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Stunted HIV prevalence rate worries health experts

Kampala, Uganda | THE INDEPENDENT  | Health experts are worried about Uganda’s current stagnant HIV prevalence rate.

According to experts, Uganda seems to be stuck at a HIV prevalence rate of 6.2 percent that has remained stagnant for the past four years.

Between the late 90s and early 2000, Uganda’s prevalence rate stood at 18 percent on average nationally. In 2004 it reduced to 6.4 percent before increasing to 7.4 percent in 2011.

Currently, it stands at 6.2 percent. This figure has remained the same since 2016 and according to health experts does not look like it will be going down anytime soon.

Experts say that if the current state continues, Uganda will not be able to meet its 90:90:90 2030 goal of having 90 percent of persons living with HIV know their status, 90 percent of those living with HIV being enrolled onto ARVs and having 90 percent of them with suppressed viral loads as an effect of being enrolled onto treatment.

Dr. Karusa Kiragu Gikonyo, the UNAIDS Country director says that the stunted prevalence rate should be expected in Uganda because while Uganda has made big strides in the fight against HIV, it is still lagging behind in meeting international goals.

According to data from UNAIDS, Uganda is lagging behind when it comes to meeting both its second and third 90. It is estimated that 84 percent of people living with HIV know their HIV status, however only 68 percent and 64 percent respectively are on treatment or have suppressed viral loads. She says that given Uganda’s status at meeting its 90:90:90 goals, a lot more work has to be done.

Dr. Kiragu says that for Uganda’s prevalence to reduce, the second and third 90 need to be addressed. She says that Uganda needs to address the third 90 which is affected by discrimination and stigma that still exists in the HIV fight.

It is estimated that 1.4 million people live with HIV in Uganda.  However only 1.2 are in treatment.

Professor Pontiano Kaleebu, the Director of the Uganda Virus Institute says that the cases of stagnation as far as the prevalence rate are not uniform. He says in some places like fishing communities, the rate is high.

“At the national level it stands at that figure but in different parts of the country we continue to see the numbers fluctuating. Island areas have higher incidence and prevalence rates compared to other parts of the country,” Dr. Kaleebu said.

Over the years, Uganda has advocated for the use of condoms, abstinence and faithfulness in relations as the main tools to fight HIV/AIDS. In the recent past, new HIV policies like the test and treat- which calls for all persons that test positive for HIV being started on treatment have been rolled out.

Despite the big strides made in the past to fight HIV, Dr. Nelson Musooba, the Director General of Uganda AIDS Commission says that the current trend is hard to reduce since it is hard to reach out to the few people who are estimated not to know their HIV status.

Despite calls from researchers that something needs to be done to address the current prevalence rate, the health ministry says that there is no need for worry.

Dr. Joshua Musinguzi, the head of the AIDS Control Programme at the health ministry says that there’s no cause of worry.

“The biggest problem we have is that few men are enrolled on treatment. We are now working on ways to attract men like leaving testing facilities open beyond 5:00 pm. We are also encouraging couple assisted notification where couples are encouraged to come for testing together,” Dr. Musinguzi said.

He adds that if new campaigns are successful, the current prevalence rate will drop.

“If the new endeavours are as successful as we know that they can be, then our prevalence rate will reduce and we shall be able to meet out 2030 goal,” Dr. Musinguzi explained.

Whether or not Uganda is able to meet its 2030 goal is something that waits to be seen. However Prof Kaleebu says that for any successes to be seen at this stage of the HIV fight, a bit more work needs to be done.

“We need to understand the populations that are highly troubled by the epidemic. If as a country we can understand why people in rural areas have low prevalence rates while those in towns have higher rates and we come up with campaigns specifically designed to tackle this problem, then we can change things around,” Prof Kaleebu said.

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