Safe sex messages missing HIV-positive youth

HIV-positive youth in Uganda are not receiving the support and education they need to avoid risky sexual behaviours that could lead to the infection of others, a new study has found.

The adolescent sexuality study, released last week, was conducted by Uganda's Makerere University, in conjunction with the Paediatric Infectious Diseases Clinic (PIDC) at Mulago Hospital in the capital, Kampala, the country's largest referral facility. It surveyed 75 HIV-positive youth, aged between 11 and 21, who were being treated at the clinic between October and December 2006.

"We discovered that many of the children were having sex and not using protection for various reasons, including money and sexual abuse," Dr Sabrina Bakeera-Kitaka, head of adolescent programmes at the PIDC, told IRIN/PlusNews.

Participants were put into discussion groups and given questionnaires to complete anonymously. According to the responses, their reasons for not using condoms included peer pressure, poverty, fear of stigma, lack of guidance, alcohol use, loss of hope, and the desire to have children.

Researchers found that the refusal of local faith-based community health organisations to dispense condoms also had an impact on the likelihood of HIV-infected youth practicing safer sex.

An estimated 110,000 Ugandan children under the age of 14 are living with the HI virus, according to UNAIDS. About 7,000 of them are obtaining free antiretroviral (ARV) treatment from the public health sector, which began rolling out the drugs in 2004.

Over 85 percent of the adolescents in the study had contracted HIV/AIDS from their mothers at birth and had been taking ARV drugs for most of their lives. Nineteen of them said they had engaged in sex, nine of them with only one partner, while the others had all had multiple sexual partners.

Most of the adolescents surveyed said they preferred sexual partners who were HIV-negative, because they feared being re-infected with another, potentially more virulent strain of the HI virus.

Among participants who had not yet had sex, several were starting to question how much longer they would be able to abstain. "If you say HIV-infected people should abstain, it is like condemning us to die," said one 20-year-old male.

Local faith-based organisations favour abstinence until marriage as a method of preventing the spread of sexually transmitted diseases. The government has also recently come under heavy local and international criticism for a perceived shift in the focus of its HIV prevention efforts from condom use to abstinence, allegedly in a bid to win favour with donors, particularly the United States government.

The study's authors noted that Uganda lacked culturally appropriate techniques for encouraging safer sex among adolescents, while Bakeera-Kitaka said the findings revealed dangerous gaps in the knowledge of HIV-positive youth: a few of the participants believed everyone had HIV/AIDS, and there were also many reports of incorrect condom use.

As ARVs become more widely available, the authors recommended more tailored support for young people living with HIV to reduce high-risk sexual activities. "It is critical that we start an intervention now," Bakeera-Kitaka said.

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