UPHIA 2025 assessment evaluated three major chronic non-communicable disease (NCD)

 The UPHIA 2025 assessment evaluated three major chronic non-communicable disease (NCD) indicators among adults aged 15 years and older: elevated blood pressure, overweight and obesity, and raised random blood glucose.

1. Elevated Blood Pressure (EBP)

• Overall Prevalence: 15.5% of all surveyed adults had elevated blood pressure (defined as systolic blood pressure $\ge$ 140 mmHg or diastolic blood pressure $\ge$ 90 mmHg).
• Disparity by HIV Status: Prevalence was noticeably higher among people living with HIV (18.0%) than among HIV-negative adults (15.2%).
• Age Trends: Prevalence increased consistently with age, rising from 3.9% among youth aged 15–24 to 21.0% at ages 35–44, and peaking at 44.4% among adults aged 65 and older.
• Regional Variation: Rates ranged from a low of 7.7% in North East: Karamoja to a high of 19.8% in Central 1: South Buganda.

2. Overweight and Obesity

• Overall Prevalence: 24.8% of adults were classified as overweight or obese (defined as a Body Mass Index $\ge$25.0 kg/m²).
• Disparity by HIV Status: Prevalence was higher among adults living with HIV (26.8%) compared to HIV-negative individuals (24.6%).
• Age Trends: Rates climbed steadily with age to reach a peak of 38.0% among adults aged 35–44 and 37.4%among those aged 45–54, before declining to 23.3% in the 65+ age group.
• Regional Variation: Overweight and obesity showed the widest geographic divide of any NCD metric, spanning from 3.2% in North East: Karamoja to 40.6% in Kampala.

3. Raised Blood Glucose (RBG)

• Overall Prevalence: 0.9% of adults presented with raised random blood glucose (defined as $\ge$ 11.1 mmol/L).
• Disparity by HIV Status: Unlike hypertension and obesity, glucose levels were comparable between groups, standing at 1.0% among people living with HIV and 0.9% among HIV-negative adults.
• Age Trends: Prevalence rose from 0.1% among 15–24-year-olds to peak at 3.0% in the 55–64 age group, before dropping to 1.5% among adults aged 65 and older.
• Regional Variation: Rates were lowest in Mid North (0.4%) and reached their highest level in Central 1: South Buganda (1.5%).

Key Summary Takeaways

• Higher Burden Among People Living with HIV: Both elevated blood pressure and overweight/obesity were more prevalent among people living with HIV than among HIV-negative adults.
• Geographic Clustering: NCD indicators were consistently concentrated in the central and southern corridors, with Central 1: South Buganda, Central 
• 2: North Buganda, Kampala, and South Western reporting higher overall rates than other regions of the country.

Uganda's HIV burden varies sharply across regions, UPHIA 2025 shows

According to the UPHIA 2025 Summary Sheet, both HIV prevalence and viral load suppression (VLS) among adults aged 15 years and older show substantial geographic variation across Uganda.

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Regional Overview and Key Extremes

• HIV Prevalence: Nationally estimated at 5.9%, prevalence ranges from a low of 1.3% in North East: Karamoja to a high of 8.0% in the South Western region.
• The southern and central belts (South Western, Central 1, and Central 2) consistently show the highest prevalence rates.
• Viral Load Suppression (VLS): Nationally estimated at 86.0% among all adults living with HIV, regional VLS ranges from 78.0% in the Mid Eastern region to 92.3% in the South Western region. Estimates for North East: Karamoja and West Nile were suppressed due to a sample size of fewer than 25 survey participants.

Regional Breakdown: HIV Prevalence and VLS

The table below summarizes the regional estimates and 95% confidence intervals (CI) for both indicators:

Region	HIV Prevalence (%) [95% CI]	Viral Load Suppression (%) [95% CI]
South Western	8.0% [6.4–9.9]	92.3% [84.4–96.3]
Central 1: South Buganda	7.3% [4.5–11.7]	80.0% [73.2–85.4]
Central 2: North Buganda	7.2% [5.5–9.5]	87.0% [73.3–94.2]
Mid North	6.8% [5.1–9.0]	83.8% [76.2–89.4]
Mid Western	6.1% [4.1–9.0]	85.1% [64.8–94.6]
Kampala	5.4% [4.2–7.0]	86.4% [69.5–94.6]
North East: Teso	4.8% [3.9–5.8]	88.9% [79.9–94.2]
Mid Eastern	4.4% [3.3–6.0]	78.0% [59.6–89.5]
East Central	4.0% [3.1–5.1]	88.6% [80.9–93.4]
West Nile	1.4% [0.7–2.9]	* (Suppressed)
North East: Karamoja	1.3% [0.8–2.0]	* (Suppressed)

