Uganda is often cited as a rare example of success in a continent facing a severe AIDS crisis. The country is seen as having implemented a well‐timed and successful HIV prevention campaign, which has been credited with helping to bring adult HIV prevalence down from around 15% in the early 1990s to around 5% in 2001. Sadly, Uganda is at an important crossroad in nearly her 30-year long struggle with HIV/AIDS epidemic and prevalence has increased especially amongst the young people who constitute to over 70% of the population. After a dramatic reduction in HIV occurrence following an early comprehensive HIV prevention campaign, there is evidence that the number of people living with HIV in the country is on the increase and majority are the youth. The reasons for this increase have been attributed to the government’s shift towards abstinence‐only prevention programmes, a general complacency or ‘AIDS‐fatigue’ and a suggestion that Antiretroviral drugs have changed the perception of AIDS from a death sentence to a treatable, manageable disease.
The epidemic is also a gender issue because it affects men and women differently. The prevalence rates are higher among women with young women being at a greater risk of infection. Young girls are more vulnerable to HIV/AIDS because of intergenerational sex, discrimination, sexual violence, cultural beliefs and limited access to information. In Africa, women’s vulnerability to HIV/AIDS is rooted in the existing strong gender inequalities in the distribution of resources which leaves women economically dependent on their male sexual partners and hence lack of control over their sexuality and fertility which render them vulnerable to poverty, violence and sexual coercion.
In Uganda, HIV/AIDS has taken the lives of many as a result of limited sensitization, limited knowledge about HIV/AIDS prevention, and limited access to health services, and stigma; which have all obstructed many from accessing treatment. Many people have been involved in careless sexual relationships; extra-marital relations, premarital sex and homosexuality. However, others have faced sexual violence including rape, defilement and human trafficking all being the leading cause of the spread of HIV/AIDS. The impact of HIV is felt most acutely among poorer households especially those headed by women with little resources with which to cushion the economic burden. Research shows that HIV/AIDS affects the most productive members of society and reduces household income by up to 80% (EASSI, 2007, MFPED, 2004). HIV/AIDS robs society of both the skilled and unskilled workforce and destroys the human capital and diverts meager resources. For instance HIV/AIDS may lead to the death of a husband, and the wife now has a problem to look after the children; looking for food, paying school fees, paying for medication. This has lead to a lot of debt and poor standards of living in families.
The approach used in Uganda has been named the “ABC” approach ‐ firstly, encouraging sexual Abstinence until marriage; secondly, advising those who are sexually active to being faithful to one partner; and finally, urging Condom use, especially for those who have more than one sexual partner. Thus, In order to curb HIV prevalence, Uganda needs to take a serious look at infection trends and behavior to identify why this rise may be occurring and how to remedy it.
Already existing policies on treatment and care need to be implemented. In particular attention should be paid to among others supporting and expanding the provision of home based care and strengthening referral systems to other health facilities and complementary services in addition to increasing equitable access to Anti Retro‐viral Treatment to those in need.
Additionally, there is need for sensitization, provision of information, awareness creation and community mobilization of people about the prevention and involvement in HIV/AIDS health activities. There is need to eliminate gender inequalities in distribution of resources basically to reduce the vulnerability of women to poverty, violence and sexual coercion. There is need to need to sensitize parents to support boy and girl child education without any discrimination. Poverty reduction initiatives should be put in place to increase the household income and reduce men and women’s vulnerability to HIV/AIDS. Other strategies should include; openness through intensive education about the epidemic, voluntary counseling and testing (VCT) STDs treatment and Control and provision of “life skills”.