Youths from Kumi in eastern Uganda

KAMPALA, Uganda (WOMENSENEWS)–A poor cow herder in rural Uganda has placed his hopes in his teen daughter. Smart and hardworking, she wants to be a doctor someday. He can’t afford her school tuition, so his rich employer agrees to pay.

There is only one catch, which she does not tell her father: She is now the rich man’s concubine. She wonders if she is correct in calculating that her education is worth more than her chastity.

Her dilemma is all too familiar to anti-AIDS prevention workers at the Straight Talk Foundation, to whom she wrote seeking advice. In Africa, sex is often the only currency a young woman has.

"We tell people, ‘Abstain from sex while in school, avoid sugar daddies," said Anne Akia Feidler, a co-founder of the group. "Well, the truth is, many girls have graduated because they have sugar daddies."

Thirteen years ago, Straight Talk became one of the first organizations of its kind in Africa, providing frank advice on sex and relationships to teens in newspapers and on the radio. It is now known as one of the most successful anti-AIDS groups in Uganda, among the countries first and hardest hit by the disease.

From the bustling capital to the guerilla-infested villages of the North, thousands of Ugandan adolescents–the majority of them girls–write to Straight Talk each year. The walls of its Kampala offices, in an old colonial building surrounded by mango trees, are lined with black binders containing thousands of handwritten letters. They seek advice on topics from heartbreaks to menstrual cramps to losing a parent to AIDS.

With a formula of frank sex and relationship advice appealingly packaged with colorful cartoons, quizzes and pop music, Straight Talk became a model for similar organizations in Kenya, Tanzania and Ethiopia, among others. But like other anti-AIDS groups in Africa, it has also struggled to keep pace with the changing politics surrounding the epidemic.

Changing Climate of HIV Prevention

"The whole thing–the climate surrounding HIV prevention–has changed since the early days," said Cathy Watson, a former nurse and journalist who, with Feidler, started Straight Talk with a small grant from UNICEF in 1993.

In the early 1990s, Uganda was still struggling to recover from 25 years of dictators and war, which had fueled the epidemic. It was in those years that Yoweri Museveni, who promised to restore peace to the country after taking power in a 1986 coup, became the first African leader to openly acknowledge the catastrophe of AIDS.

He encouraged Western-funded prevention campaigns to teach people how to protect themselves. Public health experts theorized that if young people could be taught safe sex practices early, they would remain less likely to contract the virus and spread it later.

"We saw this window of opportunity," said Dr. David Serwadda, director of the Institute of Public Health at Makerere University in Kampala. The first issue of Straight Talk, a black-and-white insert in the state-owned newspaper, told readers that its goal was to encourage teens to put off sex until they were older. "But it is not going to preach," it read. "And it is not going to pretend that kids aren’t having sex. Many are."

Straight Talk Goes Down Easy

Today, Straight Talk publishes four-page color inserts that appear monthly in newspapers and are distributed in schools, clinics and shops across Uganda. It broadcasts 30-minute radio shows each week on 27 stations across the country in 11 local languages. It recently began a newspaper insert for teens in southern Sudan. The group employs some 90 people, including many youths who have been orphaned by AIDS. It receives funding from a variety of donor agencies and groups, mostly European.

Between 1992 and 2003, Uganda became known as the African "success story" in AIDS prevention as its percentage of HIV-positive adults dropped from 16 percent to about 6 percent, the only country on the continent to record such a decline. While the reason for the drop has been widely debated, the country’s posture of openness has been widely hailed.

: Deo Agaba interviews a girl for his Straight Talk radio show.

But recently, much of the emphasis has shifted to so-called "abstinence-only" education, a strategy that has been encouraged by funding from conservative Christian groups and the Bush administration. Just a few years ago, billboards with colorful condom ads peppered the capital; now they have been torn down or replaced by ads–some funded by the U.S. government–telling teens to remain chaste until marriage. Ugandan first lady Janet Museveni, a fervent born-again Christian, has also championed the abstinence shift.

Though Straight Talk has never been explicitly censored, Feidler said, there was a feeling among prevention groups of being "hemmed in."

Pro-Abstinence Pressures

The Uganda office of Population Services International, a Washington-based organization that supplies free and subsidized condoms as part of its AIDS prevention program, said it was pressured recently by representatives of Bush’s Emergency Plan for AIDS Relief and religious groups in Uganda to take down posters and pull radio ads. The organization has also seen its money from the fund reduced from $600,000 to $100,000, according to group officials.

"There was a feeling that we couldn’t talk about condoms. That we should be careful. And young people started complaining that we had become bland," Feidler said.

The AIDS prevalence rate has wavered a bit, and most recently showed a slight decline, but it will be years before the effects of any trend in prevention tactics can be measured statistically.

Officially, the favored HIV-prevention approach in Uganda remains the multi-pronged message known as ABC, for "Abstain, Be faithful and, if you can’t, use Condoms." But Serwadda agreed that, "There is a sense this abstinence message is drowning out all the others now."

Feidler, like many veterans in AIDS prevention, worries that expecting teens not to have sex is simply not realistic. She points to the young cow-herder’s daughter, the would-be doctor who is exchanging sex for tuition payments.

"I don’t know if telling that girl to abstain is really the right message," said Feidler. "Personally, I think I would tell her OK, I don’t know what I would do, but make sure you have protected sex with that man."

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Rachel Scheier is a freelance writer based in Kampala.