The Independent Uganda: You get the Truth we Pay the Price
The government is now targeting 15,000 Ugandans for new HIV/AIDS data study
COVER STORY | RONALD MUSOKE | On May 29, the Ministry of Health launched the third round of the Uganda Population-Based HIV Impact Assessment (UPHIA 2025) survey, a study that is geared towards gathering vital statistics on the progress and impact of current national HIV epidemic response efforts to guide future interventions and also close existing gaps.
The latest survey, which is the third since the surveys began in Uganda in 2016 is being conducted in conjunction with the Makerere University School of Public Health, Uganda Bureau of Statistics (UBOS), the Uganda AIDS Commission, the Uganda Virus Research Institute (UVRI) and the US Centres for Disease Control and Prevention (CDC).
It is intended to look at important HIV-related health indicators, such as new infections, prevalence, viral load suppression, and risk behaviours across the country. It will also describe how people are seeking and utilizing key HIV prevention, care, and treatment services.
Non-communicable disease burden
For the first time, this survey also seeks to understand the burden of non-communicable diseases, a growing public health concern in Uganda. Field teams that are set to begin work this month (June) will assess the prevalence of high blood pressure, high blood sugar and obesity among the general population and people living with HIV. This information is important for developing health policies that are responsive to the changing health challenges and strengthening the country’s health care system.
Speaking at the Ministry of Health headquarters in Kampala on May 29 during the launch of the survey, Dr. Sam Biraro, the Project Director of UPHIA, said the objective of the latest survey is to help experts understand the burden of HIV in the country and the impact of interventions towards HIV prevention, care and treatment.
“This survey has three primary objectives; to estimate the prevalence of HIV, to estimate the prevalence of viral load suppression and to assess progress toward UNAIDS’ 95-95-95 targets,” Dr. Biraro said.
He said, the indicators will be measured among people aged 15 years and above, and they will be estimated at both national and regional level. However, Dr. Biraro noted that unlike the previous surveys, this year’s study also seeks to assess access to sexual health information, engagement in risky sexual behaviours, comprehensive knowledge of HIV, and uptake of HIV prevention services among young adolescents ages 10 to 14 years.
15,000 Ugandans to be enrolled
About 35 field data collection teams will be deployed throughout the country and these will collect data from about 15,000 participants aged 15 years and above from about 6,700 randomly selected households in 191 villages. In addition, the survey will enroll about 1,300 children aged 10-14 years. However, blood samples will not be collected from children aged 10-14.
Each data collection team will be comprised of nine individuals including interviewers to carry out respondents’ interviews, laboratory technicians to draw blood samples and conduct household-based HIV testing, as well as counsellors to provide HIV test results together with the related counselling services. Newly diagnosed HIV positive participants, as well as known HIV positives who are not currently in care will be linked to care and treatment services of their choice.
Dr. Biraro noted that prior to conducting survey procedures, survey staff will explain the details of the survey to ensure prospective participants understand all necessary information about the survey. The teams will only enroll participants after obtaining written informed consent.
In the households, the survey staff will further collect data using tablets on; blood pressure, height, weight, random blood glucose, and they will also carry out HIV rapid tests. This data will then be transmitted to laboratories at the Uganda Virus Research Institute and the Central Public Health Laboratories (CPHL) where the samples will be scrutinized for CD4 counts, HIV viral load, HIV drug resistance, ARV metabolites, and HIV recency.
“I urge Ugandans to cooperate and provide accurate information to the survey teams,” said Dr. Jane Ruth Aceng, the Minister of Health during the survey launch. “To the survey teams; you need to uphold your ethical standards and ensure the integrity of the data collected.”
Dr. Aceng said the last UPHIA revealed significant gaps in HIV case finding, particularly among men and youth, which have influenced our programming priorities over the past five years. “Your input will help us assess the relevance of our current programmes and identify any new priorities we need to address.”
Uganda’s HIV/AIDS trends
Uganda has made remarkable strides in the fight against HIV and AIDS since the virus was first identified among members of a fishing community in the southern district of Rakai in 1982. Over the last 40 years, the epidemic has killed thousands of Ugandans, leaving behind tens of thousands of orphaned children and destitute families.
However, thanks to international support and targeted government programmes, today, adult HIV prevalence has, for instance, declined steadily from 7.2% in 2010 to 5.1% in 2023, according to statistics from the Uganda AIDS Commission. Among women, prevalence reduced from 8.5% to 6.6%, and among men, it has reduced from 5.8% to 3.6% during the same period under review.
AIDS-related deaths have also dropped significantly, from 53,000 in 2010 to 20,000 in 2023, representing a 62% reduction. Mortality among women aged 15 years and older declined from about 29,000 deaths in 2010 to about 10,000 in 2023, reflecting a 66% reduction. Among children under 15 years, deaths dropped from around 15,000 to just 3,500 over the same period—a 77% decline. “These improvements reflect the dedication of our health workers, community leaders, and development partners in expanding access to testing, prevention, and treatment services,” Dr Aceng said.
Yet, despite this progress, experts say, critical gaps remain in the country’s fight against the disease. For instance, an estimated 120,000 individuals living with HIV in Uganda have not been tested to know their status and enroll into care.
