The following article by Dr. Ian Clarke was published by Sunday Vision.
THIS week we celebrated World AIDS day. Though celebration is hardly the right word for such an occasion, it was an opportunity to highlight the fact that AIDS is still with us and take stock of the progress which has been made in combating this epidemic. In Uganda, the picture regarding AIDS is mixed — we have taken some steps forward and also gone backwards. The overall rate of HIV is now lower than it was 10 years ago, so that is progress. But more new cases are arising, so we are going backwards in that area. Surprisingly many of these new cases are in married couples or people in stable relationships and the risk of infection within a married couple is now twice the risk of infection through a prostitute!
The reason for this is that there are so many discordant couples — where one partner is positive, but the other is negative. This may be because one of the partners has another relationship, or that they were already positive when they commenced the relationship. Either way, as long as the couple are having sex, they are sitting on a time bomb. There are all sorts of possible combinations and permutations in sexual relationships and the permutations don’t get much more complicated than in Uganda. In this country, we have people with wives, co-wives, side-wives and girlfriends. Relationships may be described in terms of monogamous, serially monogamous, polygamous, informally or serially polygamous.
With all these different types and combinations, it is no wonder that AIDS is still an issue and in the face of discordancy within such networks the old message of Abstain, Be faithful or Use a condom is inadequate. The International Agencies have been looking for new ways to communicate the issue and someone came up with the message — Get off the sexual network, which for ordinary Ugandans must be one of the most obscure messages about AIDS they could have dreamed up. The message is a bit too subtle for most Ugandans — it sounds like getting off the London underground or Facebook and how does one apply it to real life? If people are already in complex relationships, they are either in that situation unwittingly because they do not know what their partner is doing, or they are aware that they have more than one partner but continue because they enjoy that lifestyle. Either way, telling them to get off the sexual network is meaningless and the simple message is — don’t have sex with anyone unless you know their HIV status, even if you have been married for many years. This means that you not only need to test yourself, you need to take your partner with you, and if they refuse, then stop having sex, or protect yourself by using a condom. This is an issue which you cannot leave to trust, it is a matter of life and death and if you don’t take the decision the death will be yours. If you are the person in the relationship who is positive, you must also ensure that your partner is protected, which you can do by using a condom.
For this World AIDS Day, the message should be straight to the point — don’t have sex with anyone, even your husband or wife, unless you know their status. It is your life and it is your responsibility to protect it. Don’t put your life in the hands of your partner, because all too often, if you happen to get infected, they will deny that it was from them and then blame you for bringing HIV into the relationship.
Do a test with your partner and know their status.
