Two weeks ago I visited an HIV positive friend in a district not far from Kampala. As usual, I checked services at the hospital where he gets his ARVs. It is run by nuns and offers free treatment for all.

I introduced myself as an HIV/family planning campaigner. The moment I [...]]]> By Barbara Kemigisa

Church and mosque resistance to contraception limits the reproductive health and the choices of people living with HIV.

Two weeks ago I visited an HIV positive friend in a district not far from Kampala. As usual, I checked services at the hospital where he gets his ARVs. It is run by nuns and offers free treatment for all.

I introduced myself as an HIV/family planning campaigner. The moment I mentioned family planning, the doctor warned not to say that to the next person I would see – a nun.

I told the nun I was an HIV/AIDS activist and that was perfect. Yet at one point in the conversation I felt like screaming: “You are pushing our effort doooooown! We can’t live without contraception!!”

I asked my friend to tell me what happens during consultations. He said that patients are not supposed to use, request, or even mention family planning.

So at this hospital, people with HIV are not supposed to engage in relationships, get married, have or space children. We don’t need contraceptives? People living with HIV need condoms, whether their partner is positive or negative, in order not to infect others or get re-infected.

This religious discomfort with contraception reflects an occurrence last month at Uganda’s national family planning conference. Routinely at such events all religions give an opening prayer, but the Muslim imam refused, saying his faith disagreed with the event.

Our blogger deplores religious resistance to contraception in Uganda.

This resistance to contraception is a huge obstacle for those of us living with HIV and in a relationship, to our efforts to build healthy and manageable families.

I know couples with low CD4 counts who are medically advised to wait before having children. This can only happen if family planning services are available to us.

Many of our youth are sexually active. We have no option but to encourage them to use protection from pregnancy.
I find it hard to accept that someone could decide for other individuals how to ensure their personal health. They forget that people deal with their lives differently.

As an activist working hard to halt the spread of sexually transmitted diseases, I feel cheated of choices.

Religious leaders could help a lot but unfortunately they sit in their offices, not knowing the real lives of the people to whom they minister. It’s ugly that some of these leaders only care about their stomachs instead of finding solutions, while those of us who look for solutions are handicapped by their attitudes.

All we get are promises that seldom come to fruition.

We should bring religious leaders together and sit them down for a reality lesson – people living with HIV need contraception!

Barbara Kemigisa is an HIV/family planning campaigner who lives positively with HIV in Uganda. When she is not campaigning, she dabbles in fashion design, plays guitar, composes and sings R&B songs about living with HIV with the same passion she puts in her work towards zero new infections.

Back then, in 2009, her CD4 count was only seven. She was very sick and had some skin infection that made her look and smell [...]]]> If you had seen Rukiya when I met her, at age 2, you would not have thought that today she would be alive and well and at school, age 7. 

Back then, in 2009, her CD4 count was only seven. She was very sick and had some skin infection that made her look and smell bad.

Her mother had lost hope for Rukiya and brought her to our association. Although I am neither a doctor nor a nurse, I could help the mother emotionally. I kept telling her to love her child despite her ill health.

Doctors put Rukiya immediately on antiretrovirals. She recovered and has been taking her daily pills conscientiously ever since, along with her mother. When she is at school, the matron reminds her to take the pills.

Drawing by Delfina.

So hard to talk about HIV

Rukiya’s story tells us a lot about couples and HIV.

The mom cleans a church pit latrine and the dad is a bricklayer. The mom says she found out she was HIV positive during antenatal care.  But she did not believe the diagnosis; she was faithful to her husband and thought he was too.

Or maybe she believed it but did not dare speak. So she kept quiet about her status.

It could be that the husband knew or suspected he was HIV positive and he too kept quiet.

I totally understand why it was hard for Rukiya’s mother to accept her initial diagnosis or talk to her husband about it.

Women are usually the first ones in a couple to learn they are HIV positive, at antenatal care.

It is really hard for you, as a woman, to talk to your partner about your HIV status, and have him understand you, not blame you.