Meanwhile, adolescent girls and young women continue to account for more than one-third of new adult infections. Men also remain underrepresented in testing, linkage to care, and viral suppression outcomes. These disparities are a call to action as the government seeks to close the remaining gaps in its HIV response.
Final survey before 2030
Dr. Aceng also noted that since this survey will be Uganda’s final population-based HIV survey before 2030, the target year for ending AIDS as a public health threat, the findings will serve as a baseline for tracking the country’s progress toward achieving this national and global goal.
“They will also guide the next phase of strategic planning, ensuring that the final push toward 2030 is informed by robust and reliable data,” she said. “This UPHIA 2024–2025 survey therefore comes at a strategic time to help us recalibrate and refocus our efforts.”
For the first time, the survey will include a qualitative post-survey assessment to hear directly from people living with HIV/AIDS, especially those who are not virally suppressed. This, the Minister of Health says, will help experts understand the patients’ challenges better and improve government support.
“The findings will inform the progress towards the 2030 goal and will guide the future strategic planning, and I must say that this survey aligns with the Ministry of Health’s integrated service delivery, which aims incorporating with HIV to care for chronic illnesses,” said Dr. Charles Olaro, the Director General Health Services in the Ministry of Health.
US funding study to the tune of Shs 37bn
Uganda is one of five countries launching its third round of the UPHIA, following previous surveys conducted in 2016 and 2020. The U.S. government, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funding implemented by the U.S. Centres for Disease Control and Prevention (CDC), has allocated US$10 million (about Shs 37 billion) for the survey.
“This survey is important as we work together to continuously monitor progress to achieve a healthier, more prosperous, and more secure future where HIV is no longer a threat to Uganda, the United States, or the world,” said U.S. Ambassador, William W. Popp.
Amb. Popp noted that of the estimated 1.5 million Ugandans living with HIV, over 1.4 million of them or 94% of them are receiving life-saving treatment supported by PEPFAR, enabling them to lead healthy and productive lives.
“As many of you may know, the very first PEPFAR client in the entire world was a Ugandan man, who is today, now more than 55 years of age, living a healthy life, a productive life in Uganda with his family. And that is a tremendous individual accomplishment, but it is also representative,” Amb. Popp said.
“We have also done this broadly to prevent HIV spread, in addition to treatment, and have had tremendous success in doing so. One example is having seen the impact of our efforts achieve dramatic reductions in mother-to-child transmission of HIV, a fall from more than 30% infection rates two decades ago to now 3%. This means, literally, hundreds of thousands of babies are being born HIV-free.”
Yet, despite the achievements, challenges persist. Amb. Popp noted that PEPFAR’s vision, UNAIDS’ vision, and Uganda’s Ministry of Health’s vision, and many other partners around the world, is to achieve a world that is free of HIV/AIDS.
“To ensure that we do that, we need to make sure that services effectively reach those most in need, and to do that we need good data and good research,” he said. “PEPFAR is a data-driven programme, and one of our key investment areas is in collecting and utilizing data to monitor the evolving HIV epidemic.” he added.
He said the data gathered from this year’s survey should help support the development of even more effective health policies and planning for the country’s robust health system in the future.
Why this survey matters
Experts who work in the HIV/AIDS response field say Population-Based HIV Impact Assessments (PHIAs) are essential for evaluating the effectiveness of HIV treatment and prevention programmes in PEPFAR-supported countries.
These assessments aim to provide an overview of the current state of the HIV epidemic and measure each country’s progress toward global HIV control targets. PEPFAR has funded PHIA surveys in 15 countries worldwide, including Kenya, Rwanda, Tanzania, Ethiopia, and Uganda, to track progress toward the 95-95-95 goals.
The 95-95-95 target set by the UNAIDS seeks to ensure that by 2030-which is just five years away, 95% of all people living with HIV know their HIV status, 95% of all people diagnosed with HIV receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy have viral suppression.
‘Not just any survey’
Prof. Rhoda Wanyenze, the Dean of Makerere University School of Public Health noted that for nearly two decades, the HIV impact assessments in Uganda have helped experts not only understand the epidemic, but also shape life-saving policies, improve access to treatment, and tailor prevention efforts to the realities on the ground.
“We are proud to implement UPHIA in partnership with the Ministry of Health and the CDC. This milestone builds on our previous experience with similar surveys including the TB prevalence and family planning surveys, among others, and reflects our strong research capacity, not only in Uganda but across the African region,” she said. “We embrace this responsibility with confidence and are committed to delivering high-quality data with the same rigor and integrity that have defined our many previous studies.”
Dr. Kasonde Mwinga, the Country Representative of the World Health Organisation (WHO) in Uganda said this year’s survey is not “just another survey.” “For the first time, we can track trends over time, allowing us to see the trajectory of our efforts and measure progress with great precision,” she said.
“In this era of shrinking HIV funding, data becomes a valuable currency; it ensures that every decision, every intervention, every dollar is directed where it will have the greatest impact,” she said, adding that: “The results of UPHIA shape national HIV incidents, guide strategic planning, and inform resource allocation.”
“The more current and accurate the data, the more effective our response. The quality of this survey will depend so much on your adherence to the highest standards and your confidence in your ability to deliver quality products,” she cautioned the attentive data collection teams that attended the survey launch.
