Uganda: Unfriendly Nurses and Culture Hinder Male Involvement in HIV Prevention

Uganda has been a pioneer in the prevention of mother-to-child transmission of HIV, with programs dating back to 2000. Though PMTCT is now available at the county level across most of the country, gaps remain. Statistics from the Health Ministry show that while almost all women attending antenatal clinics agree to HIV testing and counseling, just two-thirds return for their results. Of those who test HIV-positive, only 17 percent deliver their babies at the hospitals.

Uganda currently has more than 110,000 HIV-positive children and continues to log around 25,000 new infections annually. Most infected children acquire HIV at birth, said Dr. Zainab Akol, head of HIV/AIDS programs at the Health Ministry.

Health experts say Ugandan men play a key role in reproductive health decisions. Yet male participation in PMTCT in Uganda hovers at just 5 percent, according to Robina Kaitrimba of the non-governmental National Coordinator of Uganda National Health Users/Consumers Organization. Failure to reach the sexual partners of HIV-positive women remains the biggest barrier to PMTCT, she said.

Research by Dr. Robert Byamugisha shows men feel antenatal clinics are not male-user friendly and midwives are impolite. In some instances, Byamugisha said, midwives "did not allow men to enter with their pregnant wives to the clinic."

Titus Namanda, who lives in Bunghokho village in Mbale district, vowed never to return to the antenatal clinic. "They made me wait for three hours and I witnessed them abusing my wife and other women," he said. "I decided not to go back."

Other men give financial reasons for not attending. Mutwalibu Wambete, a father of two, pays $5 a day to rent a motorcycle that he operates as a taxi. "So if I spend time at the clinic then we shall go hungry and the children will not go to school," he said.

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