| dc.description.abstract | The trend of HIV and AIDS epidemic in Uganda is posing serious challenge to the national AIDS response and social development of Uganda with notable increasing incidence and prevalence among adolescent girls, 15-19 years with worrying increasing trends in the Karamoja sub-region mostly in Moroto District. Therefore, in January 2019, I embarked on a mission to understand the risk factors for HIV and AIDS among young people in Moroto District. The study design was a descriptive survey utilizing both quantitative and qualitative methods of data collection This study was conducted in Moroto District. Moroto district forms part of the districts of Karamoja region. From Moroto District Northern division and Nadunget sub-counties were selected for the study. Random sampling techniques were used to select the study sample of 116 adolescents and young people who responded to the structured questionnaire. Secondary stakeholders were purposively selected at district, sub-county, and community levels to supplement on the quantitative data. Majority of young people (15-24 years) in the Moroto District are aware of the HIV and AIDS infection but also glaring gaps in knowledge, especially of prevention practices and technologies are evident. Many claim to have ever known a person living with HIV (95%) in their community. In addition, a big number of young people (69.0 %) reported knowing a person who died of AIDS related illness in their community—67.9% 15-19 years and 71.9% 20-24 years. Majority demonstrate correct knowledge of two common modes of HIV transmission: unprotected sexual intercourse with an infected person (95.5%) and sharing unsterilized instruments (59.6%). There are also misconceptions about HIV risk factors like causal contact (18.4%), mosquito bites (1.8%) and witchcraft (2.6%). Knowledge of safe male circumcision in reducing the HIV infection is still low (52.0%). Whereas the practice of delayed sexual debut until marriage would be safely guarded and highly cherished in a Moroto District with strong traditions, the evidence shows that majority of young people (15-24 years) are sexually active (89.7%) i.e., had ever had sexual intercourse—90.8% males and 87.5% females. Cross-generational sex (81.3%), extra-marital sex (31.1%) and all kinds of spontaneous, multiple, casual, non-cohabiting sexual relations and cases of defilement and rape are evident in Moroto District. Most young people (66.4%) had never used a condom. Evidence of risk behavior is common, among others, evidenced by the high proportion of young people who had their first sexual intercourses under the influence of alcohol (76.2%). This is more upsetting in a society where rape and forced marriage are common phenomena. Over a tenth (10.3%) had ever experienced any form of forced sexual intercourse. Some young people (2.8%) had their first sex with someone they did not know and 27.7% of them had sex with their “spouses” (defilers in forced/arranged marriages). This was mainly attached to parents’ desire to get heads of cattle from their daughters; a manifestation of the problem of sexual and gender-based violence. Several other cultural practices which have the potential to fuel HIV risk infection exist in Moroto District, notably mentioned by young people (15-24 years) include female genital mutilation (18.0%) wife inheritance (16.7%), forced/arranged marriages (14.9%) early marriage (12.8%), tattooing (13.4%) among others. The findings showed that the majority of young people in Moroto considers avoiding sex with sex workers. followed by avoiding sharp instruments, abstinence and condom use. It was also observed that over 20% of the young people in Moroto District were doing nothing to prevent themselves from HIV/AIDS infection. In conclusion, the socio-demographic dynamics of the Moroto District render it more susceptible to increase in the prevalence of HIV and HIV and its devastating effects, for majority of the young people are sexually active and out of school. Young girls face a disproportionate risk, including early sexual debut, rape, and forced marriages. A deeper analysis of knowledge and practices of young people in Moroto District related to SMC, eMTCT, ART, HCT, condom use and HIV prevention are still low which increases HIV risk infection. Majority of the young people in Moroto District are knowledgeable on issues of HIV however, there is still need to educate the few young people who believe that HIV is transmitted through mosquito bites and causal contacts. For the few young people who are not yet aware about the HIV transmission, they should be reached with more IEC strategies to increase awareness and correct knowledge, and to tackle misconceptions about and knowledge gap about HIV transmission. Community sensitization should be prioritized, and capacity of district actors in health education and community work strengthened through recruitment and training. Intensify HIV awareness campaigns so that all the young people can know the modes of HIV transmission and prevention. This can be done by increasing on availability of IEC materials, increased radio talk shows, community sensitizations among others. In addition, there is need to need to enforce laws that prohibit drinking of alcohol by children who are under the age of 18 years. This is going to help in reducing on the number of children who engage in sex after drinking alcohol. | en_US |
