THE TRUTH ABOUT UGANDA'S
SEX-ED CAMPAIGN AGAINST AIDS
Sex-ed classes in North American and elsewhere generally fall into one of two
||Abstinence-only classes in which students are taught about
remaining sexually inactive until marriage. They are trained how to say
"no" to sex. They are kept ignorant of methods to prevent transmission of
Sexually Transmitted Diseases (STDs). Contraception to prevent
pregnancy is also not taught.
||Comprehensive sex-ed classes in which students are taught about
the benefits of choosing celibacy. But, for those who are sexually active
or who may decide to become sexually active in the future, they are also
taught how to lower the chances of STD transmission and pregnancy.
Many Fundamentalist and other Evangelical Christian group promote
abstinence-only classes. Focus on the Family and some other Fundamentalist Christian
organizations are promoting experiences in the African state of Uganda as
proof of the effectiveness of abstinence-only sex-ed classes. This appears to be invalid
information. In fact, the Ugandan campaign is a comprehensive sex-ed
||Abstinence to the sexually inactive,
||Monogamy to married couples, and
||Condoms to prevent STD transmission for almost everyone who is
The Ugandan story according to SIECUS:
The Sexuality Information and Education Council of the United
States (SIECUS) describes the Ugandan program as a comprehensive
plan involving both abstinence for those who wish to remain
sexually inactive, and the use of condoms for STD prevention for those who wish to be
SIECUS wrote that: "Uganda has been lauded as the most
successful HIV/AIDS prevention case in Africa, as it is the only country in
sub-Saharan Africa where the incidence of HIV/AIDS has decreased."
When President Yoweri Museveni took power in Uganda in 1986, he gave
priority to fighting the country's growing AIDS epidemic. The
administration established the Ugandan National Task Force on AIDS in
1990. It started as a narrowly focused STD prevention program, involving
condom distribution and promotion through popular songs, drama groups,
counseling and support services. This was expanded in 1995, and became a
comprehensive sex-ex program. Included were additional "approaches to
promote safe sex, abstinence, fewer sex partners, and condom use among young
people." President Yoweri Museveni stated, "We encouraged community
based initiatives and our campaign has produced a lot of mass networks. We
encouraged condom use and in ten years have seen it go up from 7% to 42%."
On the negative side, Museveni refuses to acknowledge that homosexuality
exists in his country. He believes that HIV infection only spreads in his
country by three
||Unprotected heterosexual sex.
||Transfusion with infected blood.
||Tribal customs such as circumcision. 1
The President appears to be in a very small minority.
International issued a report in 2001-JUN documenting numerous cases of
homosexuals who had "held illegally for up to two weeks in illegal
detention centres, army barracks and police stations before being released
without charge. A number of Ugandans fled the country fearing arrest. In
November President Museveni stated that homosexuals could live in Uganda as
long as they kept their sexual orientation secret." 2
Most public health authorities feel that driving homosexuality underground
is guaranteed to increase HIV infection which causes AIDS.
The Ugandan story according to the Ugandan AIDS Commission (UAC):
The UAC appears to be solidly behind a comprehensive plan to reduce the
transmission if HIV through a three-pronged promotion of "behaviour
change" among the general population -- specifically:
The UAC's first listed priority is "to reduce HIV prevalence by 25% by
the year 2005/6." Their first listed method of accomplishing this goal
is through the promotion of "behaviour change (abstinence, faithfulness
and safer sex) among the sexually active populations, particularly young
people aged 15-25." 13
The 1994-1998 National Operational Plan for HIV/AIDS/STD Prevention,
Care and Support of the Uganda AIDS Commission states:
"The main emphasis of the Plan will be prevention of HIV-infection
through behaviour change, promotion of STD-care and condom use for
targeted groups of people with focused educational messages. The
promotion of behaviour change will focus not only on the individual
behaviour, but will equally focus on the collective behaviours, and the
norms and the values of the community." "In order to achieve this,"
indicates the Plan, "it is necessary to give first priority to children
and youth and to start addressing norms and values right from school
entry, gradually making it more specific as the child grows." The second
priority of the Plan is to address the status and needs of women,
including rural women, and the third is to address cultural and
traditional customs and specific sites with concentration of risk
UAC National Aids Documentation Centre" (NADIC):
NADIC is funding Community-led HIV/AIDS Intitiatives (CHAIs). NADIC's
Project Brief discusses "Eligible Activities under CHAIs."
