The detrimental impact of stigma and discrimination on school dropout rates and HIV transmission in Uganda’s Mid-North region cannot be overlooked. The recently released findings from the Uganda Population-based HIV Impact Assessment (UPHIA) 2020-2021 shed light on the concerning situation in the Lango sub-region.
The prevalence of HIV in this area is alarmingly high, standing at 7.6%, surpassing the national average of 6.9%. Furthermore, the Mid-North region exhibits a lower prevalence of Viral Load Suppression (VLS) among adults, at 67.4%, compared to the national average of 75.4%. These figures underscore the urgent need to address the pervasive issues of stigma and discrimination, which exacerbate the negative public health impact of HIV.
Stigma and discrimination continue to plague various segments of society, particularly those living with HIV. As a result, many individuals, including school-going children and adolescents, are compelled to discontinue their antiretroviral therapy (ART) to avoid the social stigma and discrimination associated with their condition. Zainab Tale, a 22-year-old girl living with HIV since birth, bravely shared her personal ordeal of stigmatization within her own family.
Her siblings insisted on maintaining a distance from her, fearing that they would contract the virus before her inevitable demise. Tale’s predicament escalated when she enrolled in secondary school, where she faced severe discrimination that eventually coerced her to abandon her medication regimen.
It took the intervention of Grace, her peer educator at Lira Regional Referral Hospital, who provided intensive adherence counseling and support, to convince Tale to resume her treatment.
Despite Tale’s subsequent disclosure of her HIV status to both her peers and teachers, the discrimination and stigmatization persisted. Eventually, Tale was compelled to drop out of school, leaving her father’s home at the tender age of 17, and resorted to engaging in commercial sex work as a means of survival.
Isaac Anyii, another individual affected by stigmatization, shares a similar narrative. Diagnosed with HIV at birth, Anyii enrolled in care at the age of 11 in 2011. Tragically, due to the stigma he faced from both fellow students and teachers, Anyii discontinued his education during his second year of secondary school in 2015.
Although Anyii managed to return to school after a two-year hiatus, he was unable to complete his ordinary-level education. Instead, he pursued tailoring skills, which now serve as his primary source of livelihood. Anyii’s commitment to combating stigma is reflected in his role as an adolescent peer supporter under the Young Adolescent Program Support (YAPS), where he draws from his personal experiences to advocate for HIV-positive youths and challenge societal prejudices.
Simon Okeng, a secondary school head teacher in Oyam District, acknowledges the pervasive challenge of stigma within educational institutions, including his own.
However, his school has implemented strategic measures to tackle this issue among students. Pamela Donggo, the Deputy Chief of the Party and Technical Director at the USAID RHITES-North Lango project has spearheaded several interventions to control HIV transmission and improve adherence to medication. One notable initiative is the YAPS program, specifically designed to combat stigmatization among HIV-positive adolescents.
Between October 2021 and September 2022, Lango recorded a total of 99,093 individuals living with HIV, out of which only 94,030 were receiving treatment. This leaves a significant gap of 5,063 individuals who have yet to be reached. Additionally, within the same period, 1,888 new HIV-positive cases were identified, comprising 1,784 adults and 104 children.
Dr. Bernard Otucu, the Lira City Principle Health Officer says most people are shying away from accessing care for fear of being stigmatized although they continue to engage in risky sexual activities thus spreading the virus. According to him, the prevalence is higher among the youth especially females than males although the female gender tends to seek treatment despite being stigmatized.
But Jane Acola, the Project Coordinator AIDs Information Center blames the adolescents for engaging in unprotected sexual activities despite the high number of HIV-positive people who are not on medication due to stigma, and as a result, they continue spreading the virus.
In 1992, the government established Uganda AIDS Commission under the office of the president to coordinate a multi-sectorial response to HIV. This was followed by the President’s Fast-track Initiative to end HIV/AIDs as a public health threat by 2030.
The initiative pushed for men’s involvement in HIV prevention and closing the tap on new infections particularly among adolescent girls and young women by addressing stigma and other challenges, which foster new HIV infections.
Dr. Richard Nam, a commissioner at Uganda Aids Commission says the initiatives registered high success but people especially men relaxed, and that with why adherence is dropping.