Uganda - Military Personnel HIV/AIDS
The UPDF is among the most at risk population in regards to HIV/AIDS. This is attributed to their nature of work that is highly mobile and most times requires them to stay away from their families for long periods predisposing them to risky sexual behaviors. This risk is further spread to the communities that UPDF interacts with.
In 1986, after 15 years of civil strife, Uganda's new head of state President Yoweri Museveni responded to evidence of a serious emerging disease epidemic with a proactive commitment to prevention. In face-to-face interactions with Ugandans at all levels, he emphasized that fighting AIDS was a “patriotic duty” requiring openness, communication and strong leadership from the village level to the State House.
Uganda's dramatic decline in HIV prevalence was one of the world's earliest and most compelling AIDS prevention successes. According to Ministry of Health and other data (Okware et al., 2001), prevalence among pregnant women attending antenatal clinics has declined consistently since the early 1990s at nearly all of the country's sentinel sites. Similarly large—and even earlier—declines have been observed among military recruits, blood donors and other population-level cohorts.
Regarding HIV prevalence, the U.S. Census Bureau/Joint United Nations Programme on HIV/AIDS estimated that national HIV prevalence for all adults peaked at around 15% in the early 1990s and fell to about 4% by 2003 (although a 2004 population-based survey found approximately 7% adult prevalence; Measure DHS 2005). This degree of national prevalence decline is unique worldwide and has been the subject of curiosity and controversy since the late-1990s and more recently has come under even more intense scientific scrutiny.
Debate has focused more on the relative impact of the different “ABC” factors (Abstinence, Being faithful and Condom use), especially in more generalized epidemics driven mainly by heterosexual transmission. Moreover, it is worth noting that most of the critics of the partner reduction-focused analysis likewise do not take extreme positions (i.e., condoms only, with no role for partner reduction), although it appears that some of these critics have, perhaps inadvertently, helped to re-polarize what has come to be called the ABC debate.
Changes in age of sexual debut, casual and commercial sex trends, partner reduction and condom use all appear to have played key roles in the continuing declines. Although it is believed that HIV knowledge, risk perception and risk avoidance/risk reduction options can ultimately lead to reduced HIV incidence, there is a complex set of epidemiological, socio-cultural, political and other elements that likely affected the course of the epidemic in Uganda. Many of these elements appear to be absent or less evident in those African countries that have not yet experienced significant national prevalence declines, such as South Africa, Botswana and Malawi.
Youth-friendly approaches, such as Straight Talk, eventually supported behavior change through promoting delay of sexual debut, remaining abstinent, remaining faithful to one uninfected person if “you’ve already started,” “zero-grazing,” and using condoms if “you’re going to move around.” Behavioral changes were consistent with the dominant AIDS prevention messages of Uganda's early response (i.e., 1986–1991), specifically: “stick to one partner,” and the ubiquitous “love faithfully” and “zero-grazing” admonitions readily understood even by the many illiterate residents of this largely rural nation.
Key among the HIV/AIDS activities carried out are creation of awareness among soldiers on behavior change and treatment opportunities. Treatment abroad: A number of patients received medical treatment abroad. The country has made strides in reducing HIV/AIDS, experienced economic growth, and stabilized its north, where the Lord's Resistance Army (LRA) operated for 20 years. Uganda faces numerous challenges, however, including population growth, power and infrastructure constraints, corruption, underdeveloped democratic institutions, and human rights deficits. Uganda is a key U.S. strategic partner, particularly through its contribution to the African Union Mission in Somalia. In addition, Uganda and other governments of the region, under the leadership of the African Union and with the support of the United States, made progress in weakening the LRA and reducing its threat to central Africa.
Matters of female combatants are handled by the Directorate of Women Affairs, which falls under the Chieftaincy of Personnel and Administration. Specific interventions include: ensuring equitable participation of female combatants in courses and missions abroad; provision of a fora for a voice for women; follow up on implementation of laws and policies that empower women. Although no specific budget line has been provided for this Directorate, their activities continue to draw from the overall CPA budget.
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