The only eligible activities for
prevention of HIV transmission which can obtain funding are:
||"Local information, education and communication activities like
music, dance and drama aimed at HIV/AIDS prevention and mitigation."
||"Safer sex education including condom promotion, storage and
distribution." (Emphasis ours)
||"Information on the dangers of STDs and prevention of
Mother-to-Child-Transmission of HIV/AIDS." (Transmission can be
greatly reduced with certain medication given to pregnant woman, and
through the avoidance of breast feeding by infected women).
Abstinence is not specifically mentioned in the entire project brief. 12
UAC "Practical Information Sheet":
The UAC web site features a "Behavior Change" sheet titled "A very
simple message." It says in
"We thought that the AIDS epidemic was just a little river that we could
dam easily; Now we realize that it is a real flood that rises inexorably; Many
people start loosing hope; They forget that if you cannot dam a flood you can
escape by getting into a boat. People are different, they need different
"There are three kinds of boats called: 'Abstinence', 'Fidelity' and
'Condom' People are argued [sic]: 'Do not stay in the water, get into a boat.'
The boat of your choice. If you feel that you cannot stand the life on board,
do not fall back into the water; Switch from one boat to another."
The sheet continues, recommending that Ugandan's:
||Talk honestly and openly with your spouse or partner about how safer sex
can protect both of you from HIV/AIDS.
||Start practicing some of the safer sexual behavior listed above, use
condoms and protect yourself, say no to sex if your partner will not accept to
use a condom.
They sum up their message with:
to unsafe sex!"
LEARN HOW TO SAY NO.
Finally, their information sheet concludes with 19
suggested statements that women can say to their partner or spouse. Seven relate
to the use of condoms:
||"Yes I love you. But we still need to use condoms."
||"Being in love canít protect us against disease; We still
need to use condoms."
||"I want to start using condoms now so we wonít be at risk
||"Itís simple! I absolutely will not have sex without using
||"Using condoms is not a matter of trust. Itís a matter of
||"Letís use condoms. Itís important to me that weíre
||"Worrying about disease isnít romantic. With condoms we
wonít need to worry."
The National Strategic Framework for HIV/AIDS Activities in
The NSF has published an executive summary, which notes:
In Uganda, "There has been an overall decline in HIV positive
sero prevalence rates...from 30 to about 10% between 1992 and 1996...it appears
to have stagnated since."
"...the mechanisms that produced this reduction are not fully
understood. Owing to weak monitoring, it is not possible to apportion the
observed decline between the three factors of abstaining, being faithful to
oneís partner, and condom use."
Information, Education and Communication (IEC) programs
centered on the promotion of safer-sex practices and improving the quality of
life of persons with HIV/AIDS. Of the close to 1,500 agencies involved in
HI/AIDS. nearly 70% were involved in IEC work. As a result of their efforts:
The proportion of sexually active persons who ever used a condom
rose from 7% in 1989 to 42% in 1995.
The increase in the median age at which girls became sexually
active increased by about six months between 1989 and 1995 to about 16 years of
However, they note that their are many constraints in the
promotion of IEC:
Most people, particularly those who live in rural areas, cannot
obtain or afford condoms. They recommend that condom accessibility and
affordability be improved.
The proportion of people who use condoms properly is not known.
They note in their recommendations for the period 2000/2 to
2005/6 that" "Widespread awareness of the epidemic, openness and less
stigmatisation of individuals, increased condom use, and significant
mobilisation of local NGOs and CBOs for provision of care and social support to
people infected and affected are some of the achievements made and should be
further strengthened and sustained." They note that "the reduction in the
proportion of HIV positive persons cannot be apportioned between abstinence,
being faithful, and condom use." They recommend that "A representative
survey on knowledge, attitudes, beliefs and practices regarding HIV/AIDS needs
to be carried out during the early part of the implementation of this framework."
Only then will the effectiveness of the three approaches -- abstinence,
monogamy, and safer-sex -- be determined. They will then be able to gear their future programs accordingly.
