Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
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New Vision (Kampala) - October 26, 2008
Joseph Kariuki
The plan, titled Moving Towards Universal Access, hopes to counter the escalating HIV prevalence in the country.
It comes at a time when the HIV prevalence rate is on a decade high of 6.7%, according to the 2006 HIV/AIDS indicators. Data shows that after a quarter of a century of the epidemic, Uganda continues to experience a severe epidemic.
Currently, the report notes, 6.4% of adults and 0.7% of children, are infected. Women still lead in HIV prevalence rate at 7.3%, with men at 5.2%.
"The HIV prevalence rate has increased to 6.7, according to a recent survey," said Dr. Wiltord Kirungi, while presenting a paper on the status of the HIV/AIDS epidemic and the response.
He said the number of infected people has reached the same proportions as those in 1994. It is also estimated that the number of people being infected will continue rising.
"From now on, we will have the number of people infected expanding though the number of deaths as a result of HIV has gone down compared to 1994," said Kirungi.
He attributes the increase in infections to laxity among policy-makers and complacency among people.
The situation is worse for women who do not access care. "We are reaching less than half the targeted number of mothers, but with the new plan, we hope we will be able to reach 80% of the mothers,"Kirungi said.
A key driver for the new infections is the multiple sexual partners. This, according to the report, accounts for 37% of all infections, while mother-to-child infection is still high at 18% of infections.
Transactional sex is another factor that points to laxity among people. Recent survey shows that 18% of girls are involved in cross-generational sex for money or other needs.
But a bigger gap is in lack of consistency in condom use. More than half of the risky sexual acts are not protected by condom use, the new status of HIV report notes.
Availability of antiretroviral drugs (ARVs)is also blamed for the rising HIV infections.
Rakai district chairman Vincent Semakula said: "In Rakai because of the emergence of ARVs, people think the disease has gone. Those who are circumcised think it is a permit to engage in unprotected sex."
The issue of discordant couples also emerged as a key driver of infections during the period in review. Uganda's 2005 sero-survey suggests that up to 65% of new infections are occurring among married people and discordant couples may comprise up to 50% of the transmission.
The sexual behaviour of HIV-positive people is another worry in the escalating HIV prevalence.
"Some people know they are HIV-positive, but go ahead and have unprotected sex," Dr. Kihumuro Apuuli, the director of the Uganda Aids Commission, said.
According to the 2007/2008 status report, 62% of HIV-positive women admitted to having sex. The same research shows that most of the HIV-positive men are having sex with their spouses.
The report shows that nearly half of the women and 33% of men who know their spouse is infected do not use protection.
Condom use in casual sex, is minimal. Eighteen percent of men and 5% of women admit to having extramarital sex.
New plan targets key areas
In the next five years, the plan aims at reducing new infections, prevent mother-to-child transmissions and facilitate universal access to essential services.
It also aims at reducing the incidence levels of new HIV infections by 40% by 2012 through prioritising resource allocations to fund the most cost-effective HIV prevention measures.
Prevention
The report notes that increased funds and commitment to prevention-related interventions could reduce the annual number of new infections from the current 135,000 to less than 100,000 by 2012. This means that as many as 150,000 to 160,000 new infections could be prevented over the period of the plan.
Care and treatment
Uganda has 360,000 people in need of antiretroviral therapy, but the current reach is 141,000. This means less than half of the people in need of treatment can access it. If the new plan is implemented well, it is hoped that the number will increase to 216,000 by 2012. The plan hopes to reduce AIDS-related deaths by 60,000-90,000 in the next five years.
As the country braces for a five-year plan that aims at reducing the HIV infections, a call has been made to fight the scourge. The report shows that only 10-12% of men and women between 15 and 49 years have been tested for HIV and received results. Are you one of them? It is the first step in cutting infections rate.
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