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AJPH First Look, published online ahead of print May 30, 2007
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July 2007, Vol 97, No. 7 | American Journal of Public Health 1184-1186
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.072777

MATERNAL AND INFANT HEALTH IN DIVERSE SETTINGS

Framing HIV Prevention Discourse to Encompass the Complexities of War in Northern Uganda

Michael J. Westerhaus, MD, MA, Amy C. Finnegan, MALD, Yoti Zabulon, MD, MPH, DTMH and Joia S. Mukherjee, MD, MPH

Michael J. Westerhaus is with Brigham and Women’s Hospital, Boston, Mass. At the time of the study, Amy C. Finnegan was with the Africa Division of World Education, Boston. Yoti Zabulon is with the Department of HIV/AIDS, Lacor Hospital, Gulu, Uganda. Joia Mukherjee is with Partners in Health, Boston.

Correspondence: Requests for reprints should be sent to Michael J. Westerhaus, Brigham and Women’s Hospital, Department of Medicine, 75 Francis St, Boston, MA 02115 (e-mail: mwesterhaus{at}partners.org).

ABSTRACT

In northern Uganda, physical and structural violence (political repression, economic inequality, and gender-based discrimination) increase vulnerability to HIV infection. In settings of war, traditional HIV prevention that solely promotes risk avoidance and risk reduction and assumes the existence of personal choice inadequately addresses the realities of HIV transmission.

The design of HIV prevention strategies in northern Uganda must recognize how HIV transmission occurs and the factors that put people at risk for infection. A human rights approach provides a viable model for achieving this aim.






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