Final Reseach Paper by Etum Akezi Lawnsome

RISK FACTORS DRIVING HIV/AIDS EPIDEMIC IN LIRA MUNICIPALITY
OF LIRA DISTRICT
ETUM AKEZI LAWNSOME
A RESEARCH DISSERTATION REPORT SUBMITTED TO THE FACULTY OF
SOCIAL SCIENCES, UGANDA CHRISTIAN UNIVERSITY IN PARTIAL
FULFILMENT OF THE REQUIREMENTS FOR THE BACHELOR DEGREE OF
COMMUNITY LEADERSHIP AND DEVELOPMENT
MUKONO, UGANDA
2010

ABSTRACT
This research study focused on the risk factors driving HIV/AIDS epidemic in Lira Municipality
to help in the establishment of the rate of new HIV infection among the most at risk population
sub groups within the Municipality.
The objective of the study was to find out the current status and drivers of the HIV/AIDS
epidemic in Lira Municipality; to identify the contributing factors of new HIV infection in the
community, and to find out the people who are the “most at risk population” of HIV infection.
The literature reviewed to supplement the study were: UNAIDS MoT reports of 2008/09, Report
by Uganda AIDS Commission on HIV prevalence in Uganda, 2001/04, Lira Municipal Council 3
Year Rolling Development Plan 2009/2010-2011/2012 and a Case study by World Health
Organization on the Street Children in Kampala, Uganda 2009.
Methods of data collection involved questionnaires and key informants interview of 220 sampled
out adolescent children and youth as respondents out of the four divisions of Lira Municipality to
get fair representation of views and opinions including document reviews of supplementary
secondary data to support the study requirements.
The findings of the study revealed that HIV infection is rising up again because of the changing
pattern of new infection which is mostly affecting Boda boda operators, mobile business
operators-hawkers and Adolescent commercial sexual workers as the most at risk population
groups within Lira Municipality.
More concerted efforts are needed by all stakeholders of HIV/AIDS mitigation and prevention to
scale down the incidence of new infection from affecting their community within Lira
Municipality, Lira district.
(i)

DECLARATION
I do hereby declare that am the author of this paper and that any assistance I received in its
preparation is fully acknowledged and disclosed in the paper. I have also cited any resources
from which I used data, ideas or words, either quoted directly or paraphrased. I also certify that
this paper was prepared by me specifically for the partial fulfillment for the Bachelor Degree of
Community Leadership and Development at Uganda Christian University.
Signature: …………………………………………….
ETUM AKEZI LAWNSOME
Date:…………………………………………………
(ii)

DEDICATION
To God Almighty for His Love and Grace which enabled me to carry out my research study
successfully.
To Francis Otim Odeng, my Supervisor for his tireless instruction and mentoring.
To my wife, Agnes Etum for her encouragement and prayer support.
(iii)

ACKNOWLEDGEMENT
My indebtedness goes to all my respondents: boda boda operators, mobile business operators
(hawkers) and adolescent commercial sexual workers whose members include bar maids, lodge
attendants, restaurant servers, brothel prostitutes and street children within Lira Municipality
who graciously shared their information during the research period.
Special thanks and gratitude goes to Mr. Munu Nelson, the Clinical Officer of Health Centre II
of Lira Municipal Council together with all Health Assistants of Ayago and Ober Health Centres
III including all the Community Health Workers of Adyel, Ojwina, Central and Railway
divisions for their cooperation which made this research study successful.
Much tribute is given to Mr. Okwel Godfrey, Librarian Lira Resource Centre for his guidance
and assistance which helped me in the sourcing out of the relevant reference books and
publications for guiding the literature reviews on the themes for this research report.
While writing this dissertation, I benefited enormously from the insights, mentorship, and
expertise of my research advisor, Mr. Otim Odeng Francis who mentored me in pursuit of a
Bachelor Degree of Community Leadership and Development.
I acknowledge the invaluable support from my family members: my dear wife Agnes Etum and
the children for their timeless prayer, encouragement and financial support.
I finally thank God for enabling me to accomplish this work by affirming that, “I have fought the
good fight, I have finished my course, I have kept the faith” (II Timothy 4:7).
(iv)

ABBREVIATIONS/ACRONYMS
AIDS Acquired Immune Deficiency Syndrome.
HIV Human Immunodeficiency Virus.
LRA Lord‟s Resistance Army.
MoH Ministry of Health.
MoT Modes of Transmission.
PLWAs People Living With Aids.
STDs Sexually Transmitted Diseases.
UHSBS Uganda HIV/AIDS Sero-Behavioural Survey
UNAIDS Joint United Nations Programme on HIV/AIDS.
UNGASS United Nations General Assembly Special Session
UNICEF United Nations International Children Fund.
(v)

TABLE OF CONTENTS
Abstract…. ………………………………………………………….……………. (i)
Declaration……………………………………………………………………….. (ii)
Dedication ………………………………………………………………………… (iii)
Acknowledgement………………………………………………………………… (iv)
Abbreviation/Acronyms ………………………………………………………….. (v)
Contents……………………………………………………………....................... (vi)
Tables, Illustrations/ Figures……………………………………………………… (ix)
1 CHAPTER ONE: INTRODUCTION
1.1 Introduction………………………………………………………………. 1
1.2 Background of the Study…………………………………………………. 1
1.3 Statement of the Problem ………………………………………………… 3
1.4 Objectives of the Study…………………………………………………… 4
1.5 Research Questions …………………………………………………......... 4
1.6 Conceptual Framework……………………………………………………. 4
1.7 Scope of the Study…………………………………………………............ 5
1.8 Significance of the Study………………………………………………….. 5
1.9 Definition of key concepts…………………………………………………. 6
1.10 Organization of the Dissertation……………………………………………. 7
(vi)

2 CHAPTER TWO: LITERATURE REVIEW
2.1 Introduction ………………………………………………………………… 8
2.2 The current status and drivers of HIV/AIDS in Lira Municipality…………. 8
2.3 The contributing factors on new HIV infection in the community…………. 9
2.4 The most at risk population of HIV infection……………………………… 10
3 CHAPTER THREE: METHODOLOGY
3.1 Introduction …………………………………………………………………. 15
3.2 Research Design ……………………………………………………………. 15
3.3 Study Population……………………………………………………………. 15
3.4 Population Sampling………………………………………………………… 16
3.5 Methods of Data Collection ………………………………………………… 16
3.6 Data Analysis and Quality Control…………………………………………. 18
3.7 Limitations of the Study and Solutions……………………………………………. 19
4. CHAPTER FOUR: PRESENTATION OF DISCUSSION AND FINDINGS
4.1 Introduction………………………………………………………………….. 20
4.1.1 Respondents Characteristics…………………………………………………. 20
4.2 The current status and drivers of HIV/AIDS in Lira Municipality…………… 23
4.3 The contributing factors on new HIV infection in the community……........... 25
4.4 The most at risk population of HIV infection……………………………….. 26
5. CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS
5.1 Introduction…………………………………………………………………. 27
(vii)

