Essays, poems and Stories of an African-American

Wednesday, 27 January 2016

The Single-Parent Paradox: Problematizing causes of vulnerability to HIV; Informing HIV prevention and Control Policies in Uganda


Background: 
Personal decisions; economic pressures; and lifestyle are responsible for increasing numbers of single-parents. These same issues are also risk factors linked to HIV disease in this category of population group. Personal decisions range from: abstinence following death of a spouse or partner; child-bearing to prove fecundity or as financial security from a more well to do partner; living independently as a self-supporting person. Economic pressures include: working so many miles away from home; situations when a female earns more than male partner; and relying on males with in polygamous relations. Lifestyle issues  include: fashion and trend of single-parenthood popular in urban settings; and pressures of living in urban settings as a single-parent. These characteristics should be linked to prevention and control interventions against HIV. 


Description:
 Anecdotal methods were used to generate responses on characteristics, prevention and control practices among groups of single-parents in Wakiso (20 males:30 females); Kampala (30 males:45 females); Mukono ( 20 males: 32 females); Busia (12 males:15 females); Masaka (10 males: 20 females); Bukomansimbi (50 males: 65 females); and Kyegegwa (10 males: 23 females). Anecdotal and literature review were also used to generate further information on HIV Services and demands made that target single-parents: counseling, sexual-reproductive health, post-test practices, prevention, prophylaxis, staying negative, avoiding transmission and economic empowerment. Stigma and discrimination; pressures of bearing children; daily survival; care for children and  caring for people living with AIDS still remain single-parents related issues also linked to HIV.

Lessons learned:
For the time period January 2014 to December 2015, we reached 382 single-parents. 152 are males: 230 are females; 182 were < 45 years; 200 were > 45 years; 300 were HIV-exposed; 10 were living in discordant relations; 120 had had an STI treated in past 12 months. All 382 had engaged in unprotected sexual intercourse with a partner other than their first debut. All 382 expressed need for economic empowerment as means of looking after themselves and their families. 200 females said they had children as a means of getting support from male partners or relatives as well as a desire to bear a child/children. 75 males responded that they had a child or children with female who are not long-term partners. 100 females had lost a male partner to HIV but they bore children as a way of staying with subsequent male partners or spouses.

Conclusions/Next steps:
Single-parents are persons who have made a conscious decision to remain without formal partners. The need to bear children also means engaging in sex without condoms. Planned pregnancies may also mean unwanted STIs and HIV. HIV prevention and Control should incorporate messaging targeting unique needs of single-parents. The messaging should show merits of long-term relation, monogamous fidelity, integrate economic empowerment, discourage widow-inheritance and provide motivation to forming post-test clubs where single-parents as a cohesive force advocate for safe and healthy outcomes.