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3. HIV/AIDS knowledge, sexual relations and practices

Ever since HIV/AIDS emerged on the Ugandan scene, several studies have been conducted on people's level of knowledge and awareness of HIV/AIDS. Also studies have been carried out on sexual behaviours and practices. In all the studies, it has been revealed that the level of HIV/AIDS knowledge and awareness for most Ugandans is high. However, given the fact that this study is to serve as input into mainstreaming HIV/AIDS messages into agricultural extension, it was deemed necessary to investigate HIV/AIDS knowledge, sexual relations and practices among the crop farming, livestock farming and fishing communities. The rationale was to come out with appropriate and specific messages per locality.

Knowledge of People Living with HIV/AIDS (PLHA)

To assess peoples' knowledge of HIV/AIDS, study respondents were first asked whether they knew any person in their community who had AIDS, and if they had taken care of PLHA. Overall, 92.7% of the respondents had ever known a person who had AIDS in their community, while 74.8% reported to have ever taken care of a relative or household member who had HIV/AIDS. Over a half of the respondents (56.6%) had ever taken care of two or more persons with HIV/AIDS. In relation to the impact of HIV/AIDS on agriculture and fishing, it implies that majority people at one time had devoted their time to nursing and caring for PLHA instead of attending to agricultural and fishing activities.

Data generated through focus group discussions and individual interviews revealed that people in the study area distinguished a person with AIDS from one without AIDS by the commonly known symptoms. A big proportion of individual respondents (76.7%) noted that they knew symptoms/signs of AIDS. Commonly reported symptoms included:

Causes of HIV/AIDS spread and sexual relationship

Over a half of the respondents (53.7%) reported that HIV spread was as a result of people having multiple sexual partners, amidst low usage of condom. Around one forth (27.2%) of the sample reported unfaithfulness among partners.

12.5% of the respondents cited that redundancy was a cause of HIV/AIDS spread in their communities, and 11.2% mentioned poverty. In Iganga, over a fifth (21.3%) cited poverty as a factor behind HIV/AIDS spread. In Lira, 20.7% indicated uncontrolled alcohol taking as a factor that facilitated the spread of HIV/AIDS.

The relationship between HIV/AIDS and poverty cannot be understated. Orphaned girls without care were reportedly lured into sexual relationships with older and married men for material benefits. Similarly, cases of married women having sexual relationships with men were reported to be common especially in the fishing communities. Quantitative data on sexual relations corroborate these findings.

Among the married respondents, majority (83.3%) were in monogamous relationships, while 16.6% were in polygamous marriages. Among the unmarried, almost a third (30.8%) reported having a regular sexual partner. Of these, 82.9% reported that they had a single regular partner, while 17.2% reported more than 2 partners. Of the married and those with regular sexual partners, majority (64.5%) reported having had sexual relationship outside their marriages/regular sexual relationship. A big proportion of respondents who had been involved in a sexual relationship outside marriage or regular sexual relationship were in Iganga and Rakai.

The findings are reinforced by peoples' perceptions about their partners' fidelity. Close to a fifth (18.0%) of married or respondents with regular sexual partners thought that their spouses/partners could have had sex with anyone else in the last 12 months preceding this study, while 42.7% were not certain. Only 39.3% of the respondents contended that their partners were faithful. Thus, the findings reveal high level of suspicion among couples, which does not augur well for HIV prevention. In figure 3, individual perception of possible infidelity is cross-tabulated with one's basic activity.

Figure 3: Perceptions of infidelity by basic characteristics (in percentage %)

Majority of respondents who thought that their partners/spouses could have had sex with someone else were in fishing communities. This could be possible given the type of life that prevails in fishing communities and landing sites, characterised by high mobility and a semi-urban take live.

Socio-cultural practices that contribute to the spread of HIV/AIDS

In this study, majority respondents did not point to widespread socio-cultural practices that facilitate the spread of HIV/AIDS except for remarrying of infected widows and widowers. But even then, it was revealed that remarrying of widows by the brother-in-law was no longer culturally mandatory as it used to be before the onset of HIV/AIDS. Nevertheless, remarriages were still taking place as reported by almost a fifth (19.2%) of the respondents. A tenth of the sample (10.5%) reported sharing of skin cutting or piercing instruments as a practice that lead to the spread of HIV/AIDS. This was much related to traditional healing practices where a single razor blade can be used on several patients to administer local medicine. Other socio-cultural practices mentioned to contribute to the spread of HIV/AIDS were polygamy (9.6%) and alcoholism (6.7%).

In relation to direct impact on agricultural production and culture, the cultural practice of observing mourning period impinged on agricultural production and fishing due to absence of labour on farmland or available for fishing. In this study, 32.0% of the household respondents revealed that they spent a week a way from gardens and fishing activities if a household member passed away. In over a tenth of the households (12.0%), they spent over a week in case a household member passed away.

With regard to the loss of a community member, majority households (70.8%) spent 1-2 days without working, while for a relative who is not a family member, majority households (59.0%) spent 2-4 days without attending to their gardens.

HIV/AIDS Prevention

From the study findings, there is no doubt that several respondents and key informants knew the various ways of preventing and controlling the spread of HIV/AIDS. The issue is therefore not lack of knowledge on how to prevent an infection, but rather behavioural change. For instance, whereas 46.0% of all respondents reported that condom use would prevent HIV infection, only 15.3% had ever used it in their life. This has serious implications given the findings in this study where unfaithfulness/infidelity among partners seemed to be taking place. Where condom use is low, faithfulness among sexual partners is in doubt and abstinence is non-existent, HIV can spread very fast. This suggests that the messages to be designed or incorporated into agricultural extension should be able to empower the farmers and fishing folk to change risky behaviours that expose them to HIV infection. Without change in behaviour, HIV will spread unabated with devastating effects on agriculture. Even at the moment, the impact of HIV/AIDS on agriculture and fishing is noticeable in several communities in Uganda.

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