BWINDI, Uganda — In a nameless mud-walled bar, over a lunch of roast goat, bananas and Bell beer, a group of AIDS counselors gathers to discuss one question: Why is it so hard to practice safe sex here?From the second story:
The AIDS crisis seems hopeless because of the new infection rate. For every 100 Africans put on treatment, 250 get infected. Globally, 7,400 people are infected every day.
In the 1980s, Uganda earned renown for pushing its infection rate to 6 percent from 18 percent. Many here still remember the pounding drums on the radio and the slogans “Practice ABC” and “zero grazing” — no extramarital sex.
But infection rates are creeping back up.
“Many people are just ignorant,” said Gervis Muhumuza, 44. “They have low education, and so many misconceptions. Minus the elite class in Kampala and a few others, nobody is using condoms.”
The 2006 Demographic and Health Survey of 11,000 Ugandans found that 99 percent had heard of AIDS, but only about a third had “comprehensive knowledge” — that is, they could correctly say whether it was spread by mosquitoes, by food or by witchcraft; whether it could be prevented by condoms; and whether a healthy-looking person could have it.
The last decade has been what some doctors call a “golden window” for treatment. Drugs that once cost $12,000 a year fell to less than $100, and the world was willing to pay.I definitely see the same problem with condoms around here. One of my Grade 8s is pregnant, and there's no telling who the father is. I have no idea what to do about it--I can't even convince them I'm not rich.
In Uganda, where fewer than 10,000 were on drugs a decade ago, nearly 200,000 now are, largely as a result of American generosity. But the golden window is closing.
Uganda is the first country where major clinics routinely turn people away, but it will not be the last. In Kenya next door, grants to keep 200,000 on drugs will expire soon. An American-run program in Mozambique has been told to stop opening clinics. There have been drug shortages in Nigeria and Swaziland. Tanzania and Botswana are trimming treatment slots, according to a report by the medical charity Doctors Without Borders.
I wonder what the endgame is for the pandemic if help collapses and the disease continues to spread. One option is looking more and more likely for Swaziland. According to the United Nations Development Program, if the epidemic is not brought under control, "longer term existence of Swaziland as a country will be seriously threatened." Two percent of the Swazi population dies of AIDS every year.
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