5.2 Respondents Characteristics………………………………………………… 27
5.3 Conclusion…………………………………………………………………… 27
5.4 Recommendations…………………………………………………………… 28
References ………………………………………………………………………… 30
Appendices……………………………………………………………………….. 31
(viii)

Figures, Tables/Illustrations
Figure 1: Regional demographic statistics on HIV prevalence in Uganda ……….. 2
Table 1: Study Population………………………………………………………… 15
Table 2: Population Sampling…………………………………………………….. 16
Table 3: Respondent Gender Status………………………………………………. 20
Table 4: Age Groups………………………………………………………………. 21
Table 5: Respondent‟s Education…………………………………………………. 22
Table 6: Religion of the Respondents……………………………………………. 22
Table 7: Occupation of the Respondents………………………………………… 23
Table 8: The status HIV/AIDS in Lira Municipality……………………………. 23
Table 9: The HIV infection in Lira Municipality October 2009………………… 24
Table 10: The HIV infection in Lira Municipality November 2009……………… 24
Table 11: The drivers of HIV infection in Lira Municipality…………………….. 25
Table 12: The contributing factors of new HIV infection in Lira Municipality….. 25
Table 13: The most at risk population of HIV infection in Lira Municipality…… 26
Appendices
Appendix I: Covering and Consent Letter……………………………………… 31
Appendix II: Questionnaire of out of school children and youth……………….. 32
Appendix III: Interview of Community Workers……………………………… 34
Appendix IV: Interview Guide for Boda boda operators and hawkers………… 36
Appendix V: Checklist for Content Analysis…………………………………… 38
Appendix VI: Map of Lira Municipality………………………………………… 39
(ix)

CHAPTER ONE
INTRODUCTION
1.1 Introduction
This study aimed at establishing the current status and risk factors influencing the rate of
HIV/AIDS epidemic within Lira Municipality, and to determine the modes of HIV/AIDS
new infection and transmission to the most at risk populations in the Municipality. This
section of the study presents the background, the problem statement, the purpose, the specific
objectives, the research questions, the study variables, the justification and key concepts
used.
1.2 Background of the Study
Uganda was once held globally as a model for Africa in the fight against HIV/AIDS. This
was as a result of strong government leadership, broad-based partnerships and effective
public education campaigns which contributed to a decline in the number of people living
with HIV/AIDS in the 1990s. Although there is a lot to learn from Uganda‟s comprehensive
and timely campaign against the AIDS epidemic, emphasizing Uganda‟s success story must
not detract many from the devastating consequences that AIDS continues to have across the
country personally, socially and economically.
Studies carried out on HIV/AIDS epidemic in Uganda by Ministry of Health (MoH 2006)
reported that the overall national HIV prevalence rate was 6.4% in 2005 among men and
women aged 15 – 49 years. A total of 915,400 people were living with HIV/AIDS by
December 2005 of whom 530,932 (58%) were women and 109,000 (12%) were children
under 15 years (Hladik et. al. 2008). The report also revealed that 135,300 people were newly
infected with HIV in 2005 while 76,400 had died of AIDS in the same year.
The latest report published by UNAIDS on the Global AIDS Epidemic in 2008 estimates that
a total of 940,000 people were already living with HIV/AIDS in Uganda by December 2007.
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This report seems to have undermined the HIV prevalence and the dynamics of new infection
affecting different population sub groups of Northern Uganda in the rural and the urban
towns.
According to the Uganda HIV Sero-Behavioural Survey (UHSBS) of 2004/05, heterogeneity
of HIV prevalence was defined by geographic location, age, sex and marital status.
According to it, Central was represented by 8.5%, Kampala by 8.5% and North Central by
8.2% had the highest HIV prevalence rates which data is shown on (Figure 1) below.
Figure 1: Ministry of Health Uganda (UHSBS) of 2004/05
The report further shows that the lowest prevalence rates were in Northeast represented by
3.5% and Northwest by 2.3%. It also revealed that the HIV prevalence among residents in
urban locations was significantly higher than among residents in rural locations. This could
be true for both sexes, though the urban-rural difference was much stronger for women than
for men. Prevalence among urban women was estimated at 13% compared with 7% for rural
women, and prevalence among urban men was 7% compared with 5% for rural men.
The report also revealed that the prevalence for women and men increased with age until it
reached a peak.
For women it is estimated at the ages between 30-35 years representing 12% and for men at
the ages between 35-44 years representing 9% indicating that women are the most highly
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affected than men at younger ages showing that prevalence in women is considerably higher
at the ages of 15-34 years; or from age of 35 years and up to the age of 44 years the
prevalence rates are being similar.
Lira Municipality is located on a 77.45 sq km area consisting of four ( 4 ) divisions of Adyel,
Ojwina, Central and Railway with 21 wards (parishes) and 59 villages with a total population
of 81,790 (male 41, 013 and female 40, 777) in Lira district. Lira Municipal Council is a
lower local government under Lira District Local Government with the Mayor as the political
figure and the Town Clerk as the technical team leader. It is one of the fast growing
Municipalities in Uganda because of its location within the business corridor of the North
Central region linking communities of different origins and backgrounds through political,
social, economic, cultural and technological interactions. However this also makes its
populations exposed to high risk of HIV/AIDS prevalence among children, youth, girls, boys,
men and women. This heterogeneous composition of the populations within Lira
Municipality has generated new dynamic patterns of HIV infection and transmission referred
to as “risk factors and drivers” to different people groups through increased occurrence of
new infections identified by the study for appropriate prevention.
The study was conducted to establish the current status and drivers of the epidemic by
identifying the sources of new infections and modes of transmission of HIV among different
population groups within Lira Municipality.
1.3 Statement of the Problem
Because of the difficulties in knowing the current status of HIV infection upon different
population groups of Lira Municipality, it is very vital to investigate the contributing factors
that increase the risk for new infections among the community of the Municipality. This
study is aimed at establishing the risk factors contributing the new infection among the
community of Lira Municipality to guide in policy making, planning and resource allocation.
3