The Ugandan story according to Johns Hopkins University:
The Population Information Program, of the Center for
Communication Programs, at Johns Hopkins School of Public Health,
regularly publishes Population Reports. Their 1999-APR issue discussed how
condom promotion programs have succeeded well around the world. They cited the countries of
Nepal, Senegal, Thailand, and Uganda.
They also describe the Ugandan program as a comprehensive plan
involving both abstinence for those who wish to remain sexually
inactive, and STD prevention for those who wish to be sexually
They note that at one time, Uganda had the highest HIV infection rate in the world.
"While most other developing countries have since seen increases in
HIV/AIDS, Uganda has seen a decrease of up to 25% in the HIV infection rate
compared with the rate in 1980." It is the only country in sub-Saharan
Africa where the incidence of AIDS has decreased. "In 1991 a multi-sectoral program began, including condom distribution and
promotion involving popular songs and drama groups, counseling, and support
services. In 1995 a nationwide promotion campaign startedówith songs and
soap operas, drama, posters, and other approaches promoting safe sex,
abstinence, fewer sex partners, and condom use among young people (286). There was a subsequent rise in age at first sexual intercourse and in
monogamy and a decrease in HIV prevalence, especially among young people. The percentage of pregnant women with HIV has dropped since 1991, based on
blood tests at five sites. The use of condoms has increased
substantially among young people. Among men ages 15 to 19, the percentage who
had ever used condoms rose from 20% in 1989 to about 60% in 1995." 4
The Ugandan story according to Dr. Edward Green of Harvard:
The Christian Connections for International Health (CCIH) web site
has published a report by Edward C. Green of the Harvard School of Public
Health. 9 He reports that:
||Faith based organizations (FBO) in the country emphasized behavioral
change "on what they called abstinence (or 'delay') and fidelity."
Sometimes, this was the sole emphasis; condom usage was not mentioned.
||Teenagers in Uganda are now delaying their first sexual experience by
two years on average, from 15 to 17 years of age.
Dr. Green also reports that only about 7% of women and 10% of men aged
15-50 reported that they have adopted complete and sustained abstinence for
Dr. Green states that "It is reasonably well-established that
consistent condom use protects against HIV transmission, therefore condom
use should be promoted."
The Ugandan story according to Focus on the Family:
After hearing repeated references to the Ugandan abstinence program on
Family News in Focus radio program, we searched the Focus on the
Family web site for references to Uganda. We found many reports on the
Ugandan program. All appear to imply that it is an abstinence-only
program, and/or that increased use of condoms and safer-sex precautions have
played no significant role in the reduction of HIV incidence in that country:
||"Uganda has found great success in publicly promoting abstinence until
marriage to its young people. In 1994, Uganda launched 'True Love Waits,' an
abstinence-until-marriage program that was also supported by schools,
religious institutions, non-governmental organizations and local
communities." 5 Assuming that the program took
two years to get fully up to speed, then it would have been fully effective in
1996, the year when the reduction in HIV incidence in Uganda leveled out.
That is, the great reduction in HIV incidence happened before True Love Waits
was fully effective, and has stagnated since.
||Focus on the Family quote a 2002-FEB-16 letter of Edith G. Ssempaia, Ugandan ambassador to the United States
which commented on the abstinence part of their comprehensive program: "We
believe that the abstinence campaign in Uganda has had a significant impact on
HIV infection, which has declined by 50 percent between 1992 and 2000, and the
decline has been most marked in the 15-24 age bracket." 6|
||"Secretary Powell seems to be ignorant of the fact that Uganda has made
great progress against AIDS by emphasizing abstinence, not condoms. Uganda has
cut the rate of HIV infection by as much as 50 percent among young people by
delaying the onset of sexual activity by two years." 6|
||In a report on 2002-JUL-26, Focus
the International AIDS
Conference that was recently held in Barcelona, Spain. At the
conference, speakers concentrated on various "safe-sex" practices
as the best approach to reducing the HIV infection rate. As an example:|
Professor Paul Gundani, 42, a Roman Catholic theologian at the University
of Zimbabwe read a list of names of people in his family who have recently
developed AIDS. He said: "My sister (died) last week, and my brother last year. By now, my nephew may be dead, too."
