HIV Epidemic in Uganda

Question 1

HIV (Human Immunodeficiency Virus) epidemic in Uganda

Uganda, an East African country south of the Sahara has been battling with the HIV pandemic as far back as the 1990s when 18.5% of Ugandans were infected at its peak (Foundation, 2012). Currently, out of a population of 33.6 million people, 1.5 million are living with AIDs, at a prevalence rate of 7.2% among those aged between 15-49 years. Of the ones infected, 190,000 are children (UNAIDS, 2012). In the mid nineties and until recently, the prevalence of HIV started to gradually drop reaching 6.4% owing to the government policies of the ‘ABC’s i.e. Abstain, Be faithful, Use a Condom.

However, reports show a steady rise in the prevalence of HIV, currently standing at 7.3% (8.3% in women), (commision, 2014), mainly due to HIV prevention programmes emphasizing abstinence only, increased risky sexual behaviour especially among the married couples and availability of ARVs which has reduced people's fear for the HIV scourge. The number of new infections has been estimated at 150,000 annually 20,600 of who are children (AVERT, 2012).

HIV/AIDs has had devastating effects on the people of Uganda, including but not limited to: growing number of orphans (1,000,000 children 0-17 years old according to UNAIDS estimates of 2012, which constitutes about 20% of the child population). According to a report by UNICEF, grandmothers are said to care for around 45% of orphans in some areas most hit by AIDs scourge (UNICEF, 2007); Increasing poverty levels due to the long duration of illness, inability to work, cost of medications and hospital bills, loss of productive time caring for the sick, as well as the funeral costs; profitability of companies has been hampered due absenteeism ...

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...eal with the big numbers and there should be facilities for doing baseline investigations required for starting HAART e.g. full blood count, renal and liver function tests, as well as machines for doing a CD4 count since this is the basis for starting HAART.

• Those who become eligible should receive comprehensive adherence counselling to understand the implications of starting lifelong ARVs at a higher CD4 threshold

After successfully implementing the program, there should be continuous surveillance to establish the uptake of ARVs at this CD4 threshold and the challenges faced by the patients, health care workers and all the different stakeholders should be identified early and dealt with in a timely manner in order to ensure successful implementation and to determine areas for future research.

Question 7

Research to improve decision making regarding this policy