World AIDS Day

29 Years of Engaging Community and Young People to Champion End of HIV/AIDS

This year’s Global theme recognises the important role that communities have played and continue to play at the international, national and local levels to ensure that the AIDS response remains relevant, grounded, people centred and leaving no one behind. On the other hand, the National theme recognises Young People as an important section of the community who not only comprise majority of the Ugandan population but also those aged 15-24years contributing 34% of new HIV infections annually.

“When people and communities have power and agency, change happens,” said Winnie Byanyima, Executive Director of UNAIDS. “The solidarity of women, young people, men who have sex with men, sex workers, people who use drugs and transgender people has transformed the AIDS epidemic—empowering them will end the epidemic.”

The Communities include peer educators, networks of people living with or affected by HIV, such as gay men and other men who have sex with men, people who inject drugs and sex workers, women and young people, counsellors, community health workers, door-to-door service providers, civil society organizations and grass-roots activists.

AIC whose mission is to provide sustainable, collaborative and integrated HIV&AIDS and other related health services in Uganda, on 1st December 2019, joins the Country and the International Community to commemorate the World AIDS Day under the global Theme: “Communities make the difference” and National Theme “Engaging young people to champion the end of new HIV infections”

AIC through the National Secretariat and the 9 Regional Centres of Excellence including Hheadquarters and Kampala Branch located on Block 1321, Mengo-Kisenyi, Musajja Alumbwa Road, Jinja, Mbarara, Mbale, Soroti, Arua, Lira, Kabale and Moroto. AIC, through these regional and district liaison offices provide services in over 60 districts of Uganda. AIC’s organizational structure and mode of operations at the National, Regional, District, Sub County, Parish and Community levels ensures strong management of field operations and technical support in the districts.

AIC 2018/2019 Key Highlights
 Overall, AIC reached 308,356 people of which 162,052 (53%) were male, while 146,302 were female) in the community with information that was responsible for change of behavior thus translating into increased demand for services. Majority (56.2%) of the people were reached through dialogues, followed by Community Sensitizations (26.6%), Trainings (22.5%) and lastly Advocacies (4.4%).

 A total of 100,238 (51% male and 49% female) clients were reached with HTS services. Outreaches (80.1%) accounted for most people tested

 AIC registered an overall positivity rate of 2.25% (Male 46.6%; Female 53.4%) with Arua and Kampala recording positivity rate of 5% each. This rate is below the projected national average of 5.7%. APN strategy proved its relevance; 39.5% people tested through APN tested HIV positive.

 During the year, a total of 5031 males receive comprehensive VMMC service package at the eight regional centers.

 3,292,169 (2,128,196 males, 163,973 female) condoms were distributed using the established condom outlets including lodges, saloons, drug shops and through peers. 2,043,138 condoms were distributed at outreaches while 1,249,031 were distributed at static facilities

AIC’s Renewed Commitment to the AIDS Response
While Uganda has made remarkable progress in AIDS response, according to the 2019 UNAIDS report, there are 1.4 million people living with HIV, HIV prevalence is 5.7% with women disproportionately affected (8.8% of adult women living with HIV compared to 4.3% of men), 53,000 new HIV infections and 23,000 AIDS related deaths. 73% of adults living with HIV and 66% of Children living with HIV were on treatment by the end of 2018. 84% of people living with HIV are aware of their status, of which 87% are on treatment of which 88% are virally suppressed against the 90:90:90 targets.
The groups most affected by HIV in Uganda include young people especially adolescent girls and young women aged 15-24 years where HIV prevalence is almost four times higher than young men of the same age, female sex workers with HIV prevalence estimated at 37%, Men who have sex with men (MSM) 13%, People who inject drugs (PWID) at 16.7% and Fishing communities at 22%.
In order to renew our commitments and further contribute to attaining HIV epidemic control, our revised Strategic Plan 2017/2018-2021/2022 is aligned to SDGs, HSSIP, NSP and fast track of ending AIDS by 2030. It outlines a Combination prevention intervention where behavioral, Biomedical, Structural interventions and Use of ARVs are implemented simultaneously to not only address HIV/AIDS but also strengthen its adolescent and sexual reproductive health services. Current trends indicate the need for targeting sub-population groups that contribute greatly to the current trend of the epidemic and special attention is being made to the adolescents and young people who are highly vulnerable. The vulnerable adolescents include Street children, sex workers, child labourers, adolescents in refugees’ settlements, Children orphaned because of HIV/AIDS and other adversities, neglected and/or abandoned adolescents and Children from child headed households.
Attention is also being given to the most at risk populations such as the fishing communities, sex workers, long distance truckers and uniformed services. Other populations of importance include mobile and migrant populations, plantation workers, boda boda men, incarcerated populations as well as those in the mining and oil sectors. The plan was developed under the full leadership and involvement of the AIC Board of Trustees. The new strategic plan will also address issues of service delivery in early diagnosis and prevention of non-communicable diseases (NCDs) including Diabetes, Hypertension among others as part of the integrated package. The new AIC strategic plan will contribute to strengthened laboratory infrastructure to support the quick, and early diagnosis of different diseases to reduce morbidity and mortality at community level.
We shall address the persistent challenges to effective HIV prevention efforts for adolescents which amongst others include inadequate access to high-quality friendly HIV, sexual and reproductive education, life skills, mental health and other health care services. There is also a weak; referral system, psychosocial care and support, monitoring and evaluation for quality improvement, adherence, retention and transition strategies.

