At a glance: HIV in Uganda

• 1.4 million people with HIV
• 5.1% adult HIV prevalence
• 52,000 new HIV infections
• 17,000 AIDS-related deaths
• 1.2 million people on antiretroviral treatment

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

In 2022 in Uganda:

Did you know?

Uganda has rapidly expanded viral load monitoring in recent years – in 2016 only around half of people on HIV treatment could test their viral load, now this is offered as a standard part of HIV care. In 2022, 97% of people on ART in Uganda had a viral load test.

Preventing HIV in Uganda focuses on:

• prevention of mother-to-child transmission
• voluntary medical male circumcision
• social and behaviour change communication
• male and female condoms
• addressing gender-based violence, particularly for adolescent girls and young women
• PEP
• PrEP (oral PrEP available for high-risk groups; injectable PrEP and vaginal rings approved but not widely available)
• harm reduction for people who inject drugs (needle and syringe programmes and opioid agonist therapy are both available but limited) management of sexually transmitted infections, including partner infections
• management of sexually transmitted infections, including partner infections
• a range of prevention services for young people, particularly adolescent girls and young women
• closely linked to HIV testing services.

Did you know?

Uganda began offering needle and syringe programmes in 2017. And in 2021 it made opioid agonist therapy available nationally, following a successful pilot in 2020.

Testing for HIV is:

• lower among men than women
• available in health facilities, in community settings, workplaces and in people’s homes
• offered to the partners and children