Background
Uganda is often held up as a model for Africa in the fight against HIV & AIDS. Strong government leadership, broad-based partnerships and effective public education campaigns all contributed to a decline in the number of people living with HIV and AIDS in the 1990s.
Although there is a lot to learn from Uganda’s comprehensive and timely campaign against the AIDS epidemic, emphasizing Uganda’s success story must not detract from the devastating consequences that AIDS continues to have across the country: personally, socially and economically. There are currently an estimated 940,000 people living with HIV in Uganda, and a further 1.2 million children who have been orphaned by AIDS.
The current situation
The current HIV prevalence in Uganda is estimated to be 5.4% amongst adults. According to the Uganda HIV and AIDS Sero-Behavioural Survey, the number of people living with HIV is higher in urban areas (10.1% prevalence) than rural areas (5.7%); it is also higher among women (7.5%) than men (5.0%).
It is feared that HIV prevalence in Uganda may be rising again; at best it has reached a plateau where the number of new HIV infections matches the number of AIDS-related deaths. There are many theories as to why this may be happening, including the government’s shift towards abstinence-based prevention programme, and a general complacency or ‘AIDS-fatigue’. It has been suggested that antiretroviral drugs have changed the perception of AIDS from a death sentence to a treatable, manageable disease; this may have reduced the fear surrounding HIV, and in turn have led to an increase in risky behaviour.
The impact of AIDS on Uganda
AIDS has had a devastating impact on Uganda. It has killed approximately one million people, and significantly reduced life expectancy19. AIDS has depleted the country’s labour force, reduced agricultural output and food security, and weakened educational and health services. The large number of AIDS related deaths amongst young adults has left behind over a million orphaned children.
"If someone in Uganda tells you they haven't been affected by HIV/AIDS they're lying."Jennifer Bakyawa, a Ugandan journalist
Women are particularly affected by the epidemic in Uganda, representing 59% of those infected with HIV/AIDS in the country. Ugandan women tend to marry and become sexually active at a younger age than their male counterparts, and often have older and more sexually experienced partners. This (plus various biological and social factors23) puts young women at greater risk of infection; in fact, young women in Uganda are nine times more likely than young men to contract HIV.
The way forward
Uganda is at an important crossroads in the history of its AIDS epidemic. After a dramatic reduction in HIV prevalence following an early comprehensive HIV prevention campaign, there are signs that the number of people living with HIV in the country may be starting to rise again.
In order to avoid this, Uganda needs to take a serious look at infection trends and behaviour to identify why this rise may be occurring and how to remedy it. Experts believe that complacency and the ‘normalisation’ of AIDS may be leading to an increase in the risky behaviour that early prevention campaigns sought to reverse.
"People now think that because we have had HIV for so many years, it is a normal condition among the population."Kihumuro Apuuli, director of Uganda Aids Commission (UAC).
Uganda clearly needs to revive and adapt its HIV prevention programme, moving away from abstinence-only initiatives to a comprehensive programme that incorporates not only abstinence, fidelity and condom use, but also HIV testing and preventing mother to child transmission.
Uganda is often held up as a model for Africa in the fight against HIV & AIDS. Strong government leadership, broad-based partnerships and effective public education campaigns all contributed to a decline in the number of people living with HIV and AIDS in the 1990s.
Although there is a lot to learn from Uganda’s comprehensive and timely campaign against the AIDS epidemic, emphasizing Uganda’s success story must not detract from the devastating consequences that AIDS continues to have across the country: personally, socially and economically. There are currently an estimated 940,000 people living with HIV in Uganda, and a further 1.2 million children who have been orphaned by AIDS.
The current situation
The current HIV prevalence in Uganda is estimated to be 5.4% amongst adults. According to the Uganda HIV and AIDS Sero-Behavioural Survey, the number of people living with HIV is higher in urban areas (10.1% prevalence) than rural areas (5.7%); it is also higher among women (7.5%) than men (5.0%).
It is feared that HIV prevalence in Uganda may be rising again; at best it has reached a plateau where the number of new HIV infections matches the number of AIDS-related deaths. There are many theories as to why this may be happening, including the government’s shift towards abstinence-based prevention programme, and a general complacency or ‘AIDS-fatigue’. It has been suggested that antiretroviral drugs have changed the perception of AIDS from a death sentence to a treatable, manageable disease; this may have reduced the fear surrounding HIV, and in turn have led to an increase in risky behaviour.
The impact of AIDS on Uganda
AIDS has had a devastating impact on Uganda. It has killed approximately one million people, and significantly reduced life expectancy19. AIDS has depleted the country’s labour force, reduced agricultural output and food security, and weakened educational and health services. The large number of AIDS related deaths amongst young adults has left behind over a million orphaned children.
"If someone in Uganda tells you they haven't been affected by HIV/AIDS they're lying."Jennifer Bakyawa, a Ugandan journalist
Women are particularly affected by the epidemic in Uganda, representing 59% of those infected with HIV/AIDS in the country. Ugandan women tend to marry and become sexually active at a younger age than their male counterparts, and often have older and more sexually experienced partners. This (plus various biological and social factors23) puts young women at greater risk of infection; in fact, young women in Uganda are nine times more likely than young men to contract HIV.
The way forward
Uganda is at an important crossroads in the history of its AIDS epidemic. After a dramatic reduction in HIV prevalence following an early comprehensive HIV prevention campaign, there are signs that the number of people living with HIV in the country may be starting to rise again.
In order to avoid this, Uganda needs to take a serious look at infection trends and behaviour to identify why this rise may be occurring and how to remedy it. Experts believe that complacency and the ‘normalisation’ of AIDS may be leading to an increase in the risky behaviour that early prevention campaigns sought to reverse.
"People now think that because we have had HIV for so many years, it is a normal condition among the population."Kihumuro Apuuli, director of Uganda Aids Commission (UAC).
Uganda clearly needs to revive and adapt its HIV prevention programme, moving away from abstinence-only initiatives to a comprehensive programme that incorporates not only abstinence, fidelity and condom use, but also HIV testing and preventing mother to child transmission.
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