My wife fears sex, I fear death' - impacts of the USAID freeze

My wife fears sex, I fear death' - impacts of the USAID freezeLife for Mike Elvis Tusubira, a motorcycle taxi rider with HIV in Uganda, has been turned upside down since US President Donald Trump halted foreign aid last month.Not only does the 35-year-old fear for his own survival as he takes life-saving anti-retroviral (ARV) drugs - but he says he will have to split up from his wife as they can no longer have safe sex.His partner is HIV-negative and relies on PrEP, a medicine that reduces the risk of contracting HIV.

"It means that even my marriage will end, because actually without the preventive measures, she's not going to stay,"No condoms, no [anti-HIV] lubricants, no PrEP, nothing. We can't stay in marriage without meeting. It means that I have to stay single."All the couple's medicines and contraceptives were supplied thanks to funding from the US government's main overseas aid agency USAID.

Since the sudden shutdown, which he heard about on social media, they have not been able to replenish their supplies. His wife has completely run out of PrEP now and they are both afraid that relying just on condoms - they have some left - is too risky.

Trump ordered the 90-day pause on foreign aid on his first day back in office, after which stop-work orders began to be issued to organisations funded by USAID.

Waivers were subsequently issued for humanitarian projects, but by that time the HIV programme Mr Tusubira was part of - run out of Marpi Clinic in the north of the capital, Kampala - had closed.

He phoned his counsellor at the Kiswa Health Centre III in the city to find out what was going on.My counsellor was in the village. He told me that he is no longer at the clinic."The father of one, who tested positive for HIV in 2022, has since missed a test to determine how much virus is in his blood and the strength of his immune system.

"I'm moving in the dark, in the darkness. I don't know whether my viral load is suppressed. I'm traumatised.He does not think his job driving a motorbike taxi - known locally as a "boda-boda" - will be able to help his family get over the hurdles they now face. Some other people say that the drugs will be in private pharmacies... as a boda-boda rider I don't know whether I can raise the money to sustain my treatment."

They have also been impacted by the loss of services provided by non-government organisations (NGOs) that received funding from USAID, he says.is wife was getting her PrEP via an NGO at Marpi and his five-year-old son was benefitting from one that provided school and food for vulnerable children."My child is no longer at school now," he said.