Most of the documentations and reports published on the status of HIV/AIDS prevalence in
Lira Municipality cover the epidemic incidences of 2005-2008 only, but there are no new
reports on the current HIV infection to guide as well strengthening Lira Municipality‟s HIV
prevention response. This study was conducted to find out the current risk factors spreading
HIV/AIDS among the community of Lira Municipality by identifying the factors responsible
for HIV prevalence, establishing the sources/drivers of the new infection and sharing out the
findings with different key players involved in HIV/AIDS mitigation and prevention in Lira
district.
It is hoped that the findings from this study would be a great asset and resource to inform
policy makers, development planners and other agencies, organizations and institutions with
a stake in HIV mitigation and prevention in Lira Municipality in their future development
programming purposes.
1.4 Objectives of the Study
The objectives of the study were:-
a) To find out the current status of the HIV/AIDS epidemic.
b) To find out the risk factors responsible for new HIV infection in the community.
1.5 Research Questions
The study was guided by the following questions:
a) What is the current status of HIV/AIDS epidemic in Lira Municipality?
b) What are the factors responsible for HIV/AIDS epidemic in the Lira Municipality?
1.6 Conceptual Framework
The conceptual framework was developed to guide the study. It presupposes that for any HIV
programming to be effective it would require the involvement of all stakeholders in all stages
of the planning cycle. This study aimed at gathering information from stratified population
groups within Lira Municipality on the risks factors that are contributing to new HIV
infection among their community. The study targeted Health Workers and selected members
of the community (men, women, boys and girls of age groups between 16-40 years) who are
4

able to answer the interview questions, questionnaires and provide information on current
risk factors influencing the spread of HIV/AIDS to different community groups of Lira
Municipality.
1.7 Scope of the Study
Lira Municipality is located on a 77.45 sq km area consisting of four ( 4 ) divisions of Adyel,
Ojwina, Central and Railway with 21 wards (parishes) and 59 villages with a total population
of 81,790 (male 41, 013 and female 40, 777).
The study covered the whole of Lira Municipality but through stratified study groups
carefully selected to provide the required information through individual interviews and
questionnaires conducted by the researcher. The study focused on gathering information on
the incidences of HIV/AIDS prevalence among the community of the Municipality between
the periods of 2006-2009. The focus of the study was to investigate the causes of the current
risk factors driving new HIV/AIDS infection among the community of Lira Municipality.
The report envisaged by UNICEF, 2007 states that urban settlements in towns and
Municipalities are influenced by socio economic, political, cultural and technological factors.
This scenario prompted this study to establish whether those factors are the drivers
contributing to the new HIV infection among the population groups of Lira Municipality
from 2008 to the present time.
1.8 Significance of the Study
The study generated information that can be utilized by government agencies, NGOs and the
community of Lira Municipality. The findings of the study are vital in the following ways:
i) The report on the current status and drivers of HIV/AIDS epidemic in Lira Municipality
are shared among key actors involved in the mitigation and preventive measures.
ii) The sources of new HIV infection and modes of transmission identified among most at
risk population sub groups within the Municipality will help in the resource allocation by
different key players.
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iii) The gaps on the current efforts and priorities of the Lira Municipal local government can
guide the future strategic planning processes regarding the HIV prevention.
1.9 Definition of Key Concepts Used
AIDS: Acquired immune deficiency syndrome.
Drivers: The structural and social factors, such as poverty, gender inequality and Human
Rights Violations that are not easily measured which increase individuals‟ vulnerability to
HIV infection.
Dynamics: A situation of rapid change in occurrence of HIV/AIDS infection and
transmission in a chosen community at a particular period of time.
Epidemics: An outbreak of a disease like HIV/AIDS that spreads more quickly and more
extensively among a group of people than would normally will be expected.
Evidence-driven: Clearly identifiable HIV prevention resource allocation by key player for
specific target groups of a particular geographical location.
Heterogeneous composition: Population of a particular community consisting of people
with different origins, cultural backgrounds, habits, life styles, norms and practices.
HIV: Human immuno deficiency virus.
Incidence: New infections per population at risk in a specified period of time.
Modes of transmission: Ways or forms through which HIV/AIDS exist and spreads into the
community of a given geographical location.
Most at risk populations (MARPS): Populations in whom there is a concentration of risk
behaviours for HIV transmission (notably: unprotected sex with multiple partners and
sharing of needles or razors) that may then drive the majority of new infections.
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Risk Factor: An aspect of personal behaviour or life-style or an environmental exposure on
which the basis of epidemiological evidence is known to be associated with HIV
transmission or acquisition.
1.10 Organization of the Dissertation
This study is divided into five chapters.
Chapter One included the introduction and contained the background to the study; statement of
the problem; objectives of the study; research questions; conceptual framework; scope of the
study; significance of the study; definition of key concepts; and organization of the dissertation.
Chapter Two covered the critical review of related literature on the subject of current status and
drivers of the HIV/AIDS epidemic in Lira Municipality, the contributing factors of new
infections in the community, the most at risk population of HIV infection; and the conclusion.
Chapter Three consisted of the methodology used which includes the research design; study
area; study population; sample size and selection; data collection methods; data processing,
analysis and presentation; procedure; and limitations of the study.
Chapter Four is a presentation, interpretation, discussion and analysis of the findings and
focuses on: the current status and drivers of the HIV/AIDS epidemic in Lira Municipality, the
contributing factors of new infections in the community, the most at risk population of HIV
infection; and the challenges in the resource allocation for HIV prevention.
Chapter Five presents the summary, conclusions and recommendations from the research study.
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CHAPTER TWO
LITERATURE REVIEW
2.1 Introduction
This chapter reviewed the literature related to the study. It covered most of the literature
written about risk factors driving HIV/AIDS epidemic in Lira Municipality, Lira district-
Lango Sub region. Literature review has been presented in sub themes according to the
objectives of the study.
2.2 The current status of the HIV/AIDS epidemic in Lira Municipality
It is estimated that there are more than 70,000 new infections every year in Uganda with
children accounting for 16,000 of the total. (85%) of these new infections are estimated to be
young people aged (15-49). More than (50%) of those infected are women and 15% are
children under the age of (15). The pandemic has had a catastrophic impact on individuals,
families, societies and economies (UNAIDS, 2004 Report on the Global AIDS Epidemic;
Referenced by UNICEF Report on HIV/AIDS prevalence in Uganda 2005).
According to the STD/HIV surveillance report (1998), the main routes of HIV transmission
in Uganda are:-
Heterosexual contact with an infected partner accounting for (75 – 80%) of new infections;
Infected mother-to-child transmission accounting for (18 – 22%);
Use of infected blood and products accounting for less than (2%) of HIV infection as of
1991; and sharing non-sterile sharp-piercing instruments with an HIV infected person
accounting for less than (1%); (The comprehensive analysis of HIV/AIDS epidemic and
response by Uganda Aids Commission November 1998).
Another literature review is the report on the HIV heterogeneity status in Uganda by Sero-
Behavioural Survey (UHSBS) 2004/05 stating that the heterogeneity in HIV prevalence is by
geographical local, age, sex and marital status. The report reveals that Central (8.5%),
Kampala (8.5%), and North Central (8.2%) regions had the highest HIV prevalence rates.
8

