Gulu Regional Media Science Café on Limited Knowledge and Responses to HIV Services Among Youth in Acholi
The Health Journalists Network in Uganda (HEJNU) Media Café on HIV/AIDS Held at Northern Uganda Media Club (NUMEC) in Gulu City on 9th April 2024.
The Media Science Café:
On Tuesday, 9th April 2024, the Health Journalists Network in Uganda (HEJNU) held a one-day health café with media practitioners in Gulu City and neighboring areas.
The engagement started in the morning and ran through mid-day.
It was attended by at least 24 journalists, editors and content creators with passion for health reporting.
The participants included journalists from online, radios, televisions, and newspapers.
It discussed, highlighted and recommended the knowledge gap and response mechanisms to HIV services among youth in the Acholi sub-region.
The café also had health experts from Uganda Aids Commission (UAC), The Aids Support Organization (TASO) and Alero Health Centre III in Nwoya district.
The Café did not only discussed mechanisms for enhanced reporting, advocacy, and supporting Uganda`s strive to combating HIV/AIDS but also developed story ideas and guides for communicating HIV prevention and control messages to the communities.
The Panelists/Guests:
➢ Victor Rwengabo, Mid-North Zonal Coordinator for Uganda AIDS Commission (UAC).
➢ Juliet Aunu Okeny, Data Clerk, Alero Health Centre III, Nwoya district.
➢ Gladys Aber, The Aids Support Organization (TASO) Youth Counsellor, Awach Health Centre IV, Gulu district.
The Journalists:
| NO | Name | Media House |
| 1 | Jesse Johnson James | Vision Group |
| 2 | Ivan Tolit | Mega FM |
| 3 | John Okot | NUMEC |
| 4 | Owen Odong | Observer |
| 5 | Okot Lil Romeo | TND News |
| 6 | David Okema | Daily Express |
| 7 | Emmy Daniel Ojara | NTV Uganda |
| 8 | Christopher Nyeko | Radio Rupiny |
| 9 | Robert Mone Ojok | Radio Rupiny |
| 10 | Jackson Kitara | Wan Luo TV |
| 11 | Rose Mary Anena | Vision Group |
| 12 | Joyce Adokorach | Speak Fm |
| 13 | Susan Atto | Speak Fm |
| 14 | Livingstone Okumu Langol | Black Star News |
| 15 | Godfrey Anywar | Capital Radio |
| 16 | Reagan Ocaya | NBS TV |
| 17 | Proscovia Achomo | Radio Pacis |
| 18 | Agnes Aromo | Peace Journalists Foundation |
| 19 | Christopher Oola | Mega 100 |
| 20 | Caroline Ayugi | Uganda Radio Network |
| 21 | Simon Wokorach | Greater North News Agency |
| 22 | Willy Chowoo | Choice Fm |
| 23 | Patrick Uma | Favor Fm |
| 24 | Wilfred Okot | The Ankole Times |
John Okot highlighted the reasons for the engagement and what was required from the participants and the panelists.
Key elements of the café were to understand the situation of HIV/AIDS in the Acholi sub-region visa-vis the national status.
To understand the roles of the media, community and the different stakeholders in the fight against HIV/AIDS, among them preventive measures and increased advocacy.
Others included experience sharing on the HIV situation in the country and lessons learnt so far.
Presentations:
The first presentation was made by Mr. Victor Rwengabo, the Mid-North Zonal Coordinator for Uganda Aids Commission (UAC).
Rwengabo presented the HIV situation in the country and the Acholi sub-region. He noted that the commission is committed to ending AIDS by 2030 and having young people in the frontline.
He highlighted that they envision a population free of HIV and its effects, adding that they have a goal to effectively manage and coordinate the multi-sectorial stakeholders towards ending HIV in Uganda.
According Rwengabo;
- Uganda has about 1.4 million people living with HIV, with 1.2 million on treatment.
- The prevalence of HIV among women aged 15-49 years is still with about 6.5% against men with 3.6%.
