Individuals tested from 2011 to 2014 (UAC, Uganda HIV & AIDS Progress Report 2015)
Hon. Dr. Bitekyerezo Medard taking an HIV Test at Annual General Meeting on 24th November 2017
L-R AIC's DFA Mr. Augustine Ssendi, TrackTB COP Dr. Raymond Byaruhanga, MSH Country Representative Mr. Herbert Mugumya, MSH President Dr. Mariam Wentworth and AIC's ED Sheila Birungi Gandi (Mrs.)
Kabaka Ronald Muwenda Mutebi 11 and prime minister of Buganda Owek:Peter Mayiga visiting the AIC stall during the Buganda health camp in Buvuma island organised by UNAIDS.
AIC ED and UNAIDS directors during the unveiling of kabaka Ronald Mutebi 11 as the UNAIDS goodwill ambassador for male involvement in HIV prevention in Buganda kingdom .
From left, Birungi Sheila(Executive Director AIC), Dr. Christine Ondoa (Director General UAC) and Hon. Moses Kizige (state minister for Karamoja affairs) chatting during the Protect The Goal launch in Moroto District.

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WORLD AIDS DAY MESSAGE 1ST DECEMBER, 2018


AIDS Information Centre - Uganda: “28 Years of  Sustained Contribution to Zero new infections, Zero HIV/AIDS-related mortality and morbidity, Zero discrimination and commitment to the global effort to end AIDS as public health threat by 2030”


On 1st December 2018, AIDS Information Centre - Uganda (AIC) joined the International Community and Country to commemorate the World AIDS day (WAD) under the Theme: “Know Your HIV status”.  While the nation commemorate this event in Manafwa District, AIC through the National secretariat and the Nine Regional Centres of Excellence supported District Local Governments, the Ministry of Health and the Uganda AIDS Commission to raise awareness about the HIV/AIDS epidemic, provided services, took stock of achievements, commemorated those who passed away and rededicated herself to the HIV and AIDS response.

GENESIS TO THE ESTABLISHMENT OF AIDS INFORMATION CENTRE - UGANDA

Founded on February 14th 1990, AIC is a NGO and the first of its kind in Uganda and Sub Saharan Africa providing comprehensive HIV&AIDS information, HIV Counseling and Testing Services (HTS). AIC was founded as a result of a growing demand from people who wanted to know their HIV status at the time when HIV prevalence was over 18% in the general population and over 30% at sentinel surveillance sites especially ANC clinics. Today, the HTS model has evolved into an integrated and comprehensive package of HIV Prevention, Care and Treatment, Social Support and Protection, and Health & Community Systems Strengthening.

It is the Voluntary Counselling and Testing (VCT) model that AIC championed which enabled Uganda develop the first VCT policy in 2002, with an aim of scaling up VCT. The first review of the VCT policy in 2005 introduced Routine HIV testing and counselling and home-based testing and counselling to complement VCT. The second review of the VCT policy in 2010 separated the HCT implementation guidelines from the HCT policy aimed at increasing coverage for HCT services to achieve universal access which resulted into increase in number of facilities providing HCT services to 3,565 in 2014; including all private hospitals and HC IVs.

There has been a progressive increase in the numbers of individuals tested since 2011 from 5,524,327 individuals to 9,564,992 in 2014 with nearly two thirds of these being women, and about 10% being children under age of 15 years. About 1,727,465 were pregnant women during ANC visits. Despite the observed progress in numbers testing in terms of proportions this is quite small (UAC HIV&AIDS Progress Report, 2015). Over the last three years the percentage of women and men aged 15-49 who received an HIV test in the past 12 months and know their results has ranged from 42% to 51.4% (LQAS 2012/14, AIS 2011). While this may be explained by the increase in the population it still shows that there are many missed opportunities for HCT.

The Country reviewed the 2010 HCT policy and introduced the HIV Testing Services (HTS) Policy in 2016 to improve efficiency and cost-effectiveness while ensuring adherence to the five core testing principles (5Cs) of Confidentiality, Consent, Counselling, Correct test result and Connection to appropriate services. By 2016, only 78% of the estimated 1.3 million HIV-positive persons in Uganda knew their HIV sero-status, and 93% of these were receiving antiretroviral treatment (UPHIA, 2016).

AIC’s vision of universal knowledge of HIV status in Uganda at inception remained relevant today as we commemorate this year’s WAD under the theme: “Know your HIV Status”.  HIV testing especially targeting young men, Adolescent and young women 15 – 24 years as it is the entry point to HIV prevention, care, and treatment and support services. HTS helps to diagnose HIV early and correctly to ensure early access to prevention, treatment and support services.

OUR VISION, MISSION AND CORE VALUES

Vision: Population free of HIV&AIDS and other preventable health problems
Mission: To provide sustainable, collaborative and integrated HIV&AIDS and other related health services in Uganda
Core Values: Integrity in all executions; Transparency; Accountability for resources and results entrusted by all stakeholders; Service excellence; Equity and fairness and Team work
Slogan: Knowledge is Power, Take an HIV Test Today!
 

