Abstract #173  -  Lawful but unsafe. The challenge of reaching married couples with HIV prevention messages.
Authors:   Presenting Author:   Mr. Franco Wandabwa - World Vision Uganda
Additional Authors:  Miss Lucy Atim,
Aim: Faith leaders of all denominations are selected to participate in a workshop where their attitudes towards HIV&AIDS is assessed and challenged, their risk perceptions demystified through various self assessments and discussions on the difference between what is lawful and what is safe in terms of protecting couples from HIV infection. Faith leaders are challenged to advocate for Safe sexual practices including mutual faithfulness, Access to treatment of Sexually transmitted Infections and Opportunistic infections, couple counseling and testing and Empowerment of couples with information on HIV/AIDS
Method / Issue: Ugandas HIV prevalence rate has stagnated at 6.4% for over four years, the Abstainace, Being Faithful and use of Condoms (ABC) strategy has led to the success of its interventions. Recent statistics are calling for a change in strategy. The 2004-2005 Uganda Sero-Behavioral Survey shows that 43% of new infections are occurring among married couples, many of whom are in discordant relationships, and majority have not accessed HIV testing. Due to cultural, gender norms and practices most married couples, find challenges discussing health related issues. Faith leaders who marry off couples usually focus on spirituality, other than information that will empower and protect each other from HIV infection. Most married couples remain oblivious to the risk, they are in and have a false sense of security which is attached to the fact that marriage is considered sacred. Marriage therefore a traditionally respected institution has remained lawful but unsafe World Vision through its Northern Uganda Malaria, AIDS and Tuberculosis project (NUMAT) in a five year USAID funded program is working with religious leaders through a Channels of Hope model to challenge negative attitudes among faith leaders against people living with HIV&AIDS to empower them reach more couples within their congregations. The curriculum uses the AIDS Risk Reduction model which is based on the idea that to avoid HIV infection, people must first perceive that their behaviors place them at risk and are thus problematic.
Results / Comments: To date, grass root congregations supported have programs specifically targeting couples with HIV prevention messages. HIV prevention among couples is integrated into already existing congregational couple programs. Couples have accessed HIV&AIDS information, and couples have been referred to access testing services. With faith leaders more open towards responding to HIV&AIDS, couples are continuously supported to avoid HIV infection and or reinfection.
Discussion: The greatest risk to HIV infection is to consider oneself not at risk. It is critical that married couples (married, cohabiting) are supported to realize their risk and take the necessary steps to avoid infection and/or reinfection. Local congregations are a sustainable avenue to reaching couples and they should be utilized by HIV implementers.
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