AIDS in Uganda

The AIDS epidemic in Uganda is said to have started in Rakai District, onthe well-travelled truck route from the United Republic of Tanzania to Uganda.

Today it is estimated that 1.5 million Ugandans are living with HIV infection. This means that 1 in every 10 Ugandan adults may be HIV positive. The number of actual AIDS cases is estimated to be 500,000. Mean survival time after progression to AIDS is said to be 1 year to 15months.

The distribution of clinical AIDS cases varies by district, with the greatest concentration found in Kampala, followed by other parts of South/ Central Uganda and the war-torn district of Gulu in the north.

While the picture is bleak, Uganda is known for its innovative approaches to HIV prevention. The Government and the nongovernmental organizational sector have encouraged many pioneering initiatives such as the first multi-sectoral commission coordinating prevention and care efforts and the first voluntary and anonymous HIV testing and counselling centre in sub-Saharan Africa.

Other innovative projects, such as the AIDS in the Workplace project, implemented by the Federation of Uganda Employers, the care and advocacy for persons with HIV/AIDS, provided by The AIDS Support Organization (TASO), and the AIDS prevention project, developed by the National Resistance Army of Uganda, have established Uganda as a fertile environment for creative approaches to AIDS prevention.

The Islamic Medical Association of Uganda’s AIDS-prevention programme is yet another pioneering initiative, focused on the country’s growing Muslim community.

Encouraging trends

Ministry of Health surveys show evidence of a significant decline in HIV infection. In some cases, the percentage of mothers testing HIV-positive at urban health clinics in 1997 was almost half of what it was in 1992.

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Most public health workers believe that Uganda’s aggressive response to the AIDS epidemic, led by open Government policies and innovative programmes, contributed to a high rate of behaviour change that fuelled this remarkable decline. Surveys of behaviour change in urban areas show that from 1989 to 1995 there were significant delays in age at first sex, less sexual relations with non-regular partners, and increased condom use.

Research carried out by IMAU in their project areas found a similar trend. A follow-up survey in project areas showed that two years after IMAU began their AIDS education effort, community members showed a significant increase in correct knowledge about HIV transmission and methods of preventing HIV infection.

The survey also found changes in high-risk behaviour, showing a significant reduction in sexual partners among respondents under 45 years of age and a significant increase in self-reported condom use.

“Our policy in fighting AIDS has been to give it ahuman face and toexpose it as ourtotal enemy. As a result of this openness, we have been able to achieve avery high degree of HIV/AIDS awareness in Uganda.”

Prime Minister Kintu Musoke - 1997. Southern Africa Economic Summit

Living positively with AIDS

“I let my Muslim brothers andsisters know the importance ofHIV testing before marriage. Not just with the first wife, butwith every wife. And the

Sarah Wakabu is HIV positive. She learned this after her husband died of AIDS in 1993.

When he first fell sick, Sarah made the bold suggestion that they both go for HIV testing.

Not surprisingly, her husband refused. Sarah waited until after her husband died to go for testing.

Sarah is now Day Centre Supervisor at The AIDS Support Organization (TASO) in Jinja, one of the organizations where IMAU refers their community members. Sarah is pleased to work for the organization that rescued her with counselling and food assistance when she first received the news that she was HIV positive.

Sarah’s job is important because she is responsible for her two sons, as well as several orphans left behind when three of her sisters and one of her brothers died of AIDS.

“I have finished building our house and I have started putting something away for my children’s future” she says.

For now, Sarah and her sons are healthy and she takes pleasure in sharing her experience of living positively with AIDS with the many HIV positive men and women who come to TASO.