The HIV prevalence rate on the Ssese Islands is about five times higher than the national prevalence rate. The Kalangala Director of Health Services, Dr. Hillary Bitakalamire, says a study of data from HIV voluntary counselling and testing centres in the district puts the HIV prevalence rate at 27 percent. The national HIV prevalence rate is at 6 percent. The study was conducted by the Medical Research Council, the Ssese Islands African AIDS Project and the Kalangala Health Centre. Bitakalamire attributes the high HIV figures to the poor distribution of condoms and negative cultural attitudes towards condom use on the Ssese Islands. He says that with 84 different islands in Kalangala, effective distribution of condoms is hard and HIV awareness messages are not reaching the intended target audience. The high HIV prevalence rates in Kalangala have also been blamed on women's ignorance of their reproductive rights and the high levels of prostitution in the district. The Kalangala Health Inspector, Edward Bugimbi, says his office is working with local and international non-governmental organizations operating in the district to increase the distribution of condoms on the islands. He says he has already started collaboration with Action Aid, Functional Adult Literacy instructors and the Kalangala District Farmers Association.