About 130,000 Ugandans get HIV every year, and Joshua Musinguzi, who heads Uganda's AIDS control program, said this was the figure most discouraging of all. It means that far too many Ugandans are getting AIDS than the government can possibly manage to treat.
"There is need for continuous dissemination of information," Musinguzi said. "Individuals have the power to make the correct decision if they want to. The menu is there: ABC."
Uganda once earned a reputation for successfully putting in place a policy called ABC: abstain, be faithful, or use condoms. Students of a certain generation were shown videos of the devastating toll of AIDS on the human body, and then told to postpone the first act of intercourse. Some believe the fear factor, now gone, was decisive in Uganda's successful control of AIDS in the mid-1990s.
"They now see AIDS as much more like diabetes, one of these chronic diseases you can live with indefinitely," Timothy Kalyegira, a well-known Ugandan social critic, said, talking about the changing attitude toward AIDS among Ugandans.
The government recently added male circumcision to the plan against AIDS, in response to studies showing the procedure reduces the risk among African men of getting HIV in half. Officials want to circumcise 4 million men by 2015 in hopes that mass circumcision, as well as a persistent media campaign urging Ugandans to "get off the sexual network," will reduced substantially the rate of new infections. They remain optimistic that U.S. support for AIDS treatment will be stable for years to come.
In April three U.S. lawmakers touring Uganda with the humanitarian group CARE visited the clinic where Engole, the first PEPFAR beneficiary, gets his medication. He told the lawmakers his story and thanked them for PEPFAR, and some hugged him.
"To see this man who has a second chance now at living a healthy life, raising a family and children, to me was a very humbling experience," U.S. Rep. Barbara, a California Democrat, said after meeting Engole. "It also was confirmation of the fact that United States foreign aid works."
Lee said Engole's example made her realize the U.S. "can't pull back" from AIDS relief in Africa.
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