International Journal of Social Science Tomorrow Vol. 1 No.

The Contribution of Religion to the Impact of HIV/AIDS

on Households in Bushenyi District, Uganda
Benon Musinguzi, Ph.D, Director Quality Assurance, Uganda Christian University, Uganda

Abstract
The HIV/AIDS epidemic is a threat to human development, especially in the poorest regions of the world.
AIDS can affect national development, widen the gap between rich and poor nations and push already-
stigmatized groups closer to the margins of society. Like other background factors, religion in Bushenyi district
has had its share towards the impact of HIV/AIDS on households, and yet relatively little research has been
conducted to establish the extent to which religion has contributed to the HIV/AIDS impact on these
households. The study was cross-sectional, that used the quantitative approach. It applied a multi-stage cluster
sampling of administrative units and a complete coverage of the smallest units (villages) that were randomly
selected. Data was collected using personal interviews and multinomial logit was used for analysis. There was
sufficient evidence from the findings that the household religion had a great influence on the impact of
HIV/AIDS on households.

Keywords: AIDS, HIV, Impact, Religion

1. Background
This is a study of the contribution of religion to the impact of HIV/AIDS on households in Bushenyi district,
Uganda. Throughout African history, few crises have presented such a threat to public health and to social and
economic progress as the HIV/AIDS epidemic has done to Bushenyi district, Uganda. HIV/AIDS can no longer
solely be considered a health problem, but a development problem as well. Due to AIDS, decades of
development have been lost in Africa, and the countries‟ efforts to reduce poverty and enhance living standards
have been greatly undermined (FAO, 2002).

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 International Journal of Social Science Tomorrow Vol. 1 No. 7
Throughout African history, few crises have presented such a threat to public health and to social and economic
progress as the HIV/AIDS epidemic has done (FAO, 2002). It is even more troubling given that much of the
suffering and the destitution caused by the epidemic could have been prevented. HIV/AIDS can no longer
solely be considered a health problem, but a development problem as well. Due to AIDS, decades of
development have been lost in Africa, and the countries‟ efforts to reduce poverty and enhance living standards
have been greatly undermined (FAO, 2002).

The HIV/AIDS epidemic has become a major threat to human development, especially in the poorest regions of
the world. The number of new infections in Uganda was at 120,000 in 2009 and it is feared HIV prevalence
may be rising again. There are many theories why this may be happening, including a general complacency or
„AIDS-fatigue‟. It has been suggested that antiretroviral drugs have changed the perception of AIDS from a
death sentence to a treatable, manageable disease. This may have reduced the fear surrounding HIV, leading to
an increase in risky behavior (Primah, 2011).

In 1982, when AIDS was first diagnosed in Uganda, few people could predict how the epidemic would evolve
and fewer still could describe with any certainty the best ways of combating it. From experience, however, we
know that AIDS can devastate whole regions, affect national development, widen the gap between rich and poor
nations and push already-stigmatised groups closer to the margins of society (UNAIDS, 2000).

2. The Problem Statement

AIDS has had a devastating impact on Uganda. It has significantly lowered life expectancy and reduced the
country‟s labor force, reduced agricultural output and food security, and weakened educational and health
services (GoU, 2009). There are many orphans, widows and widowers due to AIDS deaths and so much has
been spent by these households on these illnesses and deaths of their members. As shown in the Conceptual
framework, religion in Bushenyi district has had its share towards the impact of HIV/AIDS on households in the
district. This is both at the infection or management levels of HIV/AIDS. Although much research has been
done on the impact of HIV/AIDS on the general economy, relatively little research has been conducted to
establish the extent to which religion has contributed to the HIV/AIDS impact on these households.

3. Objectives of the Study

The broad objective of the study was to investigate the contribution of religion to the impact of HIV/AIDS
epidemic on households in Bushenyi district in the context of their demographic and economic backgrounds.

3.1 Specific Objectives

To establish the contribution of religion to the impact of HIV/AIDS on the;
 Households‟ food production
 Availability of household shelter
 Provision of clothing
 Availability of bedding

4. Significance of the Study

Bushenyi being a predominantly religious district, understanding the levels to which religious beliefs influence
the impact of HIV/AIDS illnesses/deaths on the households, will help in designing policies targeting such
households for proper planning.

5. The Conceptual Framework

Figure 1 gives the conceptual Framework in which three levels are clearly given: The Demographic and
economic background, the intermediate variables and the socio-economic impacts.

