Tuesday, May 25, 2010

Africa: Cultural Attitudes and Rumors Are Lasting Obstacles to Safe Sex

BWINDI, UGANDA - In a nameless mud-walled bar, over a lunch of roast goat, bananas and Bell beer, a group of AIDS counselors gathers to discuss one question: Why is it so hard to practice safe sex here?

The AIDS crisis seems hopeless because of the new infection rate. For every 100 Africans put on treatment, 250 get infected. Globally, 7,400 people are infected every day.

In the 1980s, Uganda earned renown for pushing its infection rate to 6 percent from 18 percent. Many here still remember the pounding drums on the radio and the slogans “Practice ABC” and “zero grazing” — no extramarital sex.

But infection rates are creeping back up.

Casual sex is on the rise, epidemiological surveys say. Condom use, never very high, has dropped. Even among people who know they are infected, only 30 percent consistently use condoms.

Donors sometimes blame their own flawed efforts. For example, the annual supply of condoms in Africa still amounts to only four per adult male.

But the counselors here — all of whom were infected — blamed no one but themselves and their neighbors.

They were all educated, fluent in English — former teachers, a former army officer, a hospital bookkeeper. But Bwindi, like much of Uganda, is made up mostly of subsistence farmers.

“Many people are just ignorant,” said Gervis Muhumuza, 44. “They have low education, and so many misconceptions. Minus the elite class in Kampala and a few others, nobody is using condoms.”

The 2006 Demographic and Health Survey of 11,000 Ugandans found that 99 percent had heard of AIDS, but only about a third had “comprehensive knowledge” — that is, they could correctly say whether it was spread by mosquitoes, by food or by witchcraft; whether it could be prevented by condoms; and whether a healthy-looking person could have it...



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