By Esther Nakkazi
This year, Uganda marks World Aids Day
under the same theme as last year, ‘Re-engaging Leadership for effective HIV
prevention’ but with the slogan: ‘Accelerating HIV prevention for Zero new infections.’
Indeed, with 130,000 new infections in 2011
according to the National AIDS Indicator Survey (UAIS) released mid this year,
from 128,000 in 2010 and 124,00 in 2009, the status of Uganda’s HIV is alarming
and at a critical crossroads.
Dr. Christine Ondoa, the minister of Health
says the focus on zero new infections once re-energised by leadership at all
levels and using the new available prevention tools in combination, would
eventually lead to zero new HIV infections in Uganda.
The science is clear. These new HIV
infections can be entirely eliminated using combination prevention tools like
giving treatment to all the 1.3 million Ugandans currently infected and living
with HIV, offering voluntary Medical Male Circumcision (VMMC), prevention of
Mother-to-Child transmission of HIV (PMTCT) and use of condoms.
But all these prevention tools have to be
implemented at the same time and scaled up to higher proportions, about 80
percent, that can create a dent on the epidemic.
“We need a comprehensive response- with
behaviour interventions backed by biomedical and social-cultural interventions
at a scale that generates impact. We have been spreading ourselves at low
levels on the ground,” said Dr. Joshua Musinguzi the HIV/AIDS control programme
manager at the Ministry of Health.
The 2011, HIV/AIDS indicator survey, exposes
Uganda’s current status of the epidemic showing a rise in prevalence after
enjoying global yardstick status in the late 1990’s when the HIV/Aids prevalence
was brought down to 5 from 18 percent in the 1980’s.
The UAIS report shows that the prevalence
still remains significantly high, currently at 7.3 percent for Ugandans aged
15-49 years from 6.4 percent in the 2004/05 survey.
Like elsewhere in the world
where women bear the burden of the disease, women in Uganda are
disproportionately infected with the prevalence higher among women at 8.3
percent than among men at 6.1 percent from rates of 7.5 and 5.0 percent in
2004/05.
Currently, two-thirds, 66 percent of women
report ever being tested for HIV and received their results, a marked increase
from 13 percent in 2004-05. HIV
testing among men has increase four-fold, from 11 percent in 2004-05 to 45
percent in 2011.
Overall,
72 percent of pregnant women reported prior testing and receiving their results
during antenatal care.
According to the most recent data, HIV
prevalence is highest among the Most at Risk Populations including commercial
sex workers, fishing communities and mobile populations.
Government statistics have put HIV
prevalence in fishing communities at 28 percent, although there are fears that
it could even be higher and 10 percent of all new infections are from sex
workers.
Dr. Fred Wabwire-Mangeni, a public health
specialist and medical researcher says it is these drivers of the epidemic that
need to be focused on to bring a change in the tide of the HIV/Aids in Uganda
now.
Moreover, in Uganda now, more urban
dwellers are HIV-positive than those living in rural areas 8.7 percent versus
7.0 percent but even here the disproportional rates for women is significant.
Women living in urban areas have a
prevalence rate of 10.7 percent and those in rural areas is 7.7 percent, there
is not much difference among the men who live in either places as the
prevalence is 6.1 percent.
HIV/Aids infection is highest among those
who are widowed, high among divorced and separated men and women and least for
those who have never been married.
Elsewhere in the world, the area where
perhaps most progress is being made is in reducing new HIV infections in
children. Half of the global reductions in new HIV infections in the last two
years have been among newborn children.
Studies show that there are more than 50
percent reduction in the rate of new HIV infections has been achieved across 25
low- and middle-income countries––more than half in Africa, the region most
affected by HIV.
But in Uganda 25,000 children get infected
annually and 0.6 percent of the children under age five are HIV-positive. There is no variation in HIV prevalence
among children by gender or urban-rural residence.
“The Ministry of Health along with our dedicated international partners takes this as an opportunity to recommit ourselves
to continued scale‐up of proven
HIV interventions, to the goal of universal access to ARV treatment, and to our shared vision of a future free of HIV.”