The demographic and economic backgrounds which include age, sex, level of education, level of income and
occupation of the sick/dead indirectly or directly influenced the way the households manage the illness/death of
a household member. Depending on one‟s level of education, level of income or type of occupation, the
household uses the available savings, sells part of their property, borrows money or fails to manage their
illnesses properly. Once either of these actions is taken in the management process, the other members of the
households are indirectly or directly affected. Beliefs within the household‟s religion directly or indirectly
contribute to the infection of the household members or the management of HIV/AIDS illness by the
households. Some religions, for example Catholics, do not allow the use of condoms in family planning and
protection against HIV. This increases their risk of infection. On the other hand, due to different beliefs and
behaviours, different religions manage the illness of AIDS differently.

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 International Journal of Social Science Tomorrow Vol. 1 No. 7
These background factors as influenced by type of religion, determine the way the households manage the
illnesses/deaths of their members. This includes accessing medication, proper diet, and availability of care and
sale of household property. Depending on how the illnesses/deaths are managed, different households have had
different experiences which include: reduced household savings/assets, reduced household production due to
the sick and those caring for the sick and psychological effects, especially the very young that lose both parents
and property.

The socio-economic impact on the affected households which includes lack of household basic needs like food,
shelter, clothing or bedding, indirectly or directly depends on the demographic and economic backgrounds, as
influenced by the religious beliefs of the households. This determines how the households manage the
illnesses/deaths of their members.

6. Methodology
This describes the study area, the study design, data processing and analysis.

6.1 The Study Area

The study was conducted in Bushenyi district, Western Uganda. Bushenyi district is on the African highway to
the Democratic Republic of Congo (DRC). Several truck drivers spend nights in all townships along this
highway. This increases the possibility of the spread of the illness, since it is most spread through having sex
with infected persons. Mutambi, a key informant who works with Integrated Community Based Initiatives
(ICOBI), a community based organisation that sensitises and tests HIV/AIDS at household level, said that
although the prevalence rates in the district were at 7%, they could be as high as 25% in some urban areas and
as low as 3% in some rural areas.

6.2 The Study Design

It was a cross-sectional study design that used the quantitative research methods. The study applied a multi-
stage cluster sampling of counties, sub-counties, parishes and villages; then a complete coverage of those
villages that were randomly selected. After clustering the five counties that made up the district, three were
chosen by simple random sampling. Within these, different sub-counties were selected and within the sub-
counties, different villages were also picked using simple random sampling. Data was collected using personal
interviews from already prepared questionnaire schedules.

Being a cross-sectional comparative study, cross-tabulations were used to analyze the relationships between
independent and dependent variables, that is, between the defined effects and the factors contributing to those
effects (Carman, 2008). Since the cross-tabulations do not indicate the strength of the relationship and the
variables were all categorical, the multinomial logit was later used at the multivariate analysis level. The
multinomial logit regression was used since the dependent variable in question is nominal and consists of more
than two categories. The multinomial logit equation is given below:

 P(Y  2) 
ln    b20  b21 X 1  b22 X 2  ....  b2 k X k
 P(Y  1) 

7. Religion as a Contributing Factor to HIV/AIDS Impact on Households

This is a major factor that determines not only the way people behave, leading to different infection rates, but
also how they react to and manage the different illnesses. While some religions may take prevention measures
like the use of condoms seriously, others like Catholics may out rightly reject such measures. Rwambali (2002)
reports the resistance of clergy, towards condom use in Tanzania. This influences infection rates, especially
between spouses with different sexual behaviours, thus, affecting the whole household.

From the onset, HIV/AIDS was permeated with various meanings, and the understanding of the pandemic was
very much dependent on one‟s moral standing on the issue. Religion was faced with a dilemma of status –
interacting with and in response to people living with HIV & AIDS. It is argued that religion places a code of
moral norms which directly impact any understanding of the pandemic related to human social behavior. Hence,
the question as to why and how religious groups should engage in public issues such as HIV & AIDS comes to
the fore (Du Toit, 2010).

It is also important to note that, for centuries, members of religious organizations have demonstrated their
commitment to respond to human need based on the teachings of their faith. As HIV/AIDS continues to create a
caring deficit, eroding the capacity of communities to care for those affected, religious organizations have come

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 International Journal of Social Science Tomorrow Vol. 1 No. 7
in to respond to the impact of the disease and sustaining hope. Faith-based Organizations have established
structures and channels of communication at every level of society. Religious infrastructure connects villages,
districts and regional centers and provides mechanisms to organize people, mobilize action, and channel
information and resources. They have experience in creating interactive information sharing among peer groups,
especially with youths and women (Foster et al. 2006).

