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UNITED AGAINST HIV / AIDS

In the run-up to the World AIDS Day (December 1), Vision publishes in-depth articles about the disease for the November media platform. HIV disproportionately affects women and adolescents due to the vulnerability created by the unequal cultural, social and economic situation, writes Vivian Agaba.

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For 32 years of Uganda and the rest of the world, they have faced HIV and AIDS, no one has been saved; men, women, infants, adolescents and adolescents have been infected and affected.
In Uganda, some 1.5 million people live with HIV / AIDS, but data analysis shows that new infections are greater in women than men. For example, in 2015, it was estimated that HIV every week HIV infected 567 young people aged 15-24, of which 363 were girls.
The 2016 report suggests that 570 young women aged 15-24 years are infected with HIV every week in Uganda.
A 20-year study by the Uganda Virus Research Institute and the Medical Research Council in Kyamulibwa, Kalung County, whose results were published in 2015, showed Ugandan women with HIV who are not on treatment die more quickly than their men.
Research shows that girls who are HIV-positive at the age of 15 die on average at 37 years of age, compared with 42 years for men.
According to the Common Information Sheet on the United Nations Program on HIV and AIDS (UNAIDS) of 2017, there are 750,000 women aged 15 years or more and 440,000 men of the same age group.
In the same data sheet, the prevalence rate of women aged 15 to 49 years is 7.3% compared to men of the same age group with a prevalence rate of 4.5%.
Why women pose more new infections
It is known that more women and adolescents are exposed to a higher risk of HIV infection than any other category.
Dr Dan Byamukama, head of HIV / AIDS prevention in the Uganda Aids Commission, says that factors can be classified into behavioral, biological and social / structural ones.

