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Time to invest in a ‘counterpublic health’ approach: promoting sexual health amongst sexually active young people in rural Uganda

This paper contributes to thinking about counterpublic health, a term used to think about those areas of public health in which investment in particular moral ideologies compromises the ability to respond effectively to public health needs (Race 2010). Drawing on findings from a qualitative study conducted with young people and NGOs in rural Uganda, findings reveal how young people become involved in secretive sexual relationships because of inhibitive mainstream influences discouraging more open expressions of sexuality. The analysis of NGO HIV prevention and sexual health programming illustrates few opportunities to normalise perceptions of young people's sexual behaviour as it is actually lived and challenges an accepted public morality which systematically enhances young people's vulnerability to HIV and other sexual health threats. This paper identifies three ways in which NGOs might adopt a counterpublic health approach to HIV prevention and sexual health programming with young people.