He spoke in front of a poster which said, "Because the bishops ban condoms,
innocent people die." The poster was an apparent reference to the
stand of a number of Roman Catholic bishops in Africa -- and the Roman
Catholic Church itself -- who oppose the use
of condoms -- not only for the prevention of pregnancy but for the
prevention of HIV infection.
||Former president of South Africa, Nelson
Mandela promoted the teaching of "enlightened" practices to prevent
||A representative from the children's TV program Sesame
Street told the conference that the South African version of their
show will feature an HIV-positive Muppet.
Pete Winn of Focus wrote: "What was not mentioned in Barcelona, however, was the fact that there
is little evidence that condoms are having an effect, while the evidence
is mounting that abstinence and traditional morality do have an impact."
10 Winn provides a hyperlink to the Uganda Aids
Commission, which he says "Condom use was not listed among
the commission's recommendations." Strictly speaking, this is a true
statement -- but only because a graphic on condom use ("condom_use.jpg"
22,571 bytes) cannot currently be read on the UAC web site; the file is apparently
inaccessible. 11 Also, as noted above, the
Uganda AIDS Commission's web site discusses
condom promotion extensively.
||In another report, Focus attributes the entire success in Uganda to the abstinence component
of their comprehensive sex-ed program: "Uganda, where more than 30,000 kids have signed abstinence pledges, has seen a
50-percent reduction in AIDS since 1992 because of its emphasis on abstinence."
Since Uganda has a population of 20.3 million, 2
and about 67% of the population is less than 25 years of age, 30,000 pledges
represent a tiny percentage of the total youth, perhaps on the order of 0.5%.
||In another article supplied by Focus on the Family reporter Pete Winn
to the Baptist Press quotes Edward C. Green, of
the Harvard School of Public Health. Green is quoted as saying that the
focus on abstinence has reduced HIV prevalence rates by 70% between 1991 and
2001. Pete Winn also quotes an unidentified Demographic and Health Survey
which reports that 95% of all Ugandans age 15 to 49 now report practicing either
monogamy or abstinence. 8
Attempts to get an accurate picture of AIDS
prevention in Uganda:
||Pete Winn of Focus on the Family quotes a Demographic and
Health Survey which states that 95% of all Ugandans age 15 to 49 claim
to practice either monogamy or abstinence.
||Edward C. Green of the Harvard School of Public Health reports
that about 8.5% of Ugandans age 15 to 50 practice abstinence.
||If both values are correct, then about 86.5% of Ugandans in this age
range must be practicing monogamy.
||That leaves 5% who admit to having multiple sexual partners, of which
some fraction use condoms to prevent AIDS transmission.
These data appear to conflict with the report that
abstinence programs are only delaying the onset of sexual activity among
teenagers by two years. We are attempting to clarify this conflict.
"Policy Update - March 2002: HIV/AIDS programs continue to be a source
of conflict," Sexuality Information and Education Council of the United
States (SIECUS) at:
"Uganda," Amnesty International, at:
"Introduction," Food and Agriculture Organization, at:
"Condom promotion works," Johns Hopkins University, at:
"Dobson addresses condom effectiveness," Focus on the Family,
"Focus on the Family
Denounces Powellís Pro-Condom Comments
Dr. James Dobson Calls on President Bush to
Repudiate Secretary of Stateís Remarks," Focus on the Family,
Bob Kellogg, "European
Journal Questions Effectiveness of Sex Ed ," Focus on the Family,
- Pete Winn, "Abstinence seen as crucial in solving
Africa AIDS crisis," Baptist Press, 2002-JUL-25, at:
- "Evidence on impact of abstinence and fidelity
in AIDS prevention - Part 1," Christian Connections for International
Health, 2001-NOV-21, at:
- Pete Winn, "Death's Door," Focus on the Family,
- "Uganda Aids Commission: Frequently Asked
- Uganda HIV/AIDS Control Project (UACP): Project
- Uganda Aids Commission: Mandate and
"Executive Summary," The National Strategic
Framework for HIV/AIDS Activities in Uganda. Downloadable in a zip file from
tue UAC at:
The Behavior Change sheet was adapted from B. Joomet
and T. Mugolola's book "The Fleet of Hope: teachers book."
Unfortunately, neither Amazon nor Barnes and Noble list the book.
Copyright © 2002 by Ontario Consultants on Religious
Originally written: 2002-JUL-18
Latest update: 2002-JUL-30
Author: B.A. Robinson