Uganda Report 2012 FINAL PO:Layout 1 - ACORD

3.0 COMMUNITY VULNERABILITY TO HIV&AIDS IN FOOD
INSECURE POST-CONFLICT COMMUNITIES
3.1 Vulnerability to HIV&AIDS
In Northern Uganda, the insecurity and displacement
that ranged on for a long time led to creation of IDPs
camps which had limited access to health services
and other livelihood amenities. Various humanitarian
agencies, NGOs and government implemented
interventions for the IDPs, focussed primarily on
ensuring basic survival of IDPs such as food and safe
water. Other interventions including those on
HIV&AIDS did not occupy the centre stage in the
short-run. HIV&AIDS campaigns were for a long time
quite minimal in the camps, which inadvertently
affected level of awareness about basic facts of
HIV&AIDS for the majority. The limited knowledge and
access to services coupled with stigma and
discrimination increased vulnerability to infection with
HIV.
The war has been here for over two decades that
caused a lot of problems…over 80% of our population
was displaced and forced into IDP camps where the
living conditions were very difficult…it put them at high
risk of infection with HIV (KI, Ditrict Local
Government, Gulu).
The problem of HIV&AIDS started and increased
during the time when people were staying together in
the IDP camps…a lot of promiscuity ensued as well as
using sex as a tool of survival (FGD, Ordinary
Community Members, Lagoro, Kitgum).
Within the IDPs, without military escort, movement of
people was also limited to the confines of the IDP
camp for the protection of displaced persons in their
respective camps. This kind of situation limited the
IDPs from accessing land for cultivation. Almost all
IDPs survived on the monthly food rations provided by
WFP through its Food Assistance Programme. Study
participants affirmed that this change in livelihood
forced people to change their ways of survival as a
coping strategy. For instance, in the absence of food,
cases were reported of young daughters and wives
who engaged in transactional sex with mostly transient
groups including soldiers, traders and relatively
affluent others. The aim was to obtain some money
that would enable the household to obtain the
necessities of life especially food stuffs. Given the rundown
health services, and the urgency of obtaining
money or services, risk reduction choices such as
condoms in transactional sex were limited. It is for this
reason that IDPs are among the population categories
considered vulnerable and at higher risk of HIV
infection than others in Uganda.
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We used to trade sex for food…I got HIV from soldiers
because of the hard life that I was living…I was a
widow with children to support but I had no source of
income,…I would sleep with soldiers to provide for my
children, that is how I got AIDS (FGD, PLHA, Layibi,
Gulu).
The spread of HIV in the IDP camps was very high
because of lack of food…there was no food. In order
to get food, some women would even send their
children to have sex with soldiers in order to get money
to buy food (FGD, District PLHA Association,
Kitgum).
Poverty has also increased the HIV prevalence, people
engage in risky sex behaviours with the intention of
making money (FGD, District PLHA Association,
Kitgum).
Although relative peace has gradually returned to the
north and most people have left the camps, the level
of community vulnerability to HIV&AIDS in these food
insecure communities is still high. Sixty-one percent
(61%) of the population in Gulu and Kitgum are below
the poverty line 44 , compared to the national average of
31%. Lack of meaningful sources of income as well as
disposable assets to sell and buy food not only
exacerbate the food security situation, but forces
some community members especially girls and
women to indulge in high risk behaviours such as
unprotected sex.
44 GoU-OPM, (2009) Op. cit
Analysis has long been made that in situations of
post-armed conflict and food insecurity, people have
limited opportunity to choose preventive measures
against HIV&AIDS, leave alone disclosing their
sero-status. Given that people are returning to their
villages, this limited disclosure poses further danger of
increasing vulnerability to infection with HIV. Even
when out of camp life, in the face of food insecurity,
poverty stricken households with no buffer system are
bound to engage in high risk survival behaviour
(transactional sex) which was used in the IDP camps
as a strategy for coping with food insecurity.
Lack of disclosure is causing more infections
lately…many people are infected but very few are
coming up, they are probably infecting others
knowingly or unknowingly. This is worse among the
youth; teenage pregnancies are high which means that
they are having unprotected sex which makes them
vulnerable to infection (KI, Akwang Sub-county,
Kitgum).