Has the HIV/AIDS epidemic changed sexual behaviour of high risk groups in Uganda?

James P.M. Ntozi, Innocent Najjumba Mulindwa, Fred Ahimbisibwe, Natal Ayiga, Jonathan
Odwee
The Department of Population Studies, Makerere University, P.O. Box 7062, Kampala, Uganda.

ABSTRACT
Background
Uganda, was the first country in sub-Saharan Africa to reverse its HIV/AIDS epidemic. Long distance drivers, prostitutes and
barmaids have been identified as the groups that engage in risky sex, which promotes HIV transmission in Uganda and other
countries across the continent. This paper investigates whether and why there were changes of sexual behaviour and practices
among five risky groups in Uganda as a consequence of HIV/AIDS epidemic.

Methodology
The paper is based on data generated from a survey on ‘resistance to sexual behaviour change in the African AIDS epidemic’,
which was conducted in the districts of Kabale, Kampala and Lira in 1999. For purposes of this paper, only data from the focus
group discussions with high-risk groups have been analysed. These include commercial sex workers, street children, long haul
truck drivers, bar maids and adolescents in three towns of Uganda (Kabale, Kampala, Lira).

Results
Results indicate that despite the HIV/AIDS epidemic, these groups had only changed their sexual behaviour a little, and they
reported to be continuing with multiple sexual partners for a variety of reasons. The adolescents and street children were under
peer pressure and a lot of sexual urge; commercial sex workers and bar maids attributed their risky behaviour to the need to
survive due to the existing poverty; and the truck drivers reflected on the need for female company to reduce their stress while on
the long lonely travels across Africa.

Nevertheless, they are all aware and perceive people with multiple sexual partners as being highly vulnerable to contracting HIV and they all reported to have adopted condom use as an HIV preventive strategy. They also observed that married people were at a high risk of contracting HIV due to non-use of condoms in marital relationships and unfaithfulness of spouses.

Conclusions
Females engage in high-risk sexual relations as a means of economic survival, and perceive their acts as a strategy to improve their
socio-economic well being. On the contrary, men in these high-risk categories do such acts out of pleasure and as avenues for
attaining fulfilled sexual lives. The search for money among women and the constant desire for men to have sexual pleasure,
which are greatly facilitated by their financial status are the forces behind reckless sexual behaviour among high-risk groups.
African Health Sciences 2003; 3(3): 107 – 116