The lowest prevalence rates were in Northeast (3.5%) and Northwest (2.3%) regions
revealing that the HIV prevalence among residents in urban locations was significantly
higher (10%) than among residents in rural locations (6%). This is true for both sexes, though
the urban-rural difference is much stronger for women than for men.
Therefore HIV prevalence among urban women is (13%) compared with (7%) for rural
women, and prevalence among urban men is (7%) compared with (5%) for rural men
(UNAIDs MoT Country Report 2009).
2.3 The factors contributing to new HIV infections in the community
In Uganda the primary risk factors for HIV infection are heterosexual contact with an
infected partner (75-80%) of all infections and mother to child transmission (15-25%) of all
infection. Use of infected blood products and aseptic conditions in health facilities account
for only (2-4%) of infections while sharing non sterile needles with an infected person only
accounts for (1%) of all infections. The extent of HIV transmission through intravenous drug
use and male to male sexual transmission is not known (Uganda AIDS Commission 2004).
Due to its modes of transmission, HIV mainly affects the sexually active population and
children. Patterns of sexual behaviour in a population are determined by much wider factors
than individual morality, personal choice or private decisions about risk. Socio-economic,
cultural, religious, political, and legal influences are important in creating the “risk
environments” in which people live. These factors have a synergistic effect and together
increase or decrease the vulnerability of sub groups especially women, children, orphans, and
those living in conflict areas (UNICEF Report on HIV/AIDS prevalence among vulnerable
groups 2004/05).
HIV prevalence in urban towns, especially in the municipalities is highest among women
(6.7%) and children (4.5%) through unprotected sex, infections from saloons and mother to
child transmission.
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The risk factors contributing to new infection are drunkenness, provocative dressing and
dancing, brothel prostitutions and co habitation (6%) and discordant relationships (43%)
resulting into morbidity (9.9%) and mortality (1.7%); increase in the number of dependants,
increase in the number of street children, increase in rape and defilement of girls and slowing
down of economic activities (Lira Municipal Council 3 Year Rolling Development Plan
2009/2010-2011/2012).
2.4 The people groups who are the “most at risk population” of HIV infection
The unprivileged populations; these are the poor young people of boys and girls, women,
uneducated youth and out of school children migrating to urban towns. Using data from the
2004 National Survey of Adolescents, several statistical variables were used to examine the
strength of the association between risky sexual behavior and perceived risk among (12–19-
year-old) adolescents in Uganda. After controlling for other correlates of sexual behavior
such as age, education, residence, region and marital status, the findings indicate highly
significant positive association between perceived risk and risky sexual behavior among
males but not females. The findings reveal that, regardless of their current sexual behavior,
most female adolescents in Uganda feel at great risk of HIV infection.
The findings also show that adolescents with broken marriages are much more vulnerable to
high risk sexual behaviors than other categories of adolescents. These results further
emphasize the need for a holistic approach in addressing the social, economic and contextual
factors that continue to put many adolescents at risk of HIV infection (Asiimwe D, Kibombo
R, Neema S. Focus group discussions on social cultural factors impacting on HIV/AIDS in
Uganda. Kampala, Uganda: Makerere Institute of Social Research; 2003).
The socio-culturally destabilized groups; these are victims of the disintegration of families,
unemployed youth, displaced people, illegitimate children and mobile workers. A higher
proportion of older adolescents‟ engaging in risky sexual behavior is not surprising given that
the (12–14-year-olds) are mostly not sexually active.
10

With regard to marital status, adolescents who are divorced or separated are apparently more
likely to engage in risky sexual behavior than other adolescents for the following reasons:-
Firstly, having been in a marital union, this group of adolescents is used to having regular
and unprotected sex, adjusting to life without regular sex or using a condom whenever they
have sex most likely poses a big challenge to them (Ministry of Health [Uganda], ORC
Macro. Uganda HIV/AIDS Sero-behavioural Survey 2004–2005. Calverton, Maryland:
Ministry of Health and ORC Macro; 2006).
Secondly, it is not uncommon for couples who have separated to have sex together whenever
an opportunity presents itself (Stein JA, Nyamathi A. Gender differences in behavioural and
psychosocial predictors of HIV testing and return for test results in a high-risk population.
AIDS Care; 2000).
Thirdly, female adolescents who have divorced/separated are usually very vulnerable to risky
sexual behaviors mainly for economic reasons because they often have to financially fend for
themselves (and perhaps for their children as well) having been deprived of their former
livelihoods. With limited or no formal education, no job skills and lack of access to capital
resources, particularly land, coupled with stigmatization, especially from family members,
such female adolescents make easy prey for men. Regarding the differences in risky sexual
behavior across the different regions of Uganda compared to the Central, there are perhaps a
number of factors responsible, among which are inequitable access to Sexual Reproductive
Health information and services, poverty and negative cultural attitudes/practices (Asiimwe
D, Kibombo R, Neema S. Focus group discussions on social cultural factors impacting on
HIV/AIDS in Uganda. Kampala, Uganda: Makerere Institute of Social Research; 2003).
The specific risk groups; these are street children, street beggars, alcoholic and drug users,
brothel prostitutes and homosexuals. AIDS has had a devastating impact on Uganda. It has
killed approximately one million people, and significantly reduced life expectancy.
(Government of Uganda; 2008; UNGASS country progress report Uganda, January 2006 to
December 2007).
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AIDS has depleted the country‟s labour force, reduced agricultural output and food security,
and weakened educational and health services. The large number of AIDS related deaths
amongst young adults has left behind over a million orphaned children (UNAIDS 2008
Report on the global AIDS epidemic).
"If someone in Uganda tells you they haven't been affected by HIV/AIDS they're lying
"Jennifer Bakyawa, a Ugandan journalist who wrote” (
Science; 2008 Ugandan confronts
corruption, slowly)
Orphans and other vulnerable children are the most affected by HIVAIDS prevalence in
Uganda. About 2 million Ugandan children have been orphaned by AIDS. The percent of
Uganda's orphans that could be attributed to AIDS rose from (17.4%) in 1990 to (42.4%) in
1995 to (51.1%) in 2001. This percentage is projected to decline to (47.2%) in 2005 and to
(38.9%) in 2010.
The impact of HIV/AIDS on children begins with parental diagnosis or onset of illness.
There are a growing number of child-headed households as a result of AIDS-related orphan
hood, and such families are particularly vulnerable, as are children living in conflict areas.
Because they have been overstretched, extended family and community structures can no
longer offer adequate support to orphans. Orphan guardians are under considerable strain,
HIV/AIDS in Uganda and many households do not have sufficient resources to take in more
children. Many guardians are in poor health; some are HIV positive.
Although standby guardians appointed by parents are predominantly male, women ultimately
assume much of the responsibility for orphaned children.
Orphans often face increased malnutrition, lack of immunization and health care, lack of
schooling and early entry into paid or unpaid labor while others end up on the streets in
towns and cities. Some orphans may be vulnerable to sexual abuse, thereby increasing their
vulnerability to HIV.
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As orphans often witness the prolonged illness or death of family members, they are more
prone to depression and psychosocial distress (AIDS Policy Research Center, University of
California San Francisco HIV/AIDS in Uganda Published; November 2003).
A risky sexual behavior is one that increases the likelihood of adverse sexual and
reproductive health consequences. These health consequences may include unwanted
pregnancy, unsafe abortion, HIV/AIDS and STDs. Examples of such behaviours are: sexual
activity under the influence of substances, sexual intercourse with drug users, unprotected
sexual intercourse, commercial sex/survival sex/prostitution, and unprotected sex with a
same sex (particularly between males) partner.
Risky sexual behaviours in some countries street children use substance to influence their
sexual behavior in ways that increase the risk of acquisition of HIV and other STDs. The
street child‟s decision on sexual behaviours such as whether to use a condom during sexual
activity, whether to negotiate for sex or to use force (rape) depends on the level of
intoxication. In general alcohol and other substance use often accompany the early sexual
experiences, especially among boys.
Having unprotected sex with substance users can lead to sexual and reproductive health
because such persons are more to likely engage in risky sexual behavior. The risk of
acquiring HIV infection through unprotected sex from a sex partner who injects substances is
particularly high. Unprotected sex is common among street children.
This could result in a variety of sexual and reproductive health problems. Street children
spend a lot of time in settings where casual sexual encounters occur (taverns or „crack
houses‟). Their risk of acquiring blood borne diseases and STDs such as HIV, syphilis and
hepatitis is increased by the fact that they often have sex with persons at high risk for these
diseases (people with multiple sexual partners or those who are sharing injection equipment
for substances of drugs and alcohol).
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Sometimes street children engage in this type of sexual activity due to the immediate need to
secure food and shelter, or as a means to obtain substances or to support their families. Street
children sometimes have sex with other street children of the same sex. This is much more
common among boys. In addition, street boys are often sexually exploited by older men.
Engaging in unprotected sexual intercourse can lead to acquisition of STDs.
Sexual violence including rape is very common on the streets. Both street girls and boys are
at risk. The perpetrators may be strangers or people known to them. Sexual abuse may also
occur within the family e.g. forced sex with a stepfather. Because of the unprotected nature
of the sexual intercourse, there is a high risk of STDs and other reproductive health
problems.
Boys and girls talk about the stress of unwanted sex. In Uganda, street girls report being
sexually assaulted by older street youth, army men and other adults. Street girls also talk
about feeling defenseless in the face of these assaults and advances. Guilt, denial, and mental
anguish are described when talking about these experiences (A case study by World Health
Organization on the Street Children in Kampala, Uganda; 2009).
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CHAPTER THREE
METHODOLOGY
3.1 Introduction
This chapter describes the methodology that was used in order to answer the research
questions. This includes sample selection procedure, data gathering, data analysis methods
and data presentation.
3.2 Research Design
The study was a survey on risk factors contributing to new HIV infection among the most at
risk population within Lira Municipality. The study employed both qualitative and
quantitative methods of data collection which included descriptive and explorative
techniques for key informant interviews; and quantitative techniques through questionnaires
and documentary reviews during data collection. The data collected is therefore presented as
both qualitative and quantitative report.
3.3 Study Population
The study population was based on three kinds of population strata: Community Health
Workers who were the key informants, Adolescent commercial sexual workers who were
taken to be target respondents and Documentations reports of the past and present situations.
The study population comprised of Boda boda operators, mobile business operators known as
the hawkers and Adolescent commercial sexual workers whose members include bar maids,
lodge attendants, restaurant servers, brothel prostitutes, street children and youth within Lira
Municipality. The categories of the study population are summarized as below:
Table 1: Study Population
Categories of the Study Population Total Population
Commercial Health Workers 20
Boda boda operators 200
Mobile business operators (hawkers) 40
Adolescent commercial sexual workers 200
Total 460
Source: Study primary data
15