OUR CONTRIBUTIONS TO THE NATIONAL EFFORTS

AIC has played significant roles towards the national efforts to scale up HIV prevention, care and treatment, Social support and Protection and Health/Community Systems Strengthening. During the past 1 year, AIC aligned its interventions and has been implementing priorities defined by her strategic plan, well aligned to Uganda’s Vision 2040, the National Development Plan II, the National HIV&AIDS Strategic Plan 2015/16 – 2019/20 and the global goal of 90/90/90 i.e. 90% of all HIV infected persons to know their HIV status, 90% of those who know their status are put on life saving ARVs and 90% of those on ART achieve viral suppression. This will contribute to the realization of the Presidential fast track initiative and the Sustainable Development Goal of ending AIDS as Public Health Threat by 2030.

A combination of biomedical, behavioral, social/structural strategies was implemented to gain multidimensional coverage and reach of the key populations and to address the different modes of HIV transmission. AIC implemented HIV Counselling and Testing, Safe Male Circumcision, HIV Care and Treatment, Sexual reproductive health services to contribute to the reduction of new HIV infections through increasing access and utilization of quality HIV prevention, care, and support and treatment services in 60 districts in Uganda

As AIC we are grateful to the different development partners who provided both technical and financial support to contribute to the annual achievements.  Together supported the National response through Ministry of Health (MOH), Uganda AIDS Commission (UAC) and Ministry of Gender, Labor and Social Development (MoGLSD) in the development of Policy documents and operational researches. At Regional, District and Community level, we ensured that the policies, guidelines and SOPs are translated into service delivery as highlighted below;

2017/2018 KEY ACHIEVEMENT HIGHLIGHTS

  • Overall, 99,914 individuals were reached with social Behavior change communication and structural interventions aimed creating demand and mitigating the impact of HIV&AIDS. 34,734 of the totals benefitted in community trainings, 57,484 from comprehensive OVC interventions and 7,696 advocacy and engagement of Political, cultural, religious and Technical leadership across the country.
  • A total of 70,443 (39,157 male, 31,286 female) clients were reached with HTS services.
  • 2,895 Couples were tested of which 206 (7%) were discordant, 12,212 were key and priority population
  • 85% of those tested positive 1525 (726 male and 799 female) were effective linked to care against the 90% national target by 2020.
  • During the year, a total of 4,469 males were circumcised by AIC at the eight regional centers of excellence.
  • 5,957,036 (5,957,036 male, 21,845 female) condoms were distributed using the established condom outlets including lodges, saloons, drug shops and through peers.
  • A total of 480 VSLA Plus groups were formed comprising of (4,589 male, 8,163 female) with saving portfolio of UGX 436,412, 700 of which UGX 298,578,390 was borrowed for investment in viable business opportunities after the members were trained in Selection, Planning and Management (SPM) of small scale business skills.

OUR RENEWED COMMITMENT TO THE HIV&AIDS RESPONSE

HIV and AIDS continue to pose a major public health and economic challenge world over, threatening the attainment of the SDGs, particularly in the Sub-Saharan Africa. Among so many factors driving the HIV epidemic are behavioral, socio cultural and biomedical factors including concurrent sexual partnerships, discordance and non-disclosure, transactional and commercial sex, low and inconsistent condom use, low male circumcision, alcohol and drug abuse. Structural, socio-cultural and economic aspects, marriage and family values, poverty and wealth; gender inequalities; stigma, human rights and discrimination as well as limited male involvement which has provided a fertile ground to sustain the epidemic, particularly in Uganda.

Despite the above setbacks, the latest UNAIDS 2017 fact sheet for Uganda and Uganda Population-based HIV Impact Assessment (UPHIA) report demonstrates that Uganda has made a stride in the national HIV&AIDS response with HIV prevalence declining from 7.3% (UAIS, 2011) to 5.9% (UNAIDS fact Sheet) 2017. The number of new infections in adults reduced from 52,000 in 2016 to 50,000 in 2017. The Coverage of Pregnant women who receive ART services for PMTCT was over 95%, 48% of HIV exposed infants accessed EID services and 16,000 new HIV infections were averted from the 860,000 HIV exposed infants as a result of the PMTCT program.

26,000 Adult and child deaths due to AIDS was recorded in 2017 and 560,000 children 0-17 years were Orphaned and made vulnerable due to AIDS and other adversities in Uganda. Along the HIV 90:90:90 cascade, of the estimated 1.3 Million PLHIV in Uganda, 1,100,000 (81%) of the PLHIV knew their HIV status against the 1st 90, 969,569 (72%) of Adults and Children living with HIV were receiving ART (2nd 90) and 760,000 (56%) of PLHIV had suppressed viral load (3rd 90). 42,489 Adults and children were newly initiated on ART and 78% of the adults and children were known to be on ART 12 months after initiation on treatment. This finding shows that with support from development partners such as PEPRAR, Global Fund and other programs, the Government of Uganda’s HIV programme is having an impact and making great progress toward the UNAIDS and national goal of having population level VLS of at least 73% by 2020.

