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UGANDA: Desperately seeking condoms in the north

Photo: Wendy Stone/IRIN
Health workers warn that the continued condom shortage could harm HIV prevention efforts
GULU/NWOYA, 18 January 2011 (PlusNews) - For the third month running, men and women seeking condoms at local health centres in some northern Ugandan districts have found empty dispensers. Health workers warn that the continuing shortage could affect regional HIV prevention efforts.

HIV/AIDS focal persons for Gulu, Kitgum and Nwoya districts say health facilities have no condoms in stock for free distribution and commercially available condoms are too expensive for many people in northern Uganda, which is still emerging from a two-decades-long conflict.

"As I speak now we have no condoms for distribution," said Charles Luwa, HIV focal point for the Ministry of Health in Gulu district. "We do not know what to do to solve this problem; we made a request to the health ministry but there is no condom delivery yet."

The condom shortage in the north follows a similar scarcity reported in several districts in mid-2010. At the time, the government blamed a long procurement process and irregular delivery of condoms to the country.

According to Zainab Akol, in charge of HIV programming at the Ministry of Health, the problem lay with district health officials who did not order condoms well in advance.

"They need to order - the problem is that people from the district do not place their orders in time," she said.

Correct and consistent condom use is one of the mainstays of Uganda's HIV prevention programme; according to the government, distribution has gone from 10 million condoms annually in 1996 to more than 130 million in 2009. However, some experts put the annual need at over 200 million.

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Luwa says even when his district does have condoms the regular allocation of 50,000 condoms per quarter is insufficient to meet the demand. People who have the money buy them at local pharmacies; those who do not are left with two choices - abstain or have sex without a condom.

A price check at a few pharmacies in Gulu found male condoms being sold for between US$0.25 and $0.50 for a three-pack, while a female condom cost up to $9.

The Gulu Youth Centre, a community-based NGO that distributed more than 15,000 condoms in 2009, is completely depleted.

"These [youth] are sexually active [and] require protection, though we don't encourage them to engage in early sex," said Faith Falal Rubanga, the centre manager. "Sexually active youths who can't afford to buy condoms are at risk."

Hotels in Gulu - many of which have partnered with municipal health authorities to stock condoms for their guests - say they too have run out.

Northern Uganda has one of the highest regional HIV levels in the country - prevalence in the northern-central region is about 8.2 percent, compared with the national average of 6.4 percent.

Not "bullet proof"

In the years since the conflict ended, towns such as Gulu have grown into large commercial centres, attracting businessmen and professionals and leading to a noticeable rise in sex work in the region's larger towns.

Comfort Atugonza, a sex worker in Gulu, told IRIN/PlusNews the shortage of condoms - known as "bullet proof" in the local sex trade - had forced her to increase her charges.

''I can't risk live sex... I provide the service but that doesn't mean I have to compromise my life''
"It's hard to do the work without bullet proof; I have turned down a number of clients who opted to have it live [without a condom] but I don't know what my other colleagues are doing in this hard situation," she said.

"I can't risk live sex... I provide the service but that doesn't mean I have to compromise my life," she added.

Another sex worker, who preferred anonymity and operates in a less upmarket area of Gulu, said she had had to make the difficult choice to have "live" sex.

Fewer than half of risky sexual acts are protected by condoms, according to the Uganda AIDS Commission. Among other things, the government attributes this to insufficient funding for condom procurement and supply chain management, leading to frequent stock-outs as well as lack of supplies for distribution.

ca/kr/mw

Theme (s): Economy, HIV/AIDS (PlusNews), Prevention - PlusNews, Urban Risk,

[This report does not necessarily reflect the views of the United Nations]

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