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FACTS ABOUT HIV& AIDS IN UGANDA

posted on Sunday, November 22, 2009 07:04 AM

The HIV epidemic is affecting the populations in all parts of the country both rural and urban. However, HIV is affecting some sub-populations more than others.

In 2008, it was estimated that the HIV prevalence was 6.2 per cent among the population aged 15-49 years; and there were just over one million people living with HIV/Aids in the country. There has been a stagnation of HIV prevalence among adults aged 15-49 years at between 6 and 7 per cent.

In 2008, there were about 110,000 new HIV infections among adults and children in the country. The number of people (adults and children) who died from HIV-related illnesses during the year was about 63,000.

There has been a shift in concentration of the epidemic from younger to older individuals with the highest prevalence for men (9.9 per cent) being among 35-39 year olds while for women (12.1 per cent) is among 30-34 year olds.
The majority of adults within the reproductive age, including the couples in both multiple or monogamous relationships do not know their HIV status.
Risk Factors

The risk factors at individual levels contributing to HIV transmission include:
oInvolvement in high risk sex (high risk sex involves having sexual intercourse with a partner whose HIV status is either not known or is HIV positive)

Having many sexual partners at the same time (multiple, concurrent sexual partnerships);
Couples having different HIV status and not sharing their HIV results (discordance and non-disclosure of HIV status);
Lack of proper and consistent condom use, particularly in high risk sex;
Having sex in exchange for money or gifts (transactional sex);
Having sex with persons who are older by 10 years or more (cross-generational sex);
Presence of other sexually transmitted infections e.g. Herpes Simplex Virus Type 2;
Not being circumcised and indulging in high risk sexual relationships (only 25 per cent of the male population in the country is circumcised);
Alcohol and drug use that could impair judgement and lead to unsafe sexual practices;
Limited fear and perception of risk to HIV infection because of availability of antiretroviral drugs (ARVs) (Complacency due to ARVs).
Drivers

The more fundamental, structural factors that influence the spread of HIV from the social perspective (drivers of the epidemic) include:

Wealth and Poverty that could predispose to high risk behaviour
Abuse of human rights
Stigma and discrimination
Inequitable distribution and access to services for HIV prevention, care and treatment.
Distribution of new HIV infections by sub-population
It is estimated that about 46 per cent of all new infections among adults aged 15 – 49 years are attributed to multiple sexual partnerships. Overall, about 37.3 per cent of all new infections that occur in adults and children are due to multiple sexual partnerships, including infections of their regular partners.

Approximately 43 per cent of all new infections among adults aged 15 – 49 occur among those who are in mutual monogamous heterosexual relationships. Overall, about 35.1 per cent of all new HIV infections that occur among adults and children are attributed to the discordant monogamous sexual relationships.

Mother to Child Transmission of HIV that is the main route of spread to children contributed approximately 18 per cent of all the new infections (both adults and children).

Commercial sex workers, their clients and partners of clients contribute about 8.7 per cent of all the new infections.

About 1 per cent of all the new infections were attributed to injection drug use, and men who have sex with men (MSM).
Implications
Having more than one sexual partner increases the chances of being involved in a larger sexual network and hence an increased risk of being infected with HIV. People should be encouraged to ideally have only one sexual partner. Being faithful alone, may not be enough even in monogamous relationships due to discordance.
Therefore, married and co-habiting individuals as well as those intending to live together should be advised to first test for HIV and thereafter practice faithfulness to an HIV negative partner.

HIV counselling and testing services should be provided for couples to identify discordance, enhance disclosure and informed decision making based on the evidence.

Having sexual relationship with any person whose HIV status is unknown should be considered high risk sex. Such people should be advised to correctly and consistently use condoms.

Transactional sex may be associated with exploitation and high risk of acquiring or transmitting HIV, especially if there is an age difference of 10 or more years between the couple. The practice should be discouraged.

Other sexually transmitted infections such as herpes simplex virus type 2 (HSV 2), increase the risk of being infected with HIV. Presence of any sexually transmitted infection requires prompt and appropriate medical treatment.

Safe male circumcision complements the traditional HIV prevention interventions in reducing the risk of acquiring HIV infection. Un-infected adult males within reproductive age should be advised to seek services for safe circumcision.

Use of alcohol and other drugs could impair judgement and lead to adoption of risky sexual behaviour. Consumption of alcohol and use of other addictive drugs should be discouraged.

Antiretroviral drugs do not cure HIV infection.
The most effective way to eradicate HIV is to avoid being infected by adopting behaviour that reduces risk of acquiring the virus. HIV prevention programmes should empower both men and women to negotiate for safer sex including the use of condoms.

Mother to child transmission of HIV remains the primary route of spread to children. Women and their partners should access the comprehensive package of services for prevention of vertical transmission of HIV, which includes use of ARVs for the HIV infected women and their babies.

Most-at-risk populations are those in whom there is a concentration of risk behaviours that lend themselves to efficient HIV transmission or acquisition. Examples include: sex workers and their partners; long distance truckers; fishing communities; uniformed security services etc. There is need to ensure that the HIV prevention interventions address the need of the most-at-risk and vulnerable populations.

Community leaders at national, regional, district and sub-district levels (religious, cultural, traditional, civic, technical etc) should be involved in mobilisation and education for HIV prevention based on their mandate within the multi-sectoral response. The people living with HIV and their networks should be involved in the prevention of further spread of the virus.

Comments

Humphrey Mutaasa

Saturday, January 23, 2010 08:04 AM

This is just abit of what ACODE Foundation can give is contacted. regards