The views expressed on this website are entirely my own and do not reflect any position of the U.S. Government or the Peace Corps.

Friday, March 9, 2012

The Invisible Cure

I recently finished reading The Invisible Cure by Helen Epstein (Book #34, yes, my “great sacrifice” isn’t always that, so all those people who are always telling me how proud they are of me can begin questioning that statement). I have to recommend it to all my public health interested friends and colleagues, and anyone who is interested in the AIDS epidemic in Africa.

Epstein writes about her research investigating possible vaccines for HIV, the virus causing AIDS. The story takes a turn, when she begins observing her surroundings in Uganda and other countries around East and Southern Africa. She makes special note of Uganda’s initial success in decreasing the HIV incidence rates compared to other countries in the region and countries around Southern Africa. So, what was the difference between what Uganda did and what the rest of the effected African countries did? Epstein poses this question many times to many different people throughout the Eastern and Southern regions of Africa and comes to one conclusion. Uganda addressed one of the factors actually putting people at risk of contracting HIV, concurrent sexual partners. While in countries like the U.S., we practice serial monogamy, where we, usually, only sleep with one person at a time, in countries like Uganda, it is very common for people to have a handful of partners at the same time. This isn’t even considered cheating or being unfaithful. Think about it, if person A is sleeping with person B, A doesn’t even have to be sleeping with more than one person at a time. B can be sleeping with person C, who is sleeping with persons D, E, and F, who are each sleeping with at least one other person. Think of the vast sexual network that creates, putting everyone in the network at risk if even only one of those people is infected.

So, what does this have to do with me and my work here in Uganda?

Well, I’m glad you asked.

For some time, when Uganda was successful in their initiatives to tackle the HIV infection rate, there was a “Zero Grazing” initiative, where NGOs and CBOs would focus on communicating the dangers of concurrent partners, advising and counseling on decreasing the number of sexual partners at any one time. This was all in a program that also conducted HIV testing, condom distribution, and peer counseling. However, it seems that the initially successful program was phased out after religious conservatives deemed it inappropriate because it seemed to promote promiscuity and early sexual debut.

I noticed in most of the outreach initiatives I’ve participated in, there is this “ABCD” initiative for HIV infection prevention, that is Abstinence, Be faithful, use Condoms, and Do not use dirty needles. While this initiative seems to be addressing concurrent couples, it really doesn’t because in the minds of many Ugandans, having concurrent partners isn’t being unfaithful. It seems to be a non-issue with most couples, in fact many people seem to assume that the person they are sleeping with is sleeping with someone else at the same time. Even in the media, there are stories of very important people having multiple wives, even sleeping with women outside of these multiple marriages. I’m curious as to what the youth of Uganda think about this, whether or not they are taught the dangers of concurrent partners at any stage in their lives and whether or not they actually see the dangers of it. I wonder if anyone I talk to will admit to having concurrent couples, if this is still a common practice for the average person.

This also has changed my views on outreach. It makes me want to talk to the student groups I’ll be working with and see how they address the issue of concurrent partners, if they do at all. I’d be most interested to see what the health workers here think about concurrent couples, because at the end of the day it is my view that you must practice what you preach. If a health worker if having concurrent couples how can they advise others not to do the same?

Sorry for the super serious post, I didn’t have any other ridiculous stories to tell, plus I thought it was about time I got a little more serious about my work here…okay I’ve always been serious but in terms of my expression of my work here.

*Cue foot in mouth*



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