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Post-conflict HIV programmes needed in the north

Little wooden boxes for condoms are given to sex workers who participate in ALISEI´s sex education programs in São Tomé and Príncipe. Mercedes Sayagues/PlusNews

By day the northern Ugandan town of Gulu is a busy municipality, but at night it really comes alive, when its pubs, powered by generators and fuelled by the local spirit, Waragi, fill up with boisterous patrons looking for a good time.

In the Buganda bar, named after a kingdom in central Uganda, several provocatively dressed young women sip sodas and scan the bar for moneyed men willing to pay for sex.

Many girls and women have resorted to sex work to earn a living because they were orphaned or unable to complete their schooling as a result of the two-decade war between the rebel Lord's Resistance Army (LRA) and the Ugandan government.

Attempts to find a peaceful resolution to the conflict have stalled, but although the LRA have allegedly been active in neighbouring Sudan and the Democratic Republic of Congo recently, their last attack in northern Uganda was over two years ago. The region has been operating in post-emergency mode, with people displaced by the conflict returning home and life slowly returning to a semblance of normality.

Post-conflict boom

Towns have witnessed an economic boom since the return of relative peace, with several banks and businesses opening branches in the area. The influx of traders and employees of large companies and non-governmental organisations (NGOs) has meant plenty of customers with money to spend.

"Many women work in the bars ... they do sex work," said Wilson Okot, the Gulu branch manager of the NGO, Reproductive and Sexual Health Uganda (RSU).

A number of NGOs are assisting people living in camps for the internally displaced, including providing them with HIV/AIDS education, treatment and care, but less has been done to reach people living in the larger towns with these services now that the conflict has subsided.

"There is no organisation taking care of [the sex workers'] concerns; it is an urgent need for their plight to be addressed," Okot said. "Most organisations are focusing on the camps and relief services, but they are abandoning people within the municipality."

According to the most recent survey by the ministry of health, HIV prevalence in Uganda's northern-central region is just over 8 percent, one of the highest in the country, with urban areas recording higher levels of infection than rural areas.

Need for action

Other African countries recovering from conflict, such as Angola and Mozambique, have seen spikes in HIV prevalence, highlighting the need for quick action to curb new infections in northern Uganda.

A report, Refocusing and Prioritising HIV Programmes in Conflict and Post-conflict Settings, presented at the International AIDS Conference in Mexico in August 2008, notes that conflicts lead to a breakdown of social norms, increasing the need for women and children to engage in transactional sex.

"When transportation begins to open after conflict ends or subsides, previously low HIV prevalence populations can move from rural to urban centres," the report commented. "Formerly separate populations begin mixing again, and increased resources create power structures that may facilitate sexual exploitation."

The authors recommend that HIV programmes target affected populations with interventions specific to the conflict, post-conflict and reconstruction stages.

Okot's organisation, RSU, runs programmes for sex workers in the capital, Kampala, and other areas, but has no immediate plans to introduce similar programmes to the north, where their budget is already stretched thin by tending to the displaced.

The International Rescue Committee, a US-based relief agency that works with refugees and victims of armed conflict, has distributed condoms in bars in urban areas of war-affected northern Uganda in the past, but this programme has now been shifted to different areas of the country.

The AIDS Support Organisation (TASO), a national NGO, also has programmes for sex workers, but not in northern Uganda. Cissy Musumba, the organisation's manager in Gulu, said TASO considered local sex workers a group at high risk of HIV and hoped to start including them in programmes in 2009.

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See also: In the wake of the LRA: HIV in Uganda and Sudan


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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