While the country has made great achievements, there are still several bottlenecks that we need to jointly address including; reversing the 50,000 new HIV infections majority of which are among young people especially girls and 4,600 new HIV infections among children below 15 years, testing and enrolling an additional 300,000 people who have contracted HIV but are not aware, scaling up interventions that target male involvement among others.

Data from UPHIA identified existing gaps in HIV programmes and specific populations that need special focus. HIV prevalence triples from those aged 15-19 years (1.1 % total, 1.8% in girls and 0.5% in boys) to those aged 20-24 years (3.3 % total, 5.1% in young women and 1.3% in young men), and then almost doubles again between 20-24 and 25-29 (6.3% total, 8.5% in women and 3.5% in men) suggesting new infections remain an issue in these age groups.  This continuing infection risk necessitates innovative interventions to prevent new infections in young people beginning around age 20.

Furthermore, women 15-24 and men under 35 years of age who are living with HIV have rates of VLS <50%. These lower rates of VLS are driven by younger people being unaware of their HIV status and not accessing available services. Interventions are needed to ensure young people know their status and if HIV positive are linked to care.

Only 55% of Ugandans have ever tested for HIV and close to 50% of the persons who are eligible for ART are not accessing the lifesaving treatment. Health seeking behavior among the men is still very poor. Programs targeting adolescents are still limited and where they do exist they are integrated with other services coupled with limited reporting leading to limited data for planning for these populations.

AIC and her stakeholders as part of renewal of commitments and further contribute to address existing challenges and augment reversal of the HIV epidemic, reviewed and approved a new strategic plan running from 2017/18- 2021/2022. The new plan is aligned to the Ministry of health sector strategic and investment plan 2015/ 2020, National Strategic Plan 2015/16- 2019/20 (NSP) and the universal 90:90:90 targets of AIDS free Generation through epidemic control. The plan is also aligned to the global and The Presidential Fast Track Initiative on Ending AIDS as a Public Health Threat by 2030 (PFTI) whose objectives include:

  1. Engaging men in HIV prevention and close the tap on new infections particularly among adolescent girls and young women.
  2. Accelerating implementation of Test and Treat and attainment of 90-90-90 targets particularly among men and young people.
  3. Consolidating progress on eliminating mother-to-child transmission of HIV.
  4. Ensuring financial sustainability for the HIV and AIDS response.
  5. Ensuring institutional effectiveness for a well-coordinated multi-sectoral response.

Current trends indicate the need for doing the right things at the right place at the right time 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. AIC will continue to pay attention to the Priority, key and vulnerable populations such as 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. In line with the Global and National Theme of “This is the time to know your HIV status”. AIC will accelerate and sustain provision of Integrated activities with the overall goal of ensuring identification of HIV infected persons currently not reached with HIV Testing Services (HTS) under the five core Principles (5Cs) namely Counselling, Consent, Confidentiality, Correct Results and Connection and Linkage to care and treatment services as defined and guided by MOH HTS Policy 2016 and the revised November 2018 HIV Treatment Guidelines for Uganda.

KEY ACTIVITIES FOR 2018 WORLD AIDS DAY

AIC will undertake large scale actions and activities during the 16 days of activism to highlight and support adolescent girls and support them to be free from GBV which is key driver and as well as effect of HIV. These include;

  1. Community sensitization, education and dialogue on GBV and VAC targeting Project Beneficiaries in Parenting & ECD, Youth Clubs in and out of school, VSLA+ Groups, Home visits and integrated HIV and Health outreaches
  2. Drama, plays, poems and debates on GBV in Schools and community and on the Climax (10th December 2018).
  3. Strategic partnership, Collaboration and Development of key talking points on GBV, HIV and Violence against Children (VAC) and Orienting and engaging members of district Council, Cultural, religious, traditional leaders and School leaders to integrate it in their routine work such as sermons, school assemblies etc.
  4. Provision of Post GBV Care services such as SRH services, HTS, PEP, Emergency Contraceptive care and referrals for legal support
  5. Participation in the celebration of the 16 days of activism against GBV and WAD
  6. Create awareness on HIV/AIDS to the population.
  7. Conduct dialogue on HIV Prevention, Treatment and Care, Social support protection with 25 members of Elders’ Association in the area
  8. Exhibit HIV Prevention, Treatment and Care, Social support and protection and services on the WAD.
  9. Provide integrated HIV Prevention, Treatment and Care, Social support protection services.
  10. Provide Social behavior change communication messages to enhance positive health choices
  11. District IEC materials to stimulate thinking so as to enhance behavior change
  12. HTS and referral to care and treatment
  13. Condom education and distribution.
  14. Screening cancer of the cervix, STD/STI screening and treatment