- At least 1,000 people get infected with HIV weekly representing 52,000.
- Adolescent girls have four times higher HIV as compared to their male counterparts.
- As of December 2022, AIDS related deaths declined from 53,000 to 17,000 from the past decade.
- UAC also says the 95-95-95 cascade have seen progress of 90% of Ugandans knowing their status, 94% enrolled on ART and 94% virally suppressed.
- A report also shows that children 0-14 years are at 72% and 15+ at 80%.
- 70% of the new infections among young people were adolescent girls.
Rwengabo explained that the risk factors and contextual factors driving the HIV Epidemic in Uganda include;
RISK FACTORS INCLUDE;
- Multiple concurrent partners.
- Lack of condom use.
- Transactional sex.
- Sexually transmitted infections.
- Cross-generational sex and early sex.
- Discordance and non-disclosure.
- Lack of circumcision.
- Alcohol use.
DRIVING FACTORS INCLUDE;
- Socio-cultural norms and values.
- Wealth, income inequality and poverty.
- Gender inequality.
- Human rights, stigma and discrimination.
- Inequality and access to prevention, care and treatment.
The population risk groups in Uganda are;
- One partner
- Stable married couple
- Casual heterosexual sex
- Female of me who have sex with men
- Men who have sex with men
- Partners of clients of sex workers
- Clients of sex workers
- Sex workers
- Partners of those using Injectable drugs
- Injecting drug abuse
The presentation further revealed that;
- In 2016/2017 13.6% of young people aged 15 to 24 years reported having sex before turning 15 years, the majority were young men representing 17.3% against 10.2% female.
This statistic has reportedly remained stagnant for the past 15 years.
Among the female counterpart, the statistic dropped from 14.4% in 2004/2005 to 10% in 2016/2017.
A presentation by Ms. Juliet Aunu By: Juliet Aunu Okeny is a MEAL Specialist (USAID Local Partner Health Services TASO Ankole and Acholi Activity).
She stated that HIV prevalence in the Acholi sub-region is higher than the national statistic.
Juliet`s presentation focused on the ‘’Limited knowledge and responses to HIV services among the youths in Acholi sub Region’’.
According to Ms. Okeny;
- The national HIV prevalence is at 5.3% while the Acholi sub-region is at 7.4%.
- Females infected with HIV is at 9.3% while the male are at 5.3%. nationally females are at 6.8% and the male at 3.8%.
- The district with the highest case is Pader with 12.3%
- The lowest is Nwoya with 3.4%
- New cases reduced by 72% from 11,358 as of 2017 to 3,175 by 2021.
TABLE SHOWING HIV PREVALENCE BY DISTRICT IN ACHOLI
| District | People Living With HIV 15Years and Above | HIV Prevalence (15-49 Years) in Percentage | Incidence | New Infections in 2022 | Percentage of ART |
| Agago | 10,500 | 7.7 | 3.6 | 380 | 80% |
| Amuru | 6,800 | 5.3 | 2.4 | 250 | 82% |
| Gulu | 5,900 | 8.8 | 4.2 | 210 | 77% |
| Gulu City | 17,600 | 11.3 | 5.2 | 630 | 84% |
| Kitgum | 7,300 | 5.2 | 2 | 220 | 89% |
| Lamwo | 5,100 | 6.0 | 2.7 | 180 | 81% |
| Nwoya | 8,600 | 5.4 | 2.2 | 280 | 86% |
| Omoro | 9,500 | 9.3 | 4.4 | 350 | 78% |
| Pader | 10,600 | 8.9 | 4 | 370 | 80% |
The Major HIV Transmission Modes are;
- Sexually Transmitted from an infected person once not protected.
- Mother to Child Transmission
- Contact with body fluids of an infected person.
She explained that;
The disease spreads more easily in the first few months about 3+ after a person is infected depending on the immunity of an individual, but people many are unaware of their status until the later stages.
