Widowhood, remarriage and migration during the HIV/AIDS epidemic in Uganda

Recently the levels of widowhood have increased in countries of sub-Saharan Africa that are afflicted by the HIV/AIDS epidemic. This paper reviews the cultures of several societies in Uganda in relation to the treatment of widows. Using a data set based on a sample of 1797 households covering east, south and western Uganda, the study finds higher proportions of widows than widowers. Over half of widowers compared to one quarter of widows remarry. Reasons for remarriages of widowers and widows are discussed. While younger widows migrated from their late spouses’ homes more than the older ones, the pattern of the widowers shows that those in ages 20-34 migrated most. Deeper analysis indicates that widowed people who moved away from their deceased spouses’ homes did so for reasons other than the death of their spouses. The widowers were more likely to move than the widows and the unhealthy ones migrated more than the healthy ones

Effect of AIDS on children: the problem of orphans in Uganda

The problem of orphans is serious in sub-Saharan Africa and has been increasing with the deaths of both parents from AIDS. A study of six districts of Uganda conducted in 1992 investigated the problem. Almost all the orphans are cared for by their extended family members who made the decisions to do so. It is recommended that more assistance be given to the family to enhance its capacity to cope with increased orphans expected in the future

AIDS morbidity and the role of the family in patient care in Uganda

Extended families and clans in African societies have extensive systems of treatment and patient management which can be used with AIDS sufferers. This paper used data from a baseline survey of six districts to study patient care in Uganda. The levels of AIDS illness are high, and highest in the sexually active age groups of 20-49 years. Of the nuclear family, parents, siblings, spouses and children are the dominant AIDS patients’ primary carers in that order. Other relatives in the extended family also contribute much primary care. The contribution of neighbours and friends to primary caring and of other relatives as secondary carers is small. This is perhaps because of the financial burden of caring for the patients. However, there are indications that households and families are coping with the effects of the disease

Socio-economic determinants of HIV serostatus: a study of Rakai District, Uganda

The objective of the study was to establish the extent to which socio-economic status affects the acquisition of HIV. Data were collected in 1992 from 1784 respondents in Rakai district by the Rakai Project, with results for HIV serology and information on demographic, socio-economic and some behavioural variables. Level of education and urban residence were positively significantly related to HIV status both at bivariate and multivariate levels. Household wealth status was positively associated with HIV status at the bivariate level, but negatively related with HIV status at the multivariate level though not statistically significantly. Occupation was significantly associated with HIV status at the bivariate level and for one model at the multivariate level, but when occupation of the partner, travel destinations of partner and respondent, condom use and number of sexual partners in the previous year were introduced in a second model, occupation was not significantly related to HIV status

Impact of AIDS on the family and mortality in Uganda

The profile of the HIV/AIDS epidemic in Uganda can be summarized in the following terms: by December 1993, the cumulative AIDS cases reported by the official health system stood at 43,875 (ACP 1994); with about equal numbers by sex, with 47.7 per cent and 52.3 per cent of male and female cases respectively, the age-sex distribution showing female to male ratios of 4:1 and 2:1 in the age groups 15-19 and 20-24 respectively. This is followed by about equal numbers of both sexes at age-group 25-29 and a slight excess of males in all age groups thereafter. Although all 39 administrative districts had cases reported by that date, there are significant variations in the severity of the epidemic from district to district, with cumulative cases per thousand population in 1993 varying from less than one in some remote districts to more than 144 in Kampala city. The distribution by residence indicates a more severe urban than rural epidemic, with trading centres being in between in severity; nationally, the frequency of AIDS-related deaths is increasing and AIDS is touching most people's lives directly or indirectly. Many researchers have conducted studies of transmission, progression rates, sexual behaviour, patient care and the impact of the disease in Uganda (e.g. Konde-Lule 1992; Serwadda et al. 1992; Barnett and Blaikie 1992; McGrath et al. 1993; Mulder et al. 1994). The findings of these investigations have greatly enhanced the understanding of the disease and its impact on Ugandans. However, most of these studies have been limited in coverage of the country; they have concentrated on Rakai, Masaka and Kampala districts which are most affected by the disease. This paper reports the findings of a study on the impact of AIDS on the family and mortality covering six districts in the west, southwest, south and east of Uganda