Table 1 shows that Bushenyi district was predominantly Protestant (66.2%) compared to both the Catholics
(17.5%) and the Moslems (16.3%). Since the management behaviours of HIV/AIDS illnesses by different
religions are different, for example: while some may pray and use medication, others may depend on prayer
alone, while others may depend on medication alone. This affects these different households, differently.

7.1 Associations between Religion and Illnesses/Death

Religion had a major role in determining the cause of illnesses/death of some household members. To
determine the extent of the role played by religion on the cause of illnesses/death of some household members,
the two variables were cross - tabulated and the results are in Table 2. The row percentages give the extent to
which religion determined the cause of illness/death. Of the three dominant religions in the area, Protestants
were the biggest in number, covering 66.2%, however, HIV/AIDS was more prevalent among the Catholics
compared to other religions. This may be attributed to their social behaviours like alcohol drinking and non use
of condoms. The Roman Catholics are not forbidden from alcohol drinking and are strictly forbidden from
using condoms. This puts them at a higher risk of HIV infection compared to all other religions. Since the
illness affects more of the middle aged, leaving behind helpless orphans and the elderly, such households will
experience a higher level of impact of long illnesses, especially AIDS, compared to other households belonging
to other religions.

7.2 Relationship between Forms of Costs and Religion of Households

This is an analysis on costs of illnesses/death on the households in relation to their religions. It explains how
people‟s religion influences spending on the illnesses/death of their household members.

The type of religion the household was practising was found to be significantly related to medical costs. The
catholic faith had the highest risk of meeting medical costs relative to other general household costs compared
to the Moslem faith (Table 3). Catholics were found to spend more than the rest, probably, because they were
more prone to HIV/AIDS illness, owing to their social and religious behaviours. The Catholics had the highest
risk of spending on medication, transportation of the sick, diet and time spent on caring for the sick compared to
the Muslims and the Protestants. This level of spending affects not only their day today welfare, but also their
savings for the future. This in the long run affects the availability of basic household needs like food, school
fees, clothing and availability of shelter.

7.3 Relationship between Level of Impact and Religion of Households

The extent of the impact of HIV/AIDS on households was significantly related to the religion the household
was practising. The Protestant households had the highest risk of lack of food due to illnesses/death of a
household member compared to both the Catholic households and the households belonging to the Moslem
faith. Generally, HIV/AIDS affects the production capacity of the households, and Bushenyi district being of a
peasant class who produce for consumption, the loss of man-power through illness of the middle aged, time
spent caring for the sick, time spent in funnels all affect the extent to which food production is affected.

Table 3 shows that the catholic households had a higher risk of impact of HIV/AIDS illnesses/deaths on
availability of shelter to the households compared to other religions. The Moslem households were list affected.
It needs to be noted that most of the shelter is temporary made of wattle and grass thatched. Such shelter is
maintained by periodic repairs, by either the household members themselves or by hired personnel. The loss of
the middle aged, time spent on caring for the sick and funnels affects the availability of households‟ members to
repair such households, and the only alternative is to hire manpower from outside the households. The Catholic
households were most significantly affected compared to all other households. This is directly associated with
the loss of the labour force and the different costs met on illnesses/deaths of their members.

Anglicans had the highest risk of lacking clothes and beddings compared to Catholics and Moslems. Unlike
food and shelter which are a result of the households‟ direct manpower input, by tilling the land and building
the shelter respectively, clothes and beddings are bought with money from the market. The results in Table 3
indicate that Anglicans could have lost most of their income earners compared to Catholics and Moslems.

It is interesting to note that while Catholic households had the highest percentage of illnesses/deaths and costs
due to illnesses/deaths of their household members, the protestant households had the highest risk of lack of

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 International Journal of Social Science Tomorrow Vol. 1 No. 7
most of the basic household needs. This clearly indicates that the impact of HIV/AIDS illnesses/deaths is not
solely a result of the costs and time spent on the sick/dead as illustrated above, but also a result of other
background factors as shown in Fig. 1, and specifically religion in this study.