So a woman will hide her status, and this brings many problems. For example:

• Reinfection if your partner is HIV positive.
• Self stigma and denial – always blaming yourself.
• Violence, especially when a man finds out later from someone else.
• Mistrust in families, spouses blaming each other about who brought the virus into the family.

Rukiya was delivered healthily, but at age two she fell sick. At hospital, the child and her parents were tested. All were HIV positive and started antiretroviral therapy. I have stayed close to them, so close that Rukiya calls me Mummy.

The parents went on to have three more children, now aged four, two, and ten months, all born HIV negative thanks to ARVs.

I tell Rukiya that I am also HIV positive and I have a family, a job and a career helping other people with HIV, and that she, too, will have a rich and happy life. And she gives me a big tooth-gapped smile and hugs me.

I am so privileged to have in my life this child, who is not from my womb, but who calls me Mummy Jackie although I am not her real mother.

Jacquelyne Alesi is a wife, mother, daughter, HIV activist and Programme Director at the Uganda Network of Young People Living with HIV/AIDS, an organization that since 2003 works to improve the quality of life for HIV-positive youth in Uganda.

I was in a four-year monogamous relationship, six years after happily undergoing gender reassignment, and felt fairly smug that [...]]]> The year was 2001. South Africa was in the midst of HIV/AIDS denialism. Safer sex was the buzzword. Casual sex was discouraged, abstinence encouraged and monogamy applauded.  Many were terrified of catching the disease.

Still from Jean-Luc Godard’s Pierre le Fou. Credit: Public domain

I was in a four-year monogamous relationship, six years after happily undergoing gender reassignment, and felt fairly smug that I was immune to HIV infection.

But, as the anti-establishment cliché goes, “rules are made to be broken”. I embarked on my first voyage abroad, a six-week business mixed with pleasure trip to France. Armed with French fluency, I swore it would be a trip of no pleasure denied, except for one.

I had vowed to myself and my fiancé, Mike, that I would not yield to the legendary, intimate delights Frenchmen had on offer.

Little did I know that there were men of other origins to indulge my penchant for those from North Africa. From Paris to Limoges to Lille, they were everywhere.

In the small town of Ambleteuse, alongside La Manche, or the English Channel, as the Brits call it, I met Mehdi. The olive-skinned, curly haired, perfect toy-boy looking, French-Algerian made all the right moves.

I succumbed. We did not have safe sex. Neither of us had condoms handy. I grappled with going “all the way”. The fear of HIV infection gripped me for months afterwards. It was still very much a possible death sentence.

A smart femme fatale

A few years later, in 2004, I went on a working trip to France, extended by a two-week vacation in Paris.

South Africa was now on the brink of its imprudent beetroot-and-garlic so called HIV “cure”. I was by then single.

This time it was no holds barred. I had gone prepared as La Femme Fatale. France, and in particular secularist Paris, taught me the freedom of casual sex. But this time I came prepared – with condoms. The option of reciprocal oral sex was another alternative to minimise the risk of infection.

Yes, I indulged in various pleasures, but when in the City of Love, who doesn’t? And of course I was less afraid of contracting HIV than I was in 2001. Antiretrovirals (ARV) now keep HIV-positive people healthy for years.

Glamourised by the media as another manageable chronic condition, HIV is not portrayed as a death sentence anymore – provided, of course, one is diagnosed early, has the ARVs needed and takes them, has good nutrition and good medical care and maintains a healthy lifestyle. Not all people living with HIV in Africa enjoy these.

The blessed cumulative efficacy of ARVs has resulted in the progressive depreciation of the fear of HIV infection among youth. I am certainly eons less fearful than I was in 2001.

However, whether sexually desirous or hedging one’s bets, one cannot adopt a laissez-faire attitude. HIV can still kill. It still does. And resistance to ARVS is a real, life-threatening possibility.

Thus, until the golden dream of a vaccine becomes reality, the rules of HIV prevention remain. Let us not play Russian roulette. Not even in Moscow with a handsome stranger and a shot or two of vodka. So pack your condoms!

Simone Heradien is an artist, activist, journalist, maximalist (likes things big), always on the ball. But come sunset, to unwind, you’ll find me dancing on a bar counter in some or other music hall.