Marriage, Risk Behaviours and HIV Infection in Rural Rakai, South Western Uganda

Abstract

The HIV/AIDS epidemic is still a global problem that is most severe in sub-Saharan Africa. It is estimated that over 2.1 million (1.9 – 2.7 million) people became newly infected with HIV in 2012 year (UNAIDS, 2013 and 70% of new infections in 2012occurred in Sub-Saharan Africa, mainly as a result of unprotected heterosexual intercourse. The consequences for adult morbidity and mortality are expected to continue into the future. This has placed severe economic and/or psycho-social stress on households, families and communities. Men and women are affected with HIV/AIDS differently and the burden of disease is also different by gender (UNAIDS, 2011; UNFPA, 2004; Clark, 2004). For example women comprised of 59% (56-63%) of the adults living with HIV in Sub Saharan Africa in 2010 as they have for most of the past decade. The socio-economic impact on rural households and families has different repercussions, depending on whether it is the man/father or woman/mother who is infected first, and/or, whether one or both die. The impact is often more severe in women, particularly in sub-Saharan Africa where heterosexual sex is the dominant mode of HIV transmission. Studies from Africa have shown that women are more at risk for HIV-infection than men (Audrey et al, 2004) and the difference in infection levels between women and men is even more pronounced among young people. In sub-Saharan Africa, women form the largest proportion of sexually active adults at all ages, but women aged 15–24-years, on average, are 3.4 times more likely to be infected than their male counterparts (Clark, 2004). The consequences of HIV/AIDS morbidity and mortality may be immediate or long term and include grief, loss of income, increased dependency ratio, detrimental changes in family composition, orphanhood and fostering (Makumbi, et. al, 2005) as well as changes in child roles and school enrolment failure.