3.4 Population Sampling
The researcher used stratified sampling of the most risk at population sub groups out of the
four Divisions of Lira Municipality. The researcher sampled out 2 Community Health
Workers, 50 Boda boda operators, 5 mobile business operators (hawkers) and 50 Adolescent
commercial sexual workers as respondents from each of the four divisions of the Lira
Municipality.
The actual sampling was done through purposive selection by identifying the respondents
from their work places to enable them give their answers as their responses being recorded.
This method was used because each respondent was allowed to express his/her views,
opinions, or attitudes freely as the information generated could easily be verified by the
participants as acceptable information which could answer the tested variables.
The details of the population sampling are shown below.
Table 2: Population Sampling
Categories of Population Sampling Total Population Sample Size
Community Health Workers 20 8
Boda boda operators 200 100
Mobile business operators (hawkers) 140 20
Adolescent commercial sexual workers 200 100
Total 560 228
The sample size was 228 out of the total study population of 460 persons. This number of
respondents was considered a satisfactory and representative sample for the study.
3.5 Methods of Data Collection
Qualitative and quantitative data collection methods were mainly used in addition to content
analysis of secondary data. The purpose of qualitative methods was to learn about the risk
factors contributing to the new HIV infection among most at risk population gaps and to
generate new understanding that can be used to mitigate the current HIV/AIDS prevalence
among the entire population of Lira Municipality.
16

The data collection method included both open – ended and semi-structured as well as
structured interviews so as to achieve generation of homogeneous data. For the quantitative
methods; there was a semi-structured questionnaire and obseveration checklist. The
research instruments (4 for each instrument) used during the study presented the reliability
and validity of responses from which major adjustments were undertaken to suit the current
study.
3.5.1 Questionnaire Design
The study employed a semi-structured questionnaire to determine the opinion, attitudes,
preferences and perceptions of persons of interest to the researcher. The questionnaire
technique was chosen for this study for the following reasons:
1. To ask the same questions from all the participants in the study.
2. To use descriptive and analytical research for cross examination of given data,
summarizing and analyzing the data into valid and reliable information.
3. To report the results of each question with a large number of inputs.
The questionnaire included both the closed ended form which permits limited responses
from multiple choice questions and open ended form which permits any respondent to be
free to respond in his/her own words leading to the expression of ones views, opinions,
feelings and attitudes towards the question asked.
The questionnaires were expected to accomplish the following tasks.
i. To collect data from Community Health Workers, Boda boda operators, mobile business
operators (hawkers) and Adolescent commercial sexual workers about current HIV
infection.
ii. To collect data from key informants on the factors contributing to new HIV infection
among most at risk population within Lira Municipality given their expertise in
HIV/AIDS mitigation and prevention.
17

3.5.2 Checklist
Secondary data sources were reviewed using a checklist based on time of arrival, place of
activity, numbers of partners, frequency of sex, condom distribution points and time of
accessibility. Qualitative data based on descriptive level and reference to literature review.
3.5.3 Interview Guide
An interview guide for Community Health Workers as key informants and the target
respondents was used to conduct in depth interviews at prearranged times convenient to
respondents.
Interviews with key informants and target respondents helped in understanding the current
HIV prevalence including factors contributing to new HIV infection among most at risk
population and the extent to which resources are allocated to mitigate and prevent the
epidemic by the Lira Municipality budget related to the present strategic plans.
3.5.4 Documentary Analysis
Documents included HIV/AIDS reports and strategic plans-past and current. Documentary
review helped to generate quantitative data: the number of people affected by HIV/AIDS,
the rate of new HIV infection, the number of people accessing HIV/AIDS related services
with plans, and the quality of content in the planning documents.
3.6 Data Analysis and Quality Control
Data processing and analyses were conducted through scores of responses, editing,
classification and tabulations for both qualitative and quantitative methods. The data
collected were processed to limited levels and all study schedules for primary data collection
were edited to check for accuracy, completeness, uniformity, and consistency of information
and data gathered.
Qualitative data from the key informants was recorded based on the guided interviews and
questionnaires used in the field study and the responses were listed according to emerging
sub-themes of the study, which analyses are used for report writing.
18

