The history of aids in Uganda
The history of aids in Uganda shows a rapid spread of HIV through urban sexual networks and along major highways from its origin in the Lake Victoria region. Doctors in this area had become aware of a surge in cases of severe washing known locally as “slim disease” as well as a large number of fatal opportunistic infections. In 1982, the first aids case in Uganda was diagnosed and the link between slim disease and aids was climatically recognized. It was until 1986 when the Uganda civil war ended and president Museveni was firmly in power that the country had a major HIV prevention programme.
By this time the country was in the midst of a major epidemic with prevalence with prevalence rates of up to 29% in urban areas. Many organizations were often made up of people living with HIV educating their peers. These groups worked to break down the stigma associated with aids, and encourage a frank and honest discussion of sexual subjects that had previously been taboo.The sheer scale of the HIV epidemic in Uganda is also thought to have been a major driver of behavior change and the reduction in the number of new infections.
Many villages experienced high numbers of death each month, houses were standing empty, funerals were increasingly becoming cares for their orphaned grand children. Aids has had a devastating impact on Uganda; it has killed approximately one million people, and significantly reduced life expectancy, aids has depleted the country’s labour force, reduced agricultural output and food security and weakened educational and health services.
The large number of aids related deaths amongst young adults has left behind over a million orphaned children. It has been suggested that high number of aids related deaths in the 1990s may have been largely responsible for the decline in the number of people living with aids in Uganda during this period. The reason so many people died in this decade is that there was no available treatment to delay the onset of aids, and high number of people infected with HIV in the 1980s were reaching the end of their survival period.
In 2000 the Ugandan health ministry estimated that 800 000 people had died of an aids related illness since the beginning of the epidemic.
President Museveni encouraged input from numerous government ministries, NGOs and faith-based organizations, he relaxed controls on the media and a diversity of prevention messages spread through Uganda’s churches, schools and villages. Uganda’s first aids control programme was set up in 1987 to educate the public about how to avoid becoming infected with HIV, the programme promoted the ABC approach (abstain, be faithful, use condoms), ensured the safety of the blood supply and started HIV surveillance, story political leadership and commitment to tackling the rampaging aids epidemic was a key feature of the early response to aids in Uganda.
Prevention work at grass-roots level also began in this era, with a multitude of tiny organizations educating their peers about HIV. One of the 1 community based organizations formed was TASO (The aids support organization). It was run by sixteen volunteers who had been personally affected by HIV/aids services in Uganda and Africa providing emotional and medical support to many thousands of people who are HIV positive. The Uganda government prevention initiatives continued throughout the nineties with high levels of funding from both the government and international donors such as world Bank. In 1998, the government ran a trial to test the feasibility of rolling out antiretroviral treatment to people in developing countries free antiretroviral drugs have available in Uganda since 2004.
It is thought that the introduction of HIV drugs may have led to complacency about HIV as aids is no longer an immediate death sentence; comprehensive sex education and condom promotion are so massive.The current HIV prevalence in Uganda is estimated at 5.4% amongst adults, according to the Uganda HIV and aids zero – behavioral survey, the number of people living with HIV is higher in urban areas (10.1% prevalence) than rural areas (5.7%), it is also higher among women (7.5%) than men (5.0%). It is feared that HIV prevalence in Uganda may be rising again, at the best it has reached a plateau where the number of new HIV infections matches the number of aids related deaths, there are many theories as to why this may be happening including the governments shift towards abstinence-based prevention programmes, and a general complacency or aids-fatigue, it has been suggested that antiretroviral drugs have reduced the fear surrounding HIV and in turn have led to an increase in risky behavior.
Uganda women tend to marry and become sexually active at a younger age than their male counter parts, and often have older and more sexually experienced partners. This (plus various biological and social factors), puts young women at greater risk of infection. People living with HIV/AIDs in Uganda not only face difficulties related to treatment and management of the diseases, but they also have to deal with aids related stigma and discrimination. Stigma and discrimination towards those infected by aids are visible at all levels of society from families and local communities to government. Discrimination has also been reported in the private sector, including mandatory HIV testing for new employees, as hurting those affected, such attitudes are a major hindrance to prevention and treatment efforts.
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 aids 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. 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 be faithful to one partner and finally urging condom use, especially for those who have more than one sexual partner.