There is a way religions shape their members to behave differently from members of other religions especially
when it comes to HIV/AIDS illnesses/deaths. While some encourage living as a community and helping one
another in times of need, especially those of the same religion; and while some have some organizations to help
the vulnerable, (Fig. 3), others do not. It is most likely that while the Catholics had the highest illnesses/deaths
and highest costs due to HIV/AIDS, the vulnerable ie the orphans and widows are helped to get their basin
needs compared to the protestants. This agrees with Du Toit (2010),

“that Churches around the world have, over the past few years, become more comfortable about discussing HIV
& AIDS with their congregations and Faith-based organizations have, in fact, been involved in the HIV & AIDS
response since the earliest days of the epidemic and have often been among the first to respond, providing
services, education and care for those in need. Religious communities, mosques, temples, churches, hospitals
and clinics have reached out to provide support to those living with and affected by HIV. Their leadership has
great influence in the lives of many people, and leaders speaking out responsibly about AIDS can make a
powerful impact at both community and international level”.

The Inter Religious Council of Uganda (IRCU) utilizes the strengths of the religious institutions and leaders as
platforms for HIV/AIDS mobilization and service delivery and also as conduits to deliver messages to
congregations during religious events like sermons, prayers, baptism, marriage and death celebrations (IRCU,
2012).

8. Summary
The religion practiced by a household was a major factor in determining the costs of illness and the level of
impact on the households. Anglican households compared to other households were most affected by lack of
food, clothing and bedding due to the long illnesses/deaths of their members. Catholics, on the other hand, were
most affected by lack of shelter. The households that practice Islam were always the least affected. This clearly
shows that religion has an influence on the management of the long illnesses and their impact on the
households.

The summary of findings also agrees with the conceptual framework which shows that the economic and
demographic factors (age, sex, level of education and occupation) as influenced by type of religion determined
the socio-economic impact of the households. These include lack household basic needs like food, school fees,
bedding, clothing and shelter. They also have a major influence on the social disruption and disintegration of
the households.

9. Conclusions
There was sufficient evidence from the findings that the household religion had a great influence on the impact
of HIV/AIDS on households. The levels of impact on households were differentiated by the religions the
households were practising.

10.Recommendations for Policy and Programs

HIV/AIDS is both a preventable and a manageable illness. This is only possible if the population is
knowledgeable and has the capacity to manage the illness or if the government directly comes in to assist. Since
the household religion has a major influence in determining the impact on the households, policies based on
religious behaviours can be made for proper management of the long-term illnesses. Therefore, it is
recommended that as follows:
 That through the religious leaders, the grass root population should not only be sensitised on how HIV is
transmitted, but also on its impact on the households‟ welfare and the economy as a whole. Such an action
would facilitate behavioural change in the community.

 That resource should be put in place by government and be managed by these religious organizations to
help families that have been seriously affected by the illnesses and deaths of their members due to
HIV/AIDS. This will directly help the orphans, in particular, in accessing the basic needs of life, like
schooling, food, clothing and medication.

 That since household religion influence the pattern of HIV infection, the costs and impact of AIDS
illnesses/deaths, the government should utilise them as a tool in the fight and management of HIV/AIDS.

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 International Journal of Social Science Tomorrow Vol. 1 No. 7
Benon Musinguzi,
Ph.D,
Director Quality Assurance,
Uganda Christian University,
Uganda

References
 AllAfrica (2008) „Uganda: Stick to condom use”. http://www.avert.org; September 15, 2011
 Du Toit, J. (2010). “HIV, AIDS and Religion: An Ambiguous Relationship”.
 Ekaas, S. (2003). http://www.genderandaids.org; April 12 07.
 FAO (2002). “The Impact of HIV/AIDS on food security in Africa”. Twenty Second Regional Conference for Africa. Cairo, Egypt 4-
8 February 2002.
 Foster, G. Levine, C. & Williamson, J. (2006). A Generation at Risk: The Global Impact of HIV/Aids on Orphans and Vulnerable
Children. Cambridge university Press. The Edinburgh Building, Cambridge CB2 2RU, UK.
 GoU (2009). UNGASS Country Progress Report, Uganda, January 2008-December 2009.
 IRCU(2012)“One Million Free HIV Test Campaign “Enhancing the role of religious leaders in the fight against HIV/AIDS.”
NewVision July 12, 2012
 Primah, (2011). http://www.keycorrespondents.org/2011/10/13/is-uganda-still-considered-an-hivaids-success-story/#comment-20449
 Rwambali, F. (2002). “Mengi Condom Appeal Angers Clergy”. The East African. Nairobi Kenya, August 5, 2002.
 UNAIDS (2000), REPORT on the global HIV/AIDS epidemic.

