GAY ARE A “most at risk population”-MARPs IN UGANDA

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BACKGROUND:

The following are the Most at risk populations in Uganda:

1.       Fishing Communities; HIV Prevalence, slightly over 20%.
2.       In-mates; 13% HIV Prevalence among females; 10% HIV Prevalence among males, 2003 (MoH).
3.       CSW; 47%  HIV Prevalence 2003 (MoH); 2009(UNFPA)-KAP Survey
4.       GAY; Sodomy Laws, life imprisonment, not accepted and difficult to provide targeted services. There are situations that predispose gay people to un negotiated sex e.g., those who pay for sex-17% and those who engaged in unprotected receptive sex 37%, AIDS BEHAVIOUR, 2007 . Untreated and undiagnosed anal gonorrhoea, anal Chlamydia, anal warts, Genital warts, HSV-1 in gay people predisposes them to HIV, SYDNEY STUDY, 2009. MSM HIV Prevalence is 13.7%, Crane Survey, 2010.
5.       Uniformed services
6.       Persons staying away from their stable partners for long.
7.      Those who face; violence, abuse and discrimination.
LESSONS LEARNT:
 In Uganda  most gay also live a heterosexual life in order to reduce on repercussions of a same sex life. Issues that fuel vulnerability, risk and marginalization include: criminalisation, poverty, low skills, low risk perception, tendency to depict MARPs as societal slug in media, unwillingness to match decisions by MARPs with prioritized interventions and poor health seeking behaviour among MARPs.
RECOMMENDATIONS:
1.       Behavioural Approaches; where issues such as early sexual debuts, vaginal virginity, dress, same sex sexual intercourse, penetrative/non penetrative sexual intercourse, substance use/abuse and use of support groups will be an entry point in understanding gay Ugandans.
2.       Gauge risk perceptions around same sex sexual intercourse; In order to demystify fact that goes around attributing no risk to unprotected anal sexual intercourse.
3.       Knowledge of best practices; Such as established support groups or organisations. Especially using their activity plans.
4.       Knowledge of rights; by engaging gay communities in understanding the burden of responsibilities, values and good conduct. It would also be an opportunity to promote understanding of rights and exercise of basic rights such as: identity and associations.
5.       Confidence drives to improve attitudes towards self, others and community; This will help in a conscientisation for consistence culture for those at work to ensure survival or in schools to attain skills. It will also be an opportunity to improve self-image and self worth. It will reduce inferiority complexes among many who do not want to use their positions or identity to contribute to their own good.
6.       Generated documentation; In turn this will inform policy to effect programmes and interventions targeting gay community by allocating budget votes.
7.       Public Health/Human Rights Models;  The current criminalisation environment has  made the criminal, justice, legal system a persecution frame work for persons in same sex relations in Uganda and for those working to decrease discrimination among society. This is destructive.

CONCLUSION:

The gay are MARPs. It will be disaster if policy decided to criminalize this kind of relations and witch-hunt them since most are also formally set in heterosexual families.

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