Children who represent the game of HIV / AIDS, with messages from parents and communities
Socio-cultural norms
Socio-cultural norms are still a major factor in spreading HIV / AIDS among women and girls in that country.
For example, the Karamoja region, Charles Onyang, a health educator and a central figure in HIV / AIDS in the Moroto district, reveals that the practices of such polygamy (even in decay), childhood weddings, widows' heritage and female genital mutilation (FGM) are highlighted by girls and women to HIV / AIDS.
"We have older men who are married to girls under the age of 18, but in many cases men have more than two women. If a person is infected with HIV / AIDS, he is likely to send him to his wife," he says. .
According to Avert, which had been in the United Kingdom in the United Kingdom since last year, one of the seven youngsters (aged 15 to 19) was married in the world or in a union.
It should be noted that girls who are married are more likely to be overcome or threatened by their husbands and that they will more often describe their first sexual intercourse as compulsory compared to those who marry after turning 19 years old.
Children's brides are rarely able to exercise their desires, for example, whether they should work in a safe sex, which increases their risk of HIV infection.
FGM is another route of HIV / AIDS among women and girls. Research has shown that instruments such as razors can be used to cut different women, which is risky, "he added.
According to Byamukame, due to patriarchs, men in the end make the majority of decisions in a relationship, such as if the couple should have sex. It adds that most Ugandan women are not empowered to negotiate a safe sex, for example, asking a man to use a condom.
This scenario puts women at risk of becoming infected with HIV.
"Women should be allowed to enable them to negotiate a safe sex, and they ask men to test HIV / AIDS," he said.
Violence based on sex
In addition, Yunia Mayanja, a researcher with the Medical Research Council (MRC), UVRI and the London School of Hygiene and Tropical Medicine, said that the violence of an intimate partner involving physical and sexual violence also contributes to higher new HIV infections among women.
"We heard stories in which women were overcome because of a sex partner's denial," she notes.
The Uganda Uganda Health Survey (UDHS) in 2016 showed a reduction in the prevalence of gender-based violence (GBV), but it still exists, and therefore the fight to combat it should not be stopped.
In Uganda, it was reported that more than one in five women aged 15-49 (22%) experienced sexual violence committed by an intimate partner compared to 8% of men.
Poverty
Byamukama notes that poverty is another important factor that attracts young women and young women into early marriages, the acquisition of more sex partners and the transactional sex they face.
All this becomes vulnerable to HIV infection.
There is no knowledge of HIV prevention
Byamukama notes that research has shown that only between adolescents and young women (15-24 years) only 46% know how to prevent HIV; the remaining 54% do not have precise information on how to avoid the transmission of HIV / AIDS from person to person.
On the other hand, it adds that the lack of access to the method of preventive protection directly under the supervision of women limits their possibilities of protection.
"Men's condom is more popular and men can use it to protect themselves against HIV / AIDS infection. On the other hand, female condom is very expensive and not easily accessible," says Byamukama.
In 2016, only 900,000 condoms were purchased, and in the same year 300 million condoms were bought.
According to Byamukame, women's condoms in Uganda are unpopular, and activists call for their transformation. In addition, two years ago officials of the Ministry of Health said that they would stop the purchase of female condoms due to limited demand because they were lying in their free time at many health facilities across the country.
One important component of the fight against HIV / AIDS is testing for HIV, and many Uganda are advocating for culture
Redirection of the trend
Mayanja notes that women and girls are more exposed to the risk of HIV infection because they have higher biological risks due to larger areas of the female genitalia, which increase the potential for infection after exposure.
So, what should be done to change the trend?
The government, together with various partners at local, national and international level, deals with various activities / programs to reduce HIV / AIDS infections among women and girls.
Last year, President Yoweri Museveni launched a five-point plan on the rapid progress of the ongoing efforts to end HIV / AIDS as a threat to public health in Uganda by 2030. The purpose of the initiative is to encourage renewed focus in the country to ensure that Uganda drastically reduces new infections (especially among young women and girls).
In 2017, the president also confirmed the "Girl Girl" campaign that they would not happen early and encouraged them to stay in school.
"When girls are encouraged to stay in school, they can leave their sex until they finish school, which reduces the possibility of dropping out of school, as well as participating in early sex that can be exposed to HIV / AIDS," says Byamukama.
He also points out that the government needs programs that help women and girls to start inevitable activities to empower them economically, so that they no longer depend on men.
Various organizations deal with cultural and institutional leaders in eliminating practices such as forced child marriage, inheritance of widows and FGM.
Byamukama also suggests that women and young girls should be empowered to freely and honestly report rape and infection offenses after they have occurred by transferring them to healthcare institutions for post-exposure prophylaxis (PEP).
Also known as exposure prevention is any preventive medical treatment that has started after exposure to a pathogen in order to prevent the onset of infection.
On the other hand, Mayania mentions the categories under which more efforts need to be directed.
Structural interventions
State programs and research centers should be given priority to measures that reduce negative norms, power imbalances, the decision-making structure and other socio-economic factors affecting women, sexual minorities and adolescents within the context of the research context and beyond the research context.
Research processes and the environment
Priorities should be devoted to interventions that analyze and include gender in all research processes.
It should be invested in creating a favorable environment for female participants with children or girls or sexual minorities. Gender, gender monitoring, evaluation and evaluation Government programs and research centers should develop and implement the process of monitoring, evaluating and learning about the sex.
There is total hope and the battle continues. Experts believe that one day, Uganda and the world will be free of HIV / AIDS viruses.
Continental numbers are nothing else
Since the beginning of the epidemic of HIV / AIDS in many regions, women worldwide have been disproportionately affected by HIV.
Today, women account for more than half of all people living with HIV / AIDS. AIDS-related illnesses remain the main cause of the death of women of childbearing potential (15-44 years).
According to the international humanitarian organization Avert for HIV and AIDS, young women (15-24 years) and adolescents (10 to 19 years old) represent a disproportionate number of new HIV infections.
In 2016, new infections among young women aged 15-24 were 44% higher than men in their old age.
In East and South Africa, young women account for 26% of new HIV infections, although only 10% of the population. Approximately 7200 young women worldwide receive an HIV source every week.
In eastern and southern Africa, young women will acquire HIV five to seven years earlier than their male peers. In 2015, there were an average of 4,500 new HIV infections among young women, which doubled the number of young men. In western and central Africa, among young women, in the year 2015, 64% of new HIV infections among young people appeared.
The difference is particularly evident in Cameroon, Côte d'Ivoire and Guinea, where adolescent girls aged 15-19 years are five times more likely to be infected with HIV than boys of the same age.
NOTE OF THE EDITOR: Strengthening the power will make women less vulnerable to HIV infection
Data show that women are more affected than men in terms of new HIV cases.
Researchers have identified several risk factors that make women more vulnerable to HIV infection. These can be classified into biological, behavioral and socio-cultural.
Although nothing can be done about biological factors, such as women's anatomy, many other factors can be done. Such factors include socio-cultural factors that include the resolution of women who can not negotiate a safe sex.
Data show that because of women's education, many people are not just afraid to talk about sex, but they can not ask themselves their spouse to try testing or using a condom.
When preparing to commemorate the World AIDS Day, all stakeholders should invest in strengthening the role of women, including its economic aspect, as a way to protect them from HIV and AIDS.
Also in relation to this story
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How Uganda started fighting HIV / AIDS
Is Cancer a New Face of HIV / AIDS?
HIV / AIDS pandemic despite success
HIV: Our exclusive historical illness gallery
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