Abstinence in Uganda

About a week ago I found a couple interesting articles dealing with abstinence as a method of HIV/AIDS prevention among Ugandan young people.

In this July 15 opinion article from New Vision, Martin Sempa discusses the stigma faced by many teenagers who choose to abstain from sex:

Children who abstain are forced to survive shame and psychological violence by hiding in the “closet.” They are treated as lepers, social outcasts whose virginity is not a badge of pride, but rather a mark of disgrace. This is what I call “abstinence stigma.” While many parents teach their children the value of abstinence and saving sex for marriage, they are un-aware that the social contexts where young people make informed decisions about sex are contaminated with hostile and judgmental attitudes towards abstinence. It is a form of phobia.

In an article published by New Vision the next day (July 16), Francis Kagolo reports that state minister for primary education Peter Lokeris urged students to “take pride in virginity, and shun gifts from sugar daddies and sugar mummies” [ie. adults who give young people money or gifts in exchange for sexual favors].

Sempa, who is described by New Vision as “an AIDS prevention specialist who has spent 20 years speaking to young people about AIDS prevention,  gives the following example abstinence stigma:

During a high school classroom discussion on HIV/AIDS prevention, the teacher asked the students: “What can be done to stop the spread of this fatal disease?” Some students talked about condoms and received the knowing affirmation of the teacher.

However when James, 16, raised his hand and answered: “We must promote and support young people to abstain until marriage,” he was attacked and stigmatised!

The teacher laughed derisively and mockingly told him, “Abstinence does not work for young people. It is just a dream.” James, who had chosen to abstain from sex after an abstinence presentation in Grade Eight, felt ashamed but he knew better. Other students began to mock and sneer at him. Again, James raised his hand and tried to explain how he had made the choice to abstain till marriage. “For some of us,” he said, “abstinence is not a dream, it is a present reality.”

The comments of the teacher had already created a hostile environment for James, and now he became the butt of the class jokes. Subsequently, James was mockingly labelled stereotype names ranging from “little mamas boy,” “ignorant kid”, “holy pope”, “virgin Mary” to “you are so ugly, that’s why you can’t get any.” As if bent on breaking his will, two girls approached him and sarcastically told him they wanted to cure him of this dreaded disease called virginity. They recited stories of people who abstained and their genitals withered and fell off and that he was a good for nothing boy. They then walked away laughing.

Sempa goes on to suggest the following actions:

We need to break the chains of “abstino-phobia” with campaigns of breaking the silence. We need school-based safe spaces of small groups where young people can meet for support without fear and stigma.

We need regular scientific inquiry to assess the levels of abstinence stigma both in the classrooms and school corridors.

We need large school rallies where those who are in the abstinence closet of shame can come out loud and proud.

And we need diversity training for the teachers and school administrators to learn to be more tolerant of the children who abstain to protect themselves from diseases and death. No child should ever be shamed, for making the healthiest choice.

In the other article, Kagolo reports that the education minister made his comments on the importance of abstinence at “a ceremony organised to award Nsambya Railway Primary School for excelling in enhancing HIV/AIDS awareness among children.”

The school is one of over 1,000 primary schools across the country being recognised by the education ministry this year for excelling in implementing the Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY).

The school head teacher, Olivia Muhumuza, said several small groups of 45 children each were set up to receive HIV counselling every Monday.

After receiving the plaque, Muhumuza said the project had improved pupils’ awareness about the virus, and they were determined to avoid sexual intercourse before marriage.

These articles raise some interesting considerations.  Opponents of abstinence (or abstinence-only) prevention programs often criticize them as repressive and unrealistic.  There are a lot of issues wrapped up with this type of criticism, but these articles bring up some interesting points.  On the one hand, some Ugandan kids (and, apparently, adults) do seem to think abstinence before marriage is “a dream.”  On the other hand, others — like James — are committed to abstinence as a method of HIV prevention (and possibly for other reasons).  And as the report from Nsambya Railway Primary School suggests, children who receive careful training in HIV prevention can be very receptive to the abstinence method.

I think Mr. Sempa is on to something when he suggests an anti-stigma campaign to make abstinence more socially accepted.  While I generally disagree with those who argue for an abstinence-only approach to prevention (realistically, you’re never going to get 100% of young people to refrain from sex, especially not in the context of the myriad social, cultural, and economic pressures faced by youth in Africa and elsewhere), the A in ABC does offer many benefits, especially for children, teens, and young adults.  It makes sense to teach youths the value of safe habits and choices from a young age, and prevent the need more complicated and costly interventions later on.  Not surprisingly, though, peer pressure can easily get in the way (and it’s not like this problem is confined to Uganda, or Africa!).

It’s hard to know just how to deal with these issues, but Sempa is right that they need to be addressed.  He’s also right in pointing out the need to consider the social pressures that make up young people’s daily experience, when working on prevention strategies.  Parents and adult policy-makers might not be aware of these conditions — and if you don’t believe me, think back to high school!

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~ by h.e.g. on July 22, 2008.

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