

Uganda aggressively utilizes existing resources to fight the spread of HIV/AIDS. Among the methods used are: music, dance, drama, story-telling, dialogue, proverbs, parent-child talks, school talking compounds, community involvement in education, life skills trainings, peer education and positive deviance. As we all know today, the world has become a global village and therefore man naturally has to interact and share resources socially, emotionally, intellectually and spiritually. Love has no boundaries and sex remains a basic need. We all need to be on the same page in order to raise the fight meaningfully.

Situational analysis of Uganda

Statistics provided by the Uganda AIDS Commission (UAC) indicate that in the 1990s, the HIV prevalence rate in Uganda stood at 18.7 %. Today, Uganda has a prevalence rate of 5%. For this reason, Uganda is often regarded as a model for Africa in the fight against HIV/AIDS. Despite this achievement however, HIV/AIDS related deaths have remained high, increasing the number of orphans and widows significantly. This is due to limited access to ARVs for the majority of individuals who are clinically eligible for these drugs. Today there are 940,000 new HIV infections and 63,000 HIV related deaths. Of those infected,100,000 are children. Out of the 320,000 people who are in dire need of antiretroviral treatment, only 191,000 can access it. Globally, AVERT reports that of all those infected with HIV, 2 million people access ARVs while 4 million lack the treatment. In Uganda, orphans and widows constitute a higher share of the population that live below poverty line, as they have been impacted the most by the devastating effects of HIV/AIDS.

The Uganda’s Decline in HIV prevalence has been achieved amidst grave challenges:

Children’s psychosocial health deteriorates as they helplessly watch their parents waste away. Other challenges include malnutrition, conflicts, domestic violence, poverty, poor sanitation, poor housing, high illiteracy rates, and other diseases, resulting in a high morbidity rate. This exacerbates the challenges faced by development workers to feature possibilities for sustainable development.

Interventions

Uganda’s unique social set up and the mode of communication have contributed a lot to HIV decrease. It started with individuals getting concerned about themselves and communities. Noerine Kareeba for example, a Ugandan woman, started the “The AIDS Support Organization” (TASO). Noerine joined with other 15 affected individuals to deal with the struggles of the physical illness as well as the high stigma and discrimination that were prevalent at the time. Philip Lutaya (a Ugandan musician), after discovering his HIV positive status toured the country to perform his music giving testimonies at schools, colleges, churches and other social forums.

People created their own slogans such as Zero grazing to emphasize the practice of having one sexual partner, an anthill with a snake which when translated means, do not indulge yourself blindly in sex. In addition, traditional drumbeats played on local radio stations every morning to remind communities of the looming danger. Government officials and CBO leaders respected these community-initiated approaches and in turn facilitated planning and implementation in a very participatory way.

Since the year 2008, a number of practices were adopted: The Prevention of Mother-to-Child Transmission (PMTCT) was placed high on the agenda by encouraging antenatal care; door-to-door HIV screening using rapid tests helped to lower the spread of HIV in rural and urban areas; the “Opt-out” testing method for anybody who visiting a healthcare facility helped people to know their serostatus.

Good practices

In Uganda, people have not given up sex in order to survive HIV/AIDS. NO. Instead, the awareness created is fostering safe sex with a single partner as opposed to multiple partner sexual relationships. In villages of Uganda today, people openly talk about HIV/AIDS in households, while working in the gardens, around the fireplace, at weddings, funerals, around the drinking pot, and at other social gatherings. They have engaged significantly with AIDS in the way they talk, think, and believe. Many Ugandans now believe that HIV/AIDS can be mitigated with positive living.

Lessons learned

AIDSis regarded as important in HIV prevention. However, the foundation in Uganda was behavioral change initiated by the people themselves and information sharing within their social settings under coupled with good political will and strong leadership.

Knowledge dissemination on HIV/AIDS is very well facilitated through wider social networks and local communication channels. People get to know about their fellow community men and women infected with HIV early enough and help one another in survival. For example, community and family members take the responsibility to encourage couples to undergo HIV testing before marriage.

Social capital is mobilized rather than discovered as a pure investment. However, if there is no correct mix of these terms of social capital, investment in HIV prevention can dramatically underperform.

As you all know, good health is not merely absence of disease. Psychosocial support is a very important area to address when dealing with HIV/AIDS issues. High levels of stigma, discrimination, shifting blame and risky behaviors complicate the implementation of HIV programs.

Vermont

Let the whole of the Vermont community know the reality that HIV is now widespread all over the world. Although we cannot allow ourselves to be overwhelmed by these challenges, we dare not underestimate them. If we are to build the thriving community for which we have worked so hard, and for which so many have sacrificed so much, we need to appreciate the extent and nature of these challenges. It is the responsibility of us all – women and men, young and old, infected and affected - to join hands in solidarity and fight against the scourge.

Let us remember that the overall progress and gains made in the fight against HIV/AIDS are under threat and could see a reversal if we do not strongly uphold the necessary positive attitude towards curbing the pandemic by desisting ourselves from risky behaviors.

Through my intellectual and participant observation as an intern in AIDS Project of Southern Vermont, I am inspired to appreciate the commitment of initiators of this project and the tireless work of the project staff and board members. Most especially on this day, I want to shout loud my appreciation to the honesty, clarity, confidentiality, and accuracy of the staff in addressing myths and promoting facts about HIV/AIDS in a very holistic way.

I call upon all community members to participate in the opportunities offered by this project namely: Safe Talks, Role models, Peer outreach networks, community networks, and others so that we are able to fight this epidemic in a more informed way. Let us not frustrate the efforts of those people of good will whose actions we must emulate in order to sustain life meaningfully.

There is much strength in Vermont to facilitate the fight against challenges but also very huge weaknesses to address. Please pick materials for this day and wear a red Ribbon as a sign of your commitment to fight against HIV/AIDS.

“Hope never dies, Talk what others think that you cannot talk for the remission of lives” by Advine Tugumisirize

Thank you for listening to me