Quantitative data analysis was conducted by eliciting information from the responses of the
target respondents. Frequency tables and descriptions were used to describe and present the
findings. Quotations from key informants and documents are presented appropriately to
elaborate points.
3.7 Limitations of the Study and Solutions
Limitations refer to restrictions in the study over which researchers have no control.
The major limitations encountered during the study are:-
The researcher had to go through lots of administrative beaucracy in accessing the required
secondary data on HIV/AIDS status since such data are kept under lock and key of a
Clinical Officer in charge. So the researcher introduced himself as being a student from
Uganda Christian University who would like to find out the current risk factors of new HIV
infection among the community of Lira Municipality.
The researcher also gave assurance of copies of the study to be given to every participating
health centre for inclusion in their reference library.
Many targeted respondents feared exposure and stigmatization from the report they would
provide on their HIV/AIDS status, but the researcher had to assure all the respondents
he would keep all information gathered from them a total confidentiality.
Another challenged the researcher encountered was lack of relevant secondary data on the
current HIV status in Lira Municipality available to cross check with primary data collected
by research tools employed during the study. The researcher consulted the internet and
public libraries to access relevant information which are HIV/AIDS related to guide the
study.
Finally the majority of the respondents had different literacy levels to interpret the questions
asked during the study survey. The researcher used the interpreter to help his respondents
understand the interview questions and questionnaires in order to provide the genuine
answers required.
19

CHAPTER FOUR
PRESENTATION AND DISCUSSION OF FINDINGS
4.1 Introduction
This report presents the data gathered regarding the current HIV status and risk factors
influencing the rate of HIV/AIDS epidemic; to determine the modes of HIV/AIDS new
infection and transmission to the most at risk populations within Lira Municipality. The
following contain reports of the discussion and findings of data from the key informants,
targeted respondents and documentary analysis in the present study.
4.1.1 Respondents Characteristics
Respondents who participated in this research undertaking were of two categories:
Community Health Workers known as key informants and Boda boda, mobile business
operators and Adolescent commercial sexual workers taken as target respondents.
4.1.2 Sex
Table 3: Respondent Gender Status
Sex Frequency Percentage (%)
Male 120 53.6
Female 108 46.4
Total 228 100
4.1.3 Age
According to the study findings, (16.2 %) of the respondents fall within 10 and below
age bracket while only (8.7%) are above 40 years of age. This compares with the
respondents of 16-18 years age bracket was represented by (24.2 %) of them with
the majority; (24.2%) falling within 16-18 years as shown in Table 4 below.
20

Table 4: Age Groups
Age Frequency Percentage (%)
10 and below 37 16.2
11-15 24 10.5
16-18 55 24.2
19-25 29 12.7
26-30 28 12.3
31-35 19 8.3
36-40 16 7.1
40 and above 20 8.7
Total 228 100
4.1.4 Respondent’s Education
The study findings in Table 5 indicate that the majority of the respondents were Primary
School leavers. These together, account for (46.6 %) of men and (38.9%) of female
respondents accordingly. (25%) of men and (27.8%) of female were in the category of
Pre School level, (7.6%) of men and (24.4%) of female in Secondary level, and (20.8%) of
men and (8.9%) of female in Diploma level, implying that the highest number of
respondents was from Primary level clearly indicating that low formal education is one of
the factors responsible for the rural urban migration of many respondents interviewed.
A quotation from one of the respondents says,
“I had to move out of the village to the town because
there was no one to pay for my education and that is why I have moved to Lira town”.
21

Table 5: Respondent’s Education
Education Level Category of Respondents
Male Percentage
(%)
Female Percentage
(%)
Pre- School 30 25 30 27.8
Primary 56 46.6 43 38.9
Secondary 9 7.6 26 24.4
Diploma 25 20.8 9 8.9
Degree
Total 120 100 108 100
The findings further reveals that (20.8%) of men and (8.9%) of female are Diploma
holders who were mainly employees from Health sector while the rest, (7.6%) of men and
(24.4%) of female were Secondary school leavers who are Boda boda operators with the
majority from Primary school level as mobile business operators-hawkers and Adolescent
commercial sexual workers.
4.1.5 Religion of the Respondents
Table 6 below gives a summary of the Religion of the Respondents
Table 6: Religion of the Respondents
Religion of the Respondents Frequency Percentage (%)
Catholic 92 40.2
Protestant 89 39.1
Muslims 25 10.9
Others 22 9.8
Total 228 100
Majority of the respondents (40.2%) reported Catholic as the religion, (39.1%) were
Protestants while Muslims constituted (10.9%). All other beliefs constituted only (9.8%).
Despite the fact that there is freedom of worship, the Catholics are the majority.
22

4.1.6 Occupation of the Respondents
Table 7: Occupation of the Respondents
Occupation Frequency Percentage (%)
Self Employed 120 52.6
Public Employed 8 3.5
Private Employed 100 43.9
Total 228 100
As far as the main occupation is concerned, (52.6%) of the respondents reported self
employment (3.5%) reported being employed by public and (43.9%) reported employment
in private sector. Observations in the field showed that the majority of the respondents were
Boda boda operators and mobile business operators-hawkers and these are the ones
that reported they are self employed. And (43.9%) of the respondents were involved in private
employment and these are Adolescent commercial sexual workers whose livelihood is
through sex for money and material goods with multiple partners.
4.2 The current status of HIV/AIDS in Lira Municipality
The reports gathered from the health centres within Lira Municipality revealed the
HIV prevalence status between October and November 2009 as shown below.
Table 8 gives a summary of HIV/AIDS status in Lira Municipality between October and
November 2009
Health Centres Frequency Percentage (%)
Ayago Health Centre III 521 16.8
Lira Municipal Health Centre II 678 21.9
Lira Pentecostal Health Centre IV 543 17.6
Lira Referral Hospital 1073 34.9
Ober Health Centre III 272 8.8
Total 3087 100
Source: Study secondary data
The findings in Table 8 above reported Lira Referral Hospital to have the highest record of
HIV/AIDS patients (34.9%) followed by Lira Municipal Health Centre II with 21.9%
23

patients, Lira Pentecostal Health Centre IV (17.6%), Ayago Health Centre III (16.8%)
and Ober Health Centre III (8.8%) respectively. The study findings indicate that HIV
infection registered between October and November 2009 was on the increase with the
highest record in November as shown on the Table 10 below.
4.2.1 HIV infection in Lira Municipality in October and November 2009
Table 9 gives a summary of HIV infection in Lira Municipality in October 2009
Total 1287 100
Table 10 gives a summary of HIV infection in Lira Municipality in November 2009
Total 1800 100
The findings in Tables 9 and 10 above indicate that there was increase in HIV infection in
Lira Municipality in November 2009 implying that the new HIV infection is on the increase
among the population of Lira Municipality. The findings clearly revealed that Lira
Referral Hospital was leading with the report of HIV infection (30.7%) for October and
(37.7%) for November 2009, while Lira Municipal Health Centre II follows (24.2%) and
(20.4%) respectively.
24

