Negative attitudes attached to condom use in Uganda
Rosebell Kagumire
September 2, 2005
http://www.monitor.co.ug/socpol/socpol09021.php
The UN has attacked Uganda's HIV/Aids strategy saying abstinence only cannot work. Yet even with emphasis being put condom use, the society is one that attaches infidelity and promiscuity to the condom
He walks straight to the counter and makes his order. But rather than get served immediately, the salesperson looks up in surprise and does not deliver the order as she normally does for other customers.
On the many occasions that he has visited a clinic or shop to buy condoms, a stern look replaces the friendly look on the person behind the counter.
He appears odd not only to the salesperson but also other customers in the supermarket.
He is different from them because he wears a white collar, a symbol of his religious position and thus by the unwritten rules of society is in the wrong place and ordering the wrong commodity.
The signals on the salesperson's face tell you the kind of questions that might be running through her mind.
She seems to be questioning why and for whom this man of God is buying these condoms.
As the Reverend leaves, she and the people at the clinic turn and start murmuring, saying that the world has gone crazy and asking how this man can buy condoms even in day light.
This is what Rev. Canon Gideon Byamugisha, the first African Priest to declare his HIV positive status goes through at times.
Stifling attitude
Condom import figures are shooting up every year but socially, people's attitudes towards condoms do not give a favourable environment for acceptance. Many people attach condom use to promiscuity and infidelity.
"If people selling the condoms display suspicion on people who come to buy, then you can be assured there's still some work to do in terms of attitude change. Many get discouraged when they get such gestures and most likely don't come back to buy condoms," Byamugisha said.
Byamugisha who is the head of Networks of People Living with HIV/Aids in Uganda and the Chairman of African Religious Leaders Living with and personally affected by HIV/Aids says attitudes towards condom use are still hampering its acceptance in the country.
"To translate a good perception into a good practice, you need more than just a conviction. In order to have condom acceptance, a supportive environment is needed and we have not reached there yet," he said.
Canon Byamugisha is not alone. Edith Mukasa, a mother of one has tried a few times to buy some condoms as a birth control measure, but all the times she has gone to the clinic, people have turned and looked at her in surprise.
"Many people attach condom use to infidelity, I have tried a few times to buy some male condoms but the gestures I receive are not the best. So I have turned to some other measures," she said.
Many women and girls have braved the side effects of some birth controls and ignored the use of condoms.
Other young people use condoms for fear of getting pregnant and once they are sure they will not conceive, they do away with condoms.
Many pharmacists and clinic attendants in Wandegeya told Daily Monitor that many university girls are buying pills which according to them shows the likelihood of avoiding condom use.
Religious leaders have for ages played a great role in advocacy and behavioural change in our society but on the subject of condom use some conservatives have on many occasions campaigned against it.
They have had only one message of abstinence preached to their congregation but there are many members of society who are sexually active.
Some of them have the same attitude of attaching condom use to immorality.
The Late Rt. Rev Bishop Miseari Kauma who was a director of Uganda Aids Commission in the early 1990s was at first opposed to the use of condom but later came to believe that condom use was important in the HIV/Aids fight.
He came to campaign for increased condom campaigns and many times told young people that, "Don't be foolish but if you are, don't be stupid in this era of AIDS, use a condom."
Rev. Byamugisha said that advocating for condom use does not make one an advocate for fornication and infidelity.
"When we say that people should use condoms, we are not saying it's all right to have premarital sex and neither do we mean that it's lawful to be unfaithful. We are simply protecting lives of those members that stray away from the right path of God. We are asking them to have safe sex but not necessarily telling them it's alright to be promiscuous," he said.
Uganda has lost dozens of priests to Aids related diseases and there is no doubt that some of these priests have been opposed to the call to disseminate messages of condom use.
Condom awareness
By 1989, only seven percent of the Ugandan population had knowledge about condom use. Throughout the last decade more people have become aware of what a condom can and cannot do.
By 2002, knowledge of male condom use stood at 80 percent and 55 percent among men and women respectively according to the 2003 HIV/Aids surveillance Report by AIDS Control Programme. It is likely that many more Ugandans have used condoms.
The culture of condom use has increased with the level of education and sensitisation that explains higher figures in urban than rural areas.
Many shopkeepers that Daily Monitor talked to said people usually buy condoms in the evenings and usually wait when there isn't any other customer.
Joyce Namara, a salesperson at a shop in Bugolobi said, "Many who come here are between 20 and 40.
They usually buy in the late evening hours. Most don't talk loudly and they don't say condoms, but rather use idioms to refer to condoms and I understand them."
At one pharmacy in Kabalagala, a man only identified as David said that his customers are mostly elite who are bold in their ordering and are not bothered by who is seeing them.
It is not only negative attitudes that are challenging condom use, affordability and reliability have also had an impact.
The cheapest price of a condom in the country is about Shs300, which may not be a good price for about 30 percent of Ugandans live below poverty line.
Ahamad Agaba, a second year student at Makerere University said consistency in condom use is difficult for him because of financial reasons. He buys one or two when the need arises.
But where willingness exists accessibility is a problem.
One Gilbert Okello, a student from Apac said some youths there were using buveera (polythene bags) because condoms were not available.
Ms Grace Nyombi a Store Supervisor at Mavid Pharmaceuticals for the last 10 years said there has been a very sharp increase in demand but the supply is gradual.
"People have been educated and they know more about safer sex than 10 years ago. In fact now the problem is supply because at times condoms are out of stock," she said.
Pressure from donors
In the past months, some donors have criticised the government of Uganda for discarding "critical" HIV/Aids messages including information about condoms and safe sex.
In April, Human Rights Watch in a report titled "The Less They Know, the Better: Abstinence-Only HIV/Aids Programs in Uganda," also criticised the government saying that it had abandoned condom messages.
Statistics though show that the government's backing of condom use has not necessarily changed.
Uganda's condom imports have shot up by more than 20 million per annum for the last four years.
So far this year, about 120 million condoms have been imported, a number higher than the previous one, which was at 100 million.
Even though condom figures are still low and attitudes still challenging, Uganda has not automatically bowed to abandoning condoms for abstinence but has simply given both campaigns the attention needed.
Last year at an International HIV/Aids conference in Bangkok, President Museveni and President George Bush came out and showed their support for abstinence but Uganda has not stopped using its ABC message.
The government has also not bowed to criticism on abstinence messages from the western world, which basically does not believe in abstinence.
There are plans to install condom dispensers in public places, starting at the end of this year, which could take the use of condoms to another level.
Some sexually active people who still feel embarrassed when buying condoms in public places might find it easier to obtain them.
Although condom figures are increasing, they are still not enough for the population.
Rev. Byamugisha says Uganda has had success in bringing down the HIV/Aids prevalence rates partly using condom campaigns but a lot more is still required in terms of openness and acceptance towards condom use.
"Though condom use had increased significantly over the years, attitudes have not yet been well broken.
If n egative attitudes were eliminated, condom use could be higher than what we see now," he said.
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