The lack of knowledge of the nature of the disease had put an HIV-related stigma and discrimination to those affected by the disease. Fear of discrimination often prevents people to seek help and be tested. And oftentimes it is the main reason why they do not admit their disease in public. In a 2005 Health Survey in Uganda, approximately half of the men and women surveyed had confessed that if ever a family member contracted HIV they would prefer to keep that fact a secret (UNAIDS/WHO 2005). Their sympathy is still on their family member although they have the greater social and health responsibility to their communities.
Cases like these should be reported to health authorities so that they can be accounted for, given assistance and warned not to infect others. Due to secrecy, most infected persons who may have been aware or not aware of the problem continued to have sexual interaction. Based on the foregoing condition, it is obvious that the earlier lack of interest in the part of the government to address the problem posed by the disease and the low access to education in Sub-Saharan countries had compounded the problem of HIV so that it has now become an epidemic of magnanimous proportions. III. Condom use
Condoms are readily available and cheap and because of that they are very useful in preventing HIV infection around the world. Although condom has been around for years it is not consistently and popularly used by most people especially in Sub-Saharan countries. In most cases condoms are used only when couples agreed to a birth control. However, the rising trend of HIV infection in Sub-Saharan Africa had inevitably and forcibly informed the African people to the advantage of using condoms. Nationwide educational campaign had been undertaken to convince the people to prevent the spread of the disease by using condoms.
There may be times that urging people to use condoms is a losing battle as HIV prevalence had steadily increases in Sub-Saharan Africa for years. However, it seems that the efforts are rewarded at last when reports circulated that there was an observable increase in condom use in recent years. In studies carried out between 2001 and 2005, eight out of eleven countries in Sub-Saharan Africa reported an increase in condom use (UNAIDS 2006). This just clearly shows that hard as it may have been, the general population of Africa may have now understood the usefulness and effectiveness of condom in preventing the spread of HIV.
As the world becomes aware of the prevalence of HIV infection in Sub-Saharan countries and how the epidemic had devastated the land both economically and socially, worldwide efforts had been directed to help these struggling governments in preventing the spread of the disease. One of the ways by which they had extended help was through providing thousands of condoms. As a result the distribution of condoms to countries in Sub-Saharan Africa has also markedly increased.
Records show that in 2004 the number of condoms provided to this region by donors was equivalent to 10 for every man as compared to 4. 6 for every man in 2001(UNAIDS/WHO 2005). But in spite of this increase many countries are still in need of many more condoms. In other words, the shortage of condoms is a continuing problem for these countries especially in Uganda, which had the highest population. For instance, in Uganda between 120 and 150 million condoms are required annually, but less than 40 million were provided in 2005 (UNAIDS/WHO 2005).
It must be understood that most Sub-Saharan countries are economically poor so that its citizens cannot adequately provide condoms by themselves aside from the fact that condoms can be used only once. The inability to provide condom by the majority of the population will still be made worse in succeeding years as many families sink deeper into poverty with the early loss of breadwinners in the family due to death in AIDS. However in some years, as the cure for the disease is not yet discovered, the population of Sub-Saharan countries may be reduced sharply as many die of full-blown AIDS so that the demand for condom may also decline.
But this not a good prospect to look forward to. But unbelievable as it may seem to the Westerners, in spite of all the efforts to inform the positive role condoms play in the prevention of HIV infection there are still people living in the countries or communities in Sub-Saharan region that are ignorant of the effectivity of condom or still refuse to use condom. This was supported by a study made in some countries such as in Botswana. In Botswana alone in 2005 HIV infection levels among older men and women were unexpectedly high.
It was found out that age groups belonging to 45–49 years old had 29% infection levels while those belonging in their early 50 have had infection levels of 21%. In a survey it was alarming to know that one in four respondents or roughly around 24% did not know that consistent condom use prevents transmission (UNAIDS/WHO 2005). This was rather surprising news owing to the fact that the respondents are already mature individuals, which can be expected to be fully aware of the nature of the disease especially that it had been affecting Sub-Saharan regions for more than two decades.
This just clearly shows that lack of awareness is such a persistent problem in these countries. The lack of awareness illustrated in the country of Madagascar. In Madagascar the HIV epidemic had markedly increase in the last few years, reaching an estimated 1. 8% in 2004(UNAIDS/WHO 2005). Upon close investigation it was revealed that the main cause of the epidemic is the practice of unprotected heterosexual contact. Although there was aggressive campaign for HIV awareness, knowledge about HIV especially with its mode of transmission is still inadequate.
When surveyed in 2003-2004, less than one in Madagascans can correctly name two methods for preventing the sexual transmission of HIV. Approximately only 12% of young men and 5% of young women (aged 15–24 years) had admitted that they used a condom the last time they had sex with a casual partner (UNAIDS/WHO 2005). Similar situation can be observed in Somalia where it was reported that among the citizens there exist little knowledge of HIV transmission resulting to the prevalence of unprotected sexual contact and rare use of condom.
In fact, according to the World Health Organization report in 2004 only 13% of young men aged 15–24 years had ever used a condom, and only 5% of young women (UNAIDS/WHO 2005). It seems remarkable that these people had little knowledge of HIV transmission or about the disease itself when all around them are living examples of the devastation of AIDS. But as stated earlier, there was an increase in condom use in some Sub-Saharan countries. This can be correlated with the decline of the spread of HIV infection. In Uganda in the study of 44 communities in Rakai south of the country in 2004, condom use with casual partners had become commonplace.
This only means that the people of Uganda had now seen the importance of condom in the prevention of HIV infection (UNAIDS/WHO 2005). The success of Uganda in fighting the spread of the disease can be first attributed to President Yoweri Museveni, who was the country’s President when AIDS strike the country. He had readily foreseen the terrible effects AIDS will have to his country so that earlier on he made efforts to prevent it from spreading by educating the people as well as informing them of the importance of condom use (Bartlett 2006)