4.2.2 The Drivers of HIV infection in Lira Municipality
The findings on the drivers contributing to the new HIV infection among the community of
Lira Municipality are recorded and ranked in percentage scores shown in Table 11 below.
Table 11 gives a summary of the drivers of HIV infection in Lira Municipality
Drivers of HIV Infection Frequency Percentage (%)
Unprotected sex 89 23.2
Defilement 53 13.8
Multiple partners 178 46.4
Sharing sharp instruments 64 16.6
Total 384 100
The findings in Table 11 above indicate that multiple partners scored the highest (46.6%)
followed by unprotected sex (23.2%), sharing sharp instruments like razor and non sterile
needles (16.6%) and defilement (13.8%). Therefore having sexual relationships with multiple
partners was the main drivers of HIV infection among the population of Lira Municipality.
4.3 The contributing factors of new HIV infection in the community
The findings on the contributing factors to the new HIV infection among the community of
Table 12 gives a summary of contributing factors of new HIV infection in the
Community of Lira Municipality
Contributing Factors Frequency Percentage (%)
Drunkenness 16 7.1
Provocative dressing 25 10.9
Provocative dancing 28 12.3
Brothel prostitution 68 29.8
Co-habitation 19 8.4
Discordant relationships 72 31.5
Total 228 100
The findings in Table 12 above indicate that the most contributing factor of new HIV
infection in the community of Lira Municipality is discordant relationships (31.5%)
25

followed by brothel prostitution (29.8%), provocative dancing (12.3%), provocative dressing
(10.9%) and drunkenness (7.1%) respectively.
This confirms with the findings of the Modes of Transmission study that was conducted by
UNAIDS in partnership with Uganda Aids Commission, May 2009 which report of June 2009
indicated that (43%) of all new HIV infections were among mutual monogamous sexual
relationships, while (46%) were among persons involved in multiple sexual partnerships and
commercial sex contributed (22%), while heterosexual casual sex contributed (14%) in urban
centres around concentrated highways and urban areas within sexual networks.
4.4 The most at risk population of HIV infection
The findings on the most at risk population of new HIV infection among the community of
Table 13 gives a summary of the most at risk population of HIV infection in Lira
Municipality
Those with more than one sex partner (s) Frequency Percentage (%)
Boda boda 38 17.2
Mobile business operators (hawkers) 40 18.1
Bar maids 23 10.4
Lodge attendants 25 11.4
Restaurant servers 16 7.2
Brothel prostitutes 53 24.2
Street children 25 11.5
Total 220 100
The findings in Table 13 above indicate that the most at risk population of new HIV
infection is brothel prostitutes (24.2%) followed by mobile business operators-hawkers
(18.1%), Boda boda operators (17.2%), street children 11.5%, lodge attendants (11.4%), Bar
maids (10.4%) and restaurant servers (7.2%) respectively.
26

CHAPER FIVE
CONCLUSION AND RECOMMENDATIONS
5.1 Introduction
This chapter summarizes the key findings that emerged from the study and finally discusses
them to come up with conclusions and recommendations. The study analyzed the
respondents bio data in regard to sex, age, education, religion and occupation to enhance the
research findings. Below is the summary of the major findings.
5.2 Respondents Characteristics
Overall, the study established that out of the 228 respondents interviewed, 120 were male
(53.6%) and 108 female (46.4%) showing that the majority of the respondents were male.
While the majority of the respondents were of age bracket of 16-18 years (24.2%) with the
least being 40 years and above (8.7%) their educational background revealed that the
majority were of primary school level (46.6%) male and (38.9%), who are mainly mobile
business operators-hawkers and adolescent commercial sexual workers.
According to their religious status, the majority of the respondents were found to be
Catholics (40.2%) followed by Protestants (39.1%), Muslims (10.9%) and other beliefs
constituted only (9.8%). The study also revealed the majority of the respondents were Boba
boda operaters and mobile business operators (hawkers) who are self employed (52.6%) and
adolescent commercial sexual workers (43.9%) privately employed by involvement in sex for
money and materials goods with multiple partners as means of livelihood.
5.3 Conclusion
The study findings indicate that HIV infection was on the increase with the highest record in
November 2009 implying that the new HIV infection is on the increase among the
population of Lira Municipality. According to the findings Lira Referral Hospital was
leading in HIV infection (30.7%) for October and (37.7%) for November 2009, while Lira
Municipal Health Centre II follows with (24.2%) and (20.4%) respectively.
27

The findings indicate that sex with multiple partners was the highest (46.6%) followed by
unprotected sex (23.2%), sharing of sharp instruments like razor and non sterile needles
(16.6%) and defilement (13.8%). Therefore having sexual relationships with multiple
partners were the main drivers of HIV infection among the population of Lira Municipality.
The findings indicate the most contributing factor of new HIV infection in the
community of Lira Municipality was discordant relationships (31.5%) followed by
brothel prostitution (29.8%), provocative dancing (12.3 %), provocative dressing (10.9%)
and drunkenness (7.1%) respectively.
The findings indicate the most at risk population of new HIV infection was brothel
prostitutes (24.2%) followed by mobile business operators-hawkers (18.1%), Boda boda
operators (17.2%), street children (11.5%), lodge attendants (11.4%), Bar maids (10.4%)
and restaurant servers (7.2%) respectively.
The findings also indicate the major challenges in resource allocation for HIV mitigation
and prevention by the Lira Municipal Council Local Government was the increasing
population, insufficient HIV/AIDS facilities, lack of free anti retroviral drugs with an
untimely matching grants from the Central Government.
5.4 Recommendations
The Lira Municipal Council Local Government needs to lobby for partnership with other
agencies and NGOs dealing in AIDS related services in order to build up its capacity to
provide effective and sufficient HIV mitigation and prevention services to the different
population groups within the Municipality.
Other key players both government and non government agencies or organizations should be
involved in the planning and funding of HIV mitigation and prevention services for the
community of Lira Municipality.
28

Voluntary Counseling and Testing or Home Based Counseling and Testing should be
mandatory for all the people staying or living within Lira Municipality to ensure quality
health for all population groups.
More condom distribution points should be initiated in all strategic locations within the
Municipality to enable every one accesses it easily so as to guard against incidences of new
HIV infection.
There needs to be routine sensitization and awareness campaigns against HIV infection
among the community of Lira Municipality through media houses like local newspaper
(Rupiny), FM radios, leaflets, publications, drama groups and skits targeting children, youth
and adults to reduce the rate of HIV infection.
29

