Population census results will guide us in the HIV fight

The Uganda Bureau of Statistics (Ubos)’s provisional 2014 census report has revealed that the population of Uganda is 34.9 million. This contrasts slightly with UNFPA’s estimates of 38.8 million.
We must applaud the government and Ubos for having conducted this census after many years of postponing it. Keeping up with trends in population growth patterns is very crucial for economic planning, and for prioritising resources to meet the varied needs of the population, especially in the fight against HIVAids.
The significance of this census in shaping the vision for HIV-free society cannot be underscored. Uganda’s population is one of the youngest in the world. For sub-Sahara Africa, it presents a challenge in youth unemployment and high risk of communicable diseases, including HIV.
In the 2012 State of Uganda’s population report, Uganda’s population under the age of 30 was 78 per cent those under 15 years were 52 per cent and those aged 18-30 years constituted 21.3 per cent of the total population. The proportion of this population was projected to reach 7.7 million by 2015.
Research is showing that HIV is dominant among the age group 15-35years in Uganda. In 2001, 80 per cent of those living with HIV were in the age group 15 – 34 years. With the current estimated 1.4 million people living with HIV, most of the agencies that provide health services are reporting high turnover rates among expectant mothers at antenatal clinics, and adolescents. In 2011, Unaids reported that young people aged 15-24 accounted for 41 per cent of new HIV cases worldwide, and nearly 5 million were living with the virus.
Studies are also consistently showing that HIV prevalence among girls, and women aged 15-35 is higher than those among their male counterparts. Unaids’s figures show consistent patterns of disproportionate infection among females than males. In sub-Sahara Africa, female prevalence rates of 3.4 per cent compares unfavourably with 1.4 per cent for males.
Another 2002 study by Paul Bennel showed females had higher prevalence rates until they reached 35 years, then their rates were surpassed by male prevalence rates. This means that the age of 35years is a critical age of infection for both genders. It implies that more women under the age of 35 years are living with HIV than male peers, and more males over the age of 35 years are living with HIV than their female peers. In the provisional 2014 census result, women of reproductive age, 15-49 years are numbered 7.3 million (21 per cent) of the total population. These are expected to have 1.5 million births by 2015. We could protect these children from risks of acquiring HIV before birth.
Many HIV interventionists have argued that to stop the HIV prevalence rates, we have to focus on behavioural change. Programmes such as PEPFARABCs have been implemented. But HIV appears to be a disease that is malignant among the poor, considering that 70 per cent of the global burden of the disease is found in Sub-Sahara Africa.
A robust response to HIV fight must be comprehensively streamlined to include income generation, and equitable distribution alongside behaviour change. A seminal 2007 study by Biddlecom and colleagues shows that 60 per cent of females in sub-Sahara Africa indulge in sex by the age of 18 compared to 40-45 per cent of males. Among 15-19-year-olds who have had sex, only 29-47 per cent of females and 42-55 per cent of males used contraceptives. Among Ugandan teens, one out of five reported that their first sexual experience occurred by force. Moreover, 17-26 per cent of females compared to 6-7 per cent of males have had two or more partners. This also means younger females are having unprotected sex with older wealthier males, 35 years and above. In Biddlecom’s cohort of adolescents, 90 per cent had heard of HIV, and yet fewer than 40 per cent could correctly identify ways of transmitting the disease.
Any interested reader can familiarise themselves with two reports: Protecting the next generation in Sub-Sahara Africa by Biddlecom et al., (2007) and Protecting the next generation in Uganda, by Leila Darabi et al., (2008). Both reports are published by Guttmacher Institute. They provide a humbling insight into the magnitude of works required to lay a firm foundation for an HIV-free society.

Mr Komakech is a global health researcher with interests in child-maternal health in the context of HIV. Can be contacted via mordust_26@yahoo.ca

SOURCE: Daily Monitor

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