Care for AIDS orphans in Uganda: findings from focus group discussions

A few studies have published findings on AIDS orphan care. Perhaps the pioneering study of orphans in Uganda was by Hunter (1990) who was alarmed by the high proportions of orphans in the population. She found that 23 per cent of the children in Rakai district did not have both parents in comparison to 12 per cent in Hoima; she predicted that the usual coping mechanism of the extended family would not be adequate to handle the problem. Another study, by Barnett and Blaikie (1992) in the Rakai district, narrated the experiences of different groups of orphans. Despite the existence of the extended family system in the area, Barnett and Blaikie found some of the orphans stunted and malnourished because they could not cope with orphanhood. The study concluded that most orphans were deprived of education, parental care, nutrition, shelter, clothing and the legal protection of their parents' property. However, these two studies were limited in the coverage of Uganda to the south and central regions and one district in the western region. This paper reports findings of a recent study of the care of AIDS orphans in several regions of Uganda. It is also the purpose of the paper to investigate how the various societies in Uganda have coped with the orphan problem since the onset of the AIDS epidemic. Changes in past and present coping mechanisms are discussed and recommendations for the future are made

Impacts of AIDS on marriage patterns, customs and practices in Uganda

Uganda has one of the highest numbers of reported AIDS cases in sub-Saharan Africa. This is mainly due to a number of historical and political factors. The government of Uganda has openly dealt with the AIDS crisis since 1986 but before that the socio-economic and political chaos in the country created an ideal situation for HIV to spread widely in both rural and urban areas. The HIV infection rate varies among different population subgroups: the 1987/88 sero-survey showed variations among regions and between rural and urban areas. In the most urbanized central region, 21.1 per cent of urban and 12.1 per cent of rural residents were estimated to be HIV-positive. In Western Region which is less developed than Central, 29 per cent of urban and 5.7 per cent of rural residents were infected. In contrast, in the remote and rural West Nile Region, 7.7 per cent of urban and 6.6 per cent of rural residents were HIV-positive (Asedri 1989). There is now a sizeable body of research in Uganda on sexual behaviour, social networking and HIV transmission, including sexual partner studies and studies of changing sexual behaviour in response to the epidemic (e.g. Berkley et al. 1990; Serwadda et al. 1992; Konde-Lule, Musagara and Musgrave 1993; Mulder et al. 1994). However, there is a need for more research on the impact of AIDS on the individual, the family and the community. Little is currently known about changes in households, extended families and their coping mechanisms, and the impact of AIDS on future productivity at the family level and within the community. The household is the basic unit of subsistence production in Uganda, and its existence and that of the extended family system within which it is embedded has enabled the society to weather the many stresses of war and social dislocation which have occurred in the country for over two decades. It is anticipated, however, that the increased stress occasioned by AIDS will be too much for the extended family systems to bear in the long run

HIV/AIDS, change in sexual behaviour and community attitudes in Uganda

The spread of HIV/AIDS is mostly through sexual intercourse and is largely influenced by behaviour and attitude. Data based on a sample of 1797 households are used to study changes in sexual behaviour and attitudes towards sickness and death in Ugandan communities, which were due to the realization that too many deaths were occurring in the community. Positive behaviour and attitudes include willingness to use condoms and go for HIV tests. Reasons for willingness and reluctance to test for HIV status are discussed. Changes of behaviour and attitude are significantly related to age, sex, education, ethnic group and number of AIDS patients and deaths known to a respondent

The AIDS epidemic and infant and child mortality in six districts of Uganda

Several studies in sub-Saharan Africa have associated infant and child mortality with the AIDS epidemic in the region. The paper uses retrospective survey data of six districts in the east, south and west of Uganda to study infant and child mortality, which increased in the 1980s probably because of the AIDS epidemic and started declining in the early 1990s, a period when the epidemic was reported to be subsiding. Deeper analysis of data indicates that children whose parents are polygamous, educated, formally employed and in business are at a higher risk of death from AIDS and related illness. Although AIDS as a direct cause of death is the fourth leading killer of children, other serious diseases such as diarrhoea, respiratory infection and measles are associated with AIDS

Marriage patterns in Ankole, South-Western Uganda

This paper studies marriage patterns and systems in Ankole. Discussed in the study are age at marriage, proportion married,marriage dissolution, remarriages, types of marriage and bridewealth. The paper finds that most of the marriage patterns are among the major causes of high fertility in the area