In the first
An infected person may in the first few weeks not experience symptoms such as.
- influenza-like illness
- fever
- Headache
- Rash
- Sore throat
She further explained that HIV has no cure and without proper treatment a person with the condition can develop;
- Severe illness
- Tuberculosis
- Cryptococcal (meningitis)
- Severe bacterial infections
- Cancer such as lymphomas and Kaposi`s sacroma
She added that health workers in Acholi sub-region are working to ensure easy accessibility to information on HIV services among the youth in the community targeting public places such as, schools, churches, hospitals, markets, dance holds and social gatherings.
The main focuses are on prevention and treatment through;
- Behavioral Change & Risk Reduction Interventions
- Service delivery (HCT, condom distribution, timely ANC, SNS etc)
- Risk assessment for client (help client know risk)
- Provide socio-behavioral change communication (SBCC) and link to services as appropriate
- Structural Interventions focused on addressing:
- Social (stigma, Gender inequality)
- Cultural & Religious beliefs practices
- Economic (lack of livelihood opportunities) ie ‘’An idol mind is the Devils workshop’’
- Legal- political (laws and regulation) drivers of the HIV epidemic
- And; Biomedical Prevention Interventions
- STI and STD screening and treatment i.e. test and treat policy on a positive account of a client.
- P/eMTCT, i.e. Niverapine syrup for a baby at birth till 6weeks and close monitoring of the mother’s VL suppression.
- Safe Male Circumcision (SMC/VMMC).
- ART for prevention.
- PEP.
- PrEP.
- Blood Transfusion Safety.
- ART to suppressed Viral load (95 95 95 Cascade i.e. know your status, enroll on ART and keep virologically suppressed<200 copies cells)
The common services at ART HIV Clinics include:
- HIV Testing and HIV Self testing
- Cervical cancer screening and management
- APN, SNS and Index client testing
- PMTCT, HEI monitoring
- TB screening and management
- Tertiary HIV management
- Psycho social support (counseling, YAAPs, DOT’s for non-suppressed CALHIV)
- Non-Communicable Diseases (NCDs) screening and management (diabetics, blood pressure).
- Voluntary male medical circumcision
- Dual method approach
Ms. Okeny also identified and explained some challenges in the HIV/AIDS Fight which among others include;
- Stigma and discrimination (Self/External)
- Low adherence to treatment
- Missing appointments for patients on treatment
- Long Distance between homes and HIV treatment sites
- Negative attitudes towards prevention methods ie not embracing some prevention methods
- Low messaging about HIV in community and religious gatherings and media except funded sessions
- Myths and misconceptions
- Stock outs of some drugs
- Co-infections like TB, Cervical cancer, etc
- Criticisms by some leaders or social groups – cultural and religious about cure
- Non-disclosure status especially among the youths/cohabiting couples.
The last presentation was made by Ms Gladys Aber, a youth counselor at The Aids Support Organization (TASO) at Awach Health Centre IV in Gulu district.
Aber noted the challenges faced working with youth in accessing HIV services.
She pointed out that the challenges among others include;
- The lack of youth friendly corners for HIV services.
- Fear
- The lack of transport for community outreaches.
- Stigma among the youth.
- And inadequate communication tools for creating awareness.
The presentations were followed by a session of questions from the journalists to the panelists.
Key areas of concerns from the journalists included;
- Why the low uptake of female condoms among women?
- Funding gap in the fight against HIV.
- How to fight stigma.
- The balance between local herbs and essential medicines in preventing HIV.
- Why HIV prevalence is high in Acholi sub-region?
- The need to design friendly communication strategy so that the populace embraces female condoms and safe male circumcision.
- The status of safe male circumcision in Acholi and how useful it is in the fight against HIV.
- Why low enrolment on ART in Acholi?
- How poverty is affecting enrolment on ART.
- The state of lost to trace patients on ART in Acholi.
The panelists admitted the gap in the HIV fight and rooted on the need for media involvement as a key party in the fight against HIV in the country.