Power Together

When people and communities have power and agency, change happens. Communities have put rights-based, people-centred principles at the heart of HIV programmes, ensuring that AIDS responses tackle the inequalities and injustices that fuel the epidemic.

Women and girls are the backbone of care support in their families and communities, providing unpaid and often undervalued work in caring for children, spouses, the sick, the elderly and the disabled and underpinning fragile social support systems. This must change. The involvement and leadership of communities of women is vital in the response to HIV.

The Power To Choose
Women and girls are demanding integrated contraception and HIV and sexually transmitted infection testing, prevention and care options. Almost 40% of adult women and 60% of adolescent girls (aged 15–19 years) in sub-Saharan Africa have unmet needs for modern contraception.

In several countries in sub-Saharan Africa, young women’s uptake of medicine to prevent HIV—pre-exposure prophylaxis (PrEP)—has been shown to be high in projects that integrate PrEP into youth-friendly health services and family planning clinics and when provision of PrEP is separated from treatment services.

Eleven million voluntary medical male circumcisions to prevent HIV have been performed since 2016, 4 million in 2018 alone in the 15 priority countries.

The Power To Know
The power to know allows people to keep themselves free from HIV or, if living with the virus, keep healthy. However, people are finding out their HIV status too late, sometimes years after they became infected, leading to a delay in starting treatment and facilitating HIV transmission.

Adherence to effective treatment suppresses the virus to undetectable levels, keeping people healthy and preventing transmission of the virus. Knowing this allows people living with HIV the opportunity to lead normal lives, confident that they are protecting their loved ones, and confronting stigma and discrimination.

HIV self-testing is now helping more people to find out their HIV status in privacy, breaking the barriers of stigma and discrimination and facilitating linkage to treatment.

The power to thrive
The power to thrive is ensuring that people have the right to health, education, work and a standard of living adequate for health and well-being.

New HIV infections among children have declined by 41% since 2010 and nearly 82% of pregnant women living with HIV are on antiretroviral therapy. However, thousands of children are falling between the cracks. Half of all children born with HIV who are not diagnosed early will die before their second birthday, but, globally, only 59% of HIV-exposed children were tested before two months of age.

Key populations are being left behind
Key populations and their partners account for at least 75% of new HIV infections outside of sub-Saharan Africa and are less likely to be on treatment than others. More than one third of key populations do not know their HIV status. Community-led support among gay men and other men who have sex with men is effective in increasing the uptake of PrEP, promoting safer sex, increasing HIV testing rates and supporting treatment adherence.

Transgender people are subjected to discrimination in every sphere of life, including education and employment—only 10% work in the formal economy. But community activism has led to long overdue attention to the rights and realities of transgender people.

Community empowerment activities among sex workers have been shown to increase the odds of condom use with clients by three times and reduce the odds of HIV infection by more than 30%.

The power to demand
The power to demand gives communities and individuals the power to participate in the decisions that affect them. There have been reports of crackdowns, restrictions and even attacks on groups and campaigns supporting key populations. Some governments refuse to recognize, support or engage community organizations in their national responses to HIV and are subsequently missing out on their enormous potential to reach the people most affected by HIV.

People and communities will end AIDS
The work of community-led organizations is unique and powerful and can have a substantial impact on how Uganda fairs towards ending AIDS. AIDS Information Centre-Uganda urges all leaders, Service Providers, AIDS Development Partners and Donors to fully support and enable their community-led organizations, ensure they have a seat at all decision-making tables concerning the health and well-being of their community members and remove any barriers to their active engagement in the response to HIV. Only by fully funding and fully supporting the work of community organizations will the end of AIDS become a reality.

Mrs. Sheila Birungi Gandi| Executive Director| AIC Uganda| +256700345482
Mr. Monja Minsi| Business Development and Advocacy Manager| AIC Uganda| +256754516004
Mr. Henry Lulu Leku | Regional Project Coordinator – Northern| AIC Uganda | +256 772669355