Why HIV prevalence is on the rise

Uganda was once considered a shining example of how a country – even a poor Third World one – could effectively fight HIV/Aids. The plaudits poured in 10 years ago. But, in recent years, the story has drastically changed. The country’s reputation has lost its lustre, as efforts to halt new infections have slackened.

Uganda officially launched its medical male circumcision policy in 2010 and hopes to operate on at least 4 million people in the five-year programme.Dr Fred Wabwire, a senior professor at the Makerere University’s College of Health Sciences, says HIV being less visible and the onset of ARVs, could also be contributing to the rising prevalence. “Because of ART coverage, the number of people who have HIV are living longer and they may be contributing to the prevalence that we are seeing now,” he says.

This view is shared by Dr Kibuuka. “Before the 2000s there were no ARVs. People knew that the moment they got HIV it meant death. But now, people know that even if they get HIV it is just like any chronic disease such as hypertension, diabetes and the can survive on drugs. They have somehow become complacent to the messages we had in the 90s.”

Ms Milly Katana, an HIV/Aids activist, says more vulnerable groups, which are the main drivers of the Aids epidemic, have been largely ignored in the campaign against it. “We know that men who have sex with men are very vulnerable to HIV/Aids and also the fishing communities, yet we don’t seem to be paying attention to this group of people,” she says.

The new direction the country is taking, she warns, will not enable a reduction in HIV/Aids. “We are an embarrassment to the rest of Africa because we took the lead in turning the tide against Aids but now we are a shame,” she says.

According to Ms Katana, the rising prevalence will pose an enormous challenge for Uganda in the future.
Health experts say that to turn the tide, the country has to become more serious about preventing the spread of the disease. They argue that Uganda already has all the necessary policies and guidelines, and the challenge is implementation and a poor health system that cannot drive all these strategies.

In Part Three of our series, we look at what Uganda can do to reverse the growing rate of HIV/Aids.

elirri@ug.nationmedia.com