The engagement with the editors sharing pointers with the journalists on story ideas that can be picked out of the café. The session was moderated by John Ken Okot.
The journalists developed story ideas for follow-up and these are;
- Why is the uptake of female condoms still low in Acholi? The low uptake of female condoms in Acholi can be attributed to various factors, including limited awareness and availability, cultural perceptions, and preferences for other contraceptive methods. Efforts to promote education and accessibility of female condoms could help improve uptake.
- Why is viral load suppression still an issue among children? Viral load suppression challenges among children with HIV may stem from factors like adherence to medication, access to pediatric formulations, and the complexity of treatment regimens. Addressing these issues requires tailored pediatric HIV care, caregiver support, and adherence monitoring.
- How does knowledge gap and stigma among commercial sex workers affect the HIV fight in Acholi? Knowledge gaps and stigma among commercial sex workers hinder HIV prevention and treatment efforts in Acholi by limiting access to services, testing, and treatment due to fear of discrimination. Addressing stigma through education and targeted interventions can empower this vulnerable population.
- What efforts is the Gulu district health department making to establish youth-friendly corners? The Gulu district health department is implementing initiatives to create youth-friendly spaces that offer confidential and non-judgmental services related to sexual and reproductive health. This includes providing comprehensive information, counseling, and access to contraceptives.
- How do schools and parents of children with visual impairments/disabilities access Sexual Reproductive Health information? Schools and parents of children with visual impairments/disabilities face challenges in accessing appropriate Sexual Reproductive Health (SRH) information. Tailored educational materials, accessible formats, and training for educators and parents can improve SRH education for this group.
- What are the challenges in accessing treatment and care among persons living with disabilities? Persons living with disabilities may face barriers such as physical accessibility, discrimination, and lack of disability-inclusive services when accessing HIV treatment and care. Addressing these challenges requires integration of disability-friendly approaches in healthcare settings.
- What is the co-morbidity between HIV and cervical cancer? HIV increases the risk of cervical cancer due to impaired immune function and persistent infection with oncogenic HPV strains. Regular cervical cancer screening and HPV vaccination are essential for early detection and prevention among HIV-positive individuals.
- What are the survival chances for persons living with HIV and cancer? Survival rates for persons living with both HIV and cancer depend on various factors including cancer type, stage at diagnosis, treatment availability, and HIV management. Timely diagnosis, integrated care, and adherence to treatment are critical for improving outcomes.
- What is the link between HIV drugs and cancer? Some HIV medications have been associated with increased risk of certain cancers, although the overall benefits of HIV treatment outweigh these risks. Monitoring for side effects and regular screening are important for managing potential cancer risks in individuals on long-term HIV therapy.
- What are the myths and misconceptions about HIV/AIDS treatment? Myths and misconceptions about HIV/AIDS treatment include beliefs about transmission, cure, and side effects of medications. Education campaigns aimed at dispelling myths and promoting accurate information are crucial for fostering acceptance and adherence to treatment.
- What is the UAC budget for HIV/AIDS and its effectiveness? The budget allocation for the Uganda AIDS Commission (UAC) is critical for supporting HIV/AIDS prevention, treatment, and care programs nationwide. Even with a modest percentage of 0.01%, effective utilization of these funds can have a significant impact on HIV/AIDS interventions and outcomes.
Stories from the Gulu science media Cafe:
https://www.monitor.co.ug/uganda/news/national/medics-worry-over-low-uptake-of-arvs-4631714
Patients with hearing impairment in Gulu struggle to access medical care
HIV/AIDS viral load suppression is promising in Gulu but lacking among youth
https://ankoletimes.co.ug/health/pader-district-tops-acholi-sub-region-with-12-3-hiv-prevalence-rate/
Gulu sex workers defend business as HIV/AIDS spreads in Acholi
https://www.newvision.co.ug/category/health/hunger-forces-elderly-hiv-patients-in-gulu-ci-NV_190329