“A qualitative study of Health worker’s perceptions on HIV incidence and risk factors in Ruhiira”

Abstract

Background: HIV, the virus that results in AIDS, is one of the most severe health and development challenges the world faces today. The continent most affected by HIV/AIDS is Africa. Strategies to fight HIV/AIDS have been implemented by governments, international agencies and NGOs. These strategies are most apparent in the 6th Millennium Development Goal and the 3rd Sustainable Development Goal. The East-African country of Uganda has successfully managed to reduce its HIV-prevalence from the early 1980s to 2005 through a multifaceted approach that has been hailed as a success story. However, since 2005 HIV-prevalence and incidence has risen. Critics are asking if Uganda is losing its fight against HIV. Objective: The objective of this study was to explore health workers’ perceptions of the factors that they feel contributed to the “success story” of HIV prevention in Uganda in the past and what they believe are the factors explaining current trends in HIV incidence and risk factors in the Ruhiira cluster, western Uganda. Method: I conducted semi-structured in-depth interviews with nine purposefully selected health workers involved in the management of seven health centers in the Ruhiira cluster, sponsored through the Millennium Villages Project. Results: I found that health workers have different opinions regarding the Ugandan story. Factors such as disclosure, openness about the disease and public initiatives from the President were considered as important. The role of foreign donors and funding were also said to have been crucial. There were disagreements among health workers as to whether there had been an increase in HIV-incidence. However, the majority argued that HIV-incidence was on the rise. Health workers found that there had been changes in people’s sexual behavior and that people did not follow the principles of Abstinence, Be faithful and Condoms as well as before. Health workers had concrete suggestions on how HIV-prevention could be improved. They argued that the government should strengthen and design accurate public campaigns, target groups at risk and continue the prevention of mother-to-child infection initiatives. Finally, health workers wanted better funding of the health sector and training of health workers.