By Gilbert Akampa Kakurugu,
National
The Uganda AIDS Commission has announced its plans to host the National HIV and AIDS Symposium 2023 from November 14-16 at the Kololo ceremonial grounds. This event will feature a National HIV and AIDS Scientific Meeting, the Annual Joint AIDS Review, and the Philly Lutaya Memorial Lecture, along with financing dialogues and programming and science exhibitions.
The symposium is open to the public for all three days and aims to promote awareness and reflection on what steps each individual can take to end AIDS as a public health threat by 2030.
Uganda has made significant progress in HIV prevention and treatment over the past decade, but challenges such as unequal access to treatment, high HIV incidence among young people, and limited investment in sexual behavioral change communication still exist. The symposium aims to bring together stakeholders from different sectors to work collaboratively toward a common goal. Uganda’s HIV epidemic response is largely funded by external donors, with domestic funding accounting for less than 40%.
The Ugandan Government’s contribution in absolute terms has increased by 48% from 2008/09 to 2018/19, indicating its positive commitment to increasing domestic resources towards the HIV and AIDS response.
Despite the successes of the HIV treatment program, there are gross inequalities, with HIV treatment for children, adolescents, adult men, key and priority populations, and people in some underserved geographical areas of the country, still lagging behind. To achieve the national goal of HIV epidemic control, continued investment in ART is especially necessary as the means to sustain the gains and bridge the inequalities.
Dr. Daniel Byamukama,the head of HIV prevention at Uganda AIDS commission revealed that Uganda’s HIV epidemic is mainly driven by risky sexual behavior, including multiple concurrent partnerships, casual sex, and low levels of condom usage during risky sex, and early sexual debut amongst young people. Sexual behavioral patterns of adults are tracked through population-based surveys. Based on data from previous surveys, most behavioral indicators haven’t changed much during the past decade. Again, this is related to limited investment in SBCC over the years.
One indicator for monitoring progress on SBCC is the proportion of young people aged 15 to 24 years with comprehensive awareness in regard to HIV. In 2017, 24.8% of boys and 26.3% of girls reported comprehensive knowledge, which is cause for concern.
Early successes of Uganda’s HIV response were attributable to strong SBCC, and the country looks to innovatively reinvigorate this as they aim for 2030. The unsupportive legal-policy and social environment continues to negatively impact the country’s response.
Although Uganda has achieved a significant reduction in mother-to-child transmission of HIV in recent years, vertical infections remain high, estimated at approximately 5,300 in 2020. The drop in vertical HIV infections is mainly due to the falling MTCT rate that occurred during the decade that is largely attributed to scale up of efficacious PMTCT services based on Option B+ that started in 2012. The 2019 Spectrum Estimated MTCT rate after breastfeeding was 6.0%, reflecting a drop from more than 30% that prevailed prior to 2010.
Whilst there have been successes in adult ART, some challenges have been noted in children. Children’s care across the spectrum is suboptimal due to low case identification amongst infants. Poor retention of the mother-child pairs is partly responsible as it leads to poor linkage to EID. Also, there is sub-optimal diagnosis of HIV among older children and adolescents. Furthermore, poor linkage to care and ART retention have been experienced due to non-disclosure of HIV status, stigma, discrimination, and violence, and inadequate support. The symposium aims to address these challenges and promote ending AIDS by 2030.
