By Bukenya Adam Updated at 2310 EAT on 2 February 2022.
In 2018, an estimated 1.4 million people were living with HIV, and an estimated 23,000 Ugandans died of AIDS-related illnesses.
The epidemic is firmly established in the general population. As of 2018, the estimated HIV prevalence among adults (aged 15 to 49) stood at 5.7%.Women are disproportionately affected, with 8.8% of adult women living with HIV compared to 4.3% of men.
Other groups particularly affected by HIV in Uganda are sex workers, young girls and adolescent women, men who have sex with men, people who inject drugs and people from Uganda’s transient fishing communities.
There has been a gradual increase in the number of people living with HIV accessing treatment. In 2013, Uganda reached a tipping point whereby the number of new infections per year was less than the number of people beginning to receive antiretroviral treatment.
However, as of 2018 around 27% of adults living with HIV and 33% of children living with HIV were still not on treatment. Persistent disparities remain around who is accessing treatment and many people living with HIV experience stigma and discrimination.
Adolescent girls and young women
HIV prevalence is almost four times higher among young women aged 15 to 24 than young men of the same age.
The issues faced by this demographic include gender-based violence (including sexual abuse) and a lack of access to education, health services, social protection and information about how they cope with these inequities and injustices. Indeed, young Ugandan women who have experienced intimate partner violence are 50% more likely to have acquired HIV than women who had not experienced violence.
The lack of sexual education is telling. In 2014, only 38.5% of young women and men aged 15-24 could correctly identify ways of preventing the sexual transmission of HIV and rejected major misconceptions about HIV transmission.
HIV prevalence among sex workers was estimated at 37% in 2015/16.
It is estimated that sex workers and their clients accounted for 18% of new HIV infections in Uganda in 2015/16.
A 2015 evidence review found between 33% and 55% of sex workers in Uganda reported inconsistent condom use in the past month, driven by the fact that clients will often pay more for sex without a condom.
“…you could be in a bad situation yet you are sick and on medication. At the same time you may not have anything to eat… you look for a man who can help you. Then that man will give you conditions… if you are going to have sex with him with a condom he will give you Uganda Shillings (UGX) 2,000/ =, then he says that if it is without a condom he will give you 20,000/=. Because you can’t help yourself, there is no way you can leave UGX 20,000/= and go for UGX 2,000/=”