REFERENCES
1. UNAIDS, 2004 Report on the Global AIDS Epidemic (Referenced by UNICEF Report on
HIV/AIDS prevalence in Uganda 2005; page 147).
2. The comprehensive analysis of HIV/AIDS epidemic and response by Uganda AIDS
Commission November 1998; pages 30-31.
3. UNAIDs MoT Country Report 2009; pages 13-14.
4. Uganda Aids Commission 2004, ibid.
5. UNICEF Report on HIV/AIDS prevalence among vulnerable groups 2004/05, pages 150-
155.
6. Lira Municipal Council 3 Year Rolling Development Plan 2009/2010-2011/2012; pages 136-
138.
7. Asiimwe D, Kibombo R, Neema S. Focus group discussions on social cultural factors
impacting on HIV/AIDS in Uganda. Kampala, Uganda: Makerere Institute of Social
Research; 2003.
8. Government of Uganda (2008) „UNGASS country progress report Uganda, January 2006 to
December 2007‟ (assessable through UNAIDS Uganda country report, as accessed
06/06/08).
9. UNAIDS 2008 Report on the global AIDS epidemic.
10. AIDS Policy Research Center, University of California San Francisco HIV/AIDS in Uganda
Published November 2003
11. A Case study by World Health Organization on the Street Children in Kampala, Uganda;
2009
30

COVERING AND CONSENT LETTER
Good morning/ afternoon/evening.
I am a researcher on a project entitled: “Risk Factors Driving HIV/AIDS Epidemic in Lira
District: the case study of Lira Municipality.” The study covers new HIV infection and modes of
transmission among most at risk population sub groups.
I am here to request you to participate in this study. The purpose of this study is to help in the
establishment of the rate of new HIV infection among the most at risk population sub groups
within the Municipality. Your consent to participate in this study will be highly appreciated and
it‟s quite voluntary.
All the information provided by you will be kept strictly confidential. No identifying information
about you will be revealed in any part of the report of this study.
31

QUESTIONNAIRE FOR OUT OF SCHOOL CHILDREN AND YOUTH.
Section 1
Personal Profile:
Encircle or tick or fill in the relevant responses
1. Is the respondent staying with someone? a) Yes b) No
2. Location of the respondent within Lira Municipality.
a) Village………………………… b) Parish………………… c) Division…………………
2. Sex: 1. Male 2. Female
3. Age: a) 10 and below b) 11-15 c) 16-18 d) 19-25 e) 26-30 f ) 31-35 g) 36-40
h) 40 and above.
4. Level of Education:
a) Not been to school…… b) Nursery level………. c) Primary level…………
d) Secondary level…….. e) Diploma level…….
5. Religion of the respondent a) Catholic b) Protestant c) Muslim d) Other
6. Type of work of the respondent to earn a living………………………………………….
7. The place of work of the respondent within the Municipality?
………………………………………………………………………………………………..
8. Does the respondent have a sex partner? a) Yes b) No.
9. Number of sex partners the respondent has? a) 1 b) 2 c) 3 d) 4 e) Many.
10. How often does the respondent have sex with the partner? a) Daily b) Weekly c) Monthly.
32

11. Does the respondent charge the partner some fee for sex? a) Yes b) No
12. Does the respondent use condom whenever having sex with the partner? a) Yes b) No
13. Has the respondent done VCT? a) Yes b) No
14. Place where the respondent did VCT within Lira Municipality………………………….
Thank you for having sacrificed your valuable time to participate in this discussion.
33

INTERVIEW GUIDE FOR COMMUNITY HEALTH WORKERS
1. Village: …………………………Parish:………………….Division:…………………..
2. Your sex:………………………………………………………………………………..
3. Age:……………………………………………………………………………………..
4. Education level:…………………………………………………………………………
5. Occupation:……………………………………………………………………………..
6. Religion:………………………………………………………………………………...
7. Your place of work:……………………………………………………………………..
8. What are the factors influencing the new HIV infection among the population of Lira
Municipality?
9. What are the drivers of new HIV infection among the community of Lira Municipality?
10. Who are the most population at risk of HIV/AIDS infection among the community of Lira
Municipality?
11. Where is their place of location and why? Explain
12. What do they do particularly to earn a living? Explain
13. Are there facilities for HIV mitigation and prevention in Lira Municipality? Explain
12. Are there resources allocated for HIV mitigation and prevention by the Lira Municipal
Council Local government? Explain
14. How often does your health centre carry out VCT/HCT?
15. What difficulties does your organization face in carrying out HIV mitigation and prevention
within Lira Municipality?
16. Are there instances whereby the HIV mitigation and prevention fails to be implemented?
What could be the reasons for such an event?
14. Which of the two phases is difficult to undertake HIV mitigation and prevention- planning or
implementation? Explain
15. Does your organization carry out HIV/AIDS infection monitoring and evaluation? If yes,
after how long do you carry out the monitoring and evaluation?
16. Are there any monitoring and evaluation report? If yes, where is the report? If no, why is the
report not available?
34

17. What do you consider when determining whether an organization is effectively carrying out
HIV mitigation and prevention or not?
18. What could be done to ensure a proper and sufficient resource allocation for HIV mitigation
and prevention in your organization?
Thank you for having sacrificed your valuable time to participate in this discussion
35

INTERVIEW GUIDE FOR BODA BODA OPERATORS AND HAWKERS
Section 1
Personal Profile:
Encircle or tick or fill in the relevant responses
1. Location of the respondent within Lira Municipality.
a) Village………………………… b) Parish………………… c) Division…………………
2. Sex: 1. Male 2. Female
3. Age: a) 10 and below b) 11-15 c) 16-18 d) 19-25 e) 26-30 f ) 31-35 g) 36-40
h) 40 and above.
4. Level of Education:
a) Not been to school…… b) Nursery level………. c) Primary level…………
d) Secondary level…….. e) Diploma level…….
5. Type of work of the respondent to earn a living………………………………………….
1. The place of work of the respondent within the Municipality?
………………………………………………………………………………………………..
7. What category of customer does the respondent carry mostly? a) boys b) girls c) men
d) women.
8. What time of the day? a) day b) night
9. Does the respondent have a sex partner? a) Yes b) No.
10. Number of sex partners the respondent has? a) 1 b) 2 c) 3 d) 4 e) Many.
11. How often does the respondent have sex with the partner? a) Daily b) Weekly c) Monthly.
36

12. Does the respondent use condom whenever having sex with the partner? a) Yes b) No
13. Has the respondent done VCT? a) Yes b) No
14. Place where the respondent did VCT within Lira Municipality………………………….
Thank you for having sacrificed your valuable time to participate in this discussion.
37

CHECKLIST FOR CONTENT ANALYSIS
Tick in the corresponding spaces: Y for Yes, N for No and NA for Not Applicable
HIV Mitigation and Prevention Activity Y N NA
Register for arrival time of respondents
VCT/HCT testing services
ARV referral cases
ARV facilities in place
Care for PLWAs available
Occupation of respondents Y N NA
Self employed
Public employed
Privately employed
Relationship of Respondents Y N NA
One sex partner
More than one sex partner (s)
Use of condom during sex
Access to condoms distribution points
Frequency of sex of Respondents
Daily
Weekly
Monthly
Status of Respondents Y N NA
VCT/HCT tested
HIV status
ARV referral information
ARV treatment report
38

MAP OF LIRA MUNICIPAL COUNCIL
39

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