Regional Breakdown: HIV Prevalence and VLS

The table below summarizes the regional estimates and 95% confidence intervals (CI) for both indicators:

*Estimates based on a denominator of fewer than 25 survey participants have been suppressed per survey reporting protocols.

Key Takeaways

• High Prevalence with High Suppression: The South Western region has the highest prevalence in the country (8.0%), but it also achieved the highest viral suppression rate (92.3%)
• Suppression Gaps: Mid Eastern (78.0%) and Central 1: South Buganda (80.0%) lag behind other regions in viral load suppression, falling noticeably below the national average of 86.0%
• Low Prevalence Zones: Both West Nile (1.4%) and North East: Karamoja (1.3%) have very low prevalence, resulting in sample sizes too small to generate reliable regional VLS estimates within the survey sample.

Youth viral suppression includes:

• Lower Suppression Rates: Among youth aged 15–24 years living with HIV, overall viral load suppression was 69.3%, which is considerably lower than the national adult average of 86.0% and older cohorts (such as 89.9% among adults aged 50 and older).
• Sex-Specific Estimates: For young women aged 15–24, the VLS rate was 64.1%. The estimate for young men in the 15–24 age bracket was suppressed due to a denominator of fewer than 25 survey participants.
• Identified Priority Area: The report concludes that while overall viral suppression has improved substantially across Uganda's three UPHIA surveys, younger adults continue to lag behind, and continued efforts are needed to improve suppression among young people.

youth viral suppression includes:

• Lower Suppression Rates: Among youth aged 15–24 years living with HIV, overall viral load suppression was 69.3%, which is considerably lower than the national adult average of 86.0% and older cohorts (such as 89.9% among adults aged 50 and older).
• Sex-Specific Estimates: For young women aged 15–24, the VLS rate was 64.1%. The estimate for young men in the 15–24 age bracket was suppressed due to a denominator of fewer than 25 survey participants.
• Identified Priority Area: The report concludes that while overall viral suppression has improved substantially across Uganda's three UPHIA surveys, younger adults continue to lag behind, and continued efforts are needed to improve suppression among young people.

1. How Knowledge of Status Is Defined

In the survey, awareness of HIV-positive status was defined as self-reporting HIV-positive status and/or having detectable antiretroviral (ARV) drugs in the blood. ARVs tested in the laboratory included atazanavir, efavirenz, dolutegravir, lamivudine, and tenofovir.

2. Overall Achievement of the First 95 Target

• National Awareness: 85.3% of all adults aged 15 years and older living with HIV in Uganda were aware of their HIV-positive status.
• Target Gap: This falls short of the global 2025 target of 95%.

3. Gender Disparities in Status Awareness

Knowledge of HIV status differed substantially between women and men:

• Women: 87.6% were aware of their HIV-positive status.
• Men: 80.3% were aware of their HIV-positive status.

4. Impact on the 95-95-95 Treatment Cascade

While knowledge of status is the weakest link in the cascade, link to care and suppression among those who know their status is nearly universal:

• Conditional Cascade (Progression from Awareness):
• Aware: 85.3% of adults living with HIV knew their status.
• On Treatment: 99.1% of adults who were aware of their status were receiving antiretroviral therapy (98.9% of women and 99.6% of men).
• Virally Suppressed: 96.5% of those on treatment achieved viral load suppression (95.4% of women and 99.1% of men).
• Unconditional Cascade (Across All Adults Living with HIV):
• 85.3% were aware of their status.
• 84.5% were both aware of their status and on ART (86.6% of women, 79.9% of men).
• 81.6% were aware of their status, on ART, and virally suppressed (82.6% of women, 79.2% of men).

5. Primary Conclusion

The survey concluded that the primary gap in Uganda's HIV treatment cascade remains identifying people living with HIV who are unaware of their status. Once individuals are diagnosed, they demonstrate very high levels of treatment uptake and sustained viral load suppression