HIV/AIDS preventive initiatives and prevalence rates in northern Uganda: the case of Dokolo district.

Abstract

The study assessed the effectiveness of HIV/AIDS preventive initiatives in reducing HIV/AIDS prevalence in Dokolo district from the year 2006 to 2010 when Dokolo was formalized as a district. The study had the following specific outputs; i) It established the effect of Prevention of Mother to Child Transmission (PMTCT) on HIV/AIDS prevalence in Dokolo; ii) It determined the effect of HIV/AIDS counseling and Testing (HCT) on HIV/AIDS prevalence in Dokolo; iii) It established the effect of HIV/AIDS behavior change initiatives on HIV/AIDS prevalence in Dokolo district and; iv) It found out the effect of economic factors on HIV/AIDS prevalence in Dokolo District. A cross-sectional survey study design was used. Data was obtained through questioning, in-depth interviews, observation, focus group discussions and document reviewing. A total of 132 participants took part in the study and findings revealed that PMTCT, HCT, HIV/AIDS behavior change initiatives (ABCD) and economic factors were contributing to the variations in HIV/AIDS prevalence in Dokolo district as all of them were statistically significant. Findings revealed that HIV/AIDS prevalence rate can be reduced if community members in the district change their current negative behaviors by adopting positive ones which reduce on the spread of HIV, facilities, resources and technical skills amidst sound relations between and among the various stakeholders involved in the fight against the epidemic should also be available throughout for success. It is recommended that; 1) for success in reduction of HIV prevalence rate in the district, communities should be sensitized and mobilized for active participation; 2) Preventive initiatives should be provided in a logical combination for example if HCT is being provided, PMTCT services should also be present and/or other economic services so as to enhance a positive attitude towards the HIV/AIDS preventive initiatives and; 3)Economic support of the already infected people is necessary so as to motivate positive living thus reducing the spread and therefore HIV/AIDS prevalence in Dokolo District. Other factors not explained by this research should be explored as well to determine how they affect project performance. In conclusion, this study revealed that HIV Testing and Counseling has the greatest impact on HIV/AIDS prevalence in terms of either reducing its prevalence when the HCT services are readily available and accessible and the opposite is true. The study also revealed that the second most influencing factor is economic environment then behavioral change strategies (ABCD Model) then lastly Prevention of Mother to Child Transmission of HIV/AIDS(PMTCT) which has quite an insignificant effect on HIV/AIDS prevalence. It should also be noted that PMTCT could be effective if it is readily available and accessible. The lesson learned in this study therefore is that HIV/AIDS service providers should put more emphasis on HCT as the major step to preventing the increasing prevalence of HIV/AIDS particularly in Northern Uganda. This should be in combination with other factors that also influence HIV/AIDS if we are to succeed in fighting the increasing HIV/AIDS prevalence.