Appendix

Figure 1: The conceptual framework

The conceptual framework (Figure 1.1) indicates that the affected households have reduced savings as a result of the costs met on
medication. The households also have reduced human capital resource and reduced production

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 International Journal of Social Science Tomorrow Vol. 1 No. 7
Figure 3: Launch of the Inter-Religious Institute for Peace; July 5, 2012

BUSHENYI DISTRICT PROFILE

30 Orphans and Vulnerable Children (OVCS) have been passed out in Jinja Catholic Diocese, one of the 37 Faith Based
Organisations supported by IRCU to implement OVC Program.

Figure 2: Map of Bushenyi District and its Location on the Map of Uganda (before 1 st July 2010)

‘’’’’’

CONTACT
Table 1: Percent distribution of the household members by their religions
POSTAL ADDRESS P. O BOX 01 , BUSHENYI Religion
TELEPHONE: 0485-442043, 442372 Protestant 406 66.2
Catholic 107 17.5
TELEFAX: +2560485442335 Moslem 100 16.3
Total 613 100.0
E-MAIL: _____________________________________________________________________________________
WEBSITE: _____________________________________________________________________________________

Table 2: Percentages by cause of illnesses/deaths of household members by their religion

Causes of illness/death TABLE 3: SELECTED INDICATORS
AIDS related Other long illnesses No long illness
SELECTED CHARACTERISTICS VALUES
N % N % N %
TABLE 1: NUMBER OF ADMINISTRATIVE UNITS BY COUNTY AND BYReligion
SUB TABLE 2: PERCENTAGE DISTRIBUTION OF THE MAIN ECONOMIC
COUNTY Protestant 61 15.0ACTIVITIES BY45HOUSEHOLDS 11.1 300 73.9
Catholic 26 24.3 13 12.1
Land Area (sq km)
68 63.6
4,293
NO. OF Moslem 11 11.0 9 9.0 80 80.0
NO. OF SUB NO. OF VILLAGES χ2=8.9 p=0.063
COUNTY PARISHES/ Total population
COUNTIES /ZONES /CELLS
WARDS CATEGORIES PERCENTAGE 731,392
BUHWEJU 4 23 203 Animal Rearing 1.2 Total households 142,970
BUNYARUGURU 4
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IGARA 7 46 542 Fishing 0.6 Average household Size 5.1
RUHINDA 7 35 529 Employment Income 0.4 Average Dependancy Ratio 112.6
SHEEMA 7 41 529 Trading in Agricultural Produce 1.8 Life expectancy 48.78
Deprivation of a decent S.O.L
 International Journal of Social Science Tomorrow Vol. 1 No. 7
Table 3: Results from a regression analysis predicting the costs on the households
β se p Exp(β)
Costs of illnesses/deaths of members on the households
Medical expenses
Intercept -0.393 0.685 0.566
Religion
Anglican 0.604 0.365 0.098 1.830
Catholic 0.915 0.488 0.061 2.497
Moslem* 0.000 . . 1.000
Transport costs
Intercept -0.276 0.676 0.683
Religion
Anglican 1.034 0.376 0.006 2.811
Catholic 1.360 0.491 0.006 3.896
Moslem* 0.000 . . 1.000
Expensive diet
Intercept -1.522 0.742 0.040
Religion
Anglican 0.910 0.406 0.025 2.483
Catholic 1.273 0.525 0.015 3.571
Moslem* 0.000 . . 1.000
Care time
Intercept -1.931 0.784 0.014
Religion
Anglican 1.212 0.448 0.007 3.360
Catholic 1.247 0.566 0.028 3.480
Moslem* 0.000 . . 1.000
*Reference category
Table 4: Results of a regression analysis predicting the forms of impact on the households
β se p Exp(β)
Forms of impact on the households
Lack of food
Intercept -0.800 0.856 0.350
Religion
Anglican 0.752 0.469 0.109 2.122
Catholic 0.655 0.648 0.312 1.925
Moslem* 0.000 . . 1.000
Lack of shelter
Intercept -2.850 1.058 0.007
Religion
Anglican 1.265 0.602 0.036 3.544
Catholic 1.306 0.757 0.084 3.693
Moslem* 0.000 . . 1.000
Lack of clothing
Intercept -2.452 0.895 0.006
Religion
Anglican 1.782 0.575 0.002 5.939
Catholic 0.820 0.766 0.284 2.271
Moslem* 0.000 . . 1.000
Lack of bedding
Intercept -3.083 1.465 0.035
Religion
Anglican 1.963 0.786 0.013 7.119

Catholic 1.674 1.024 0.102 5.335

Moslem* 0.000 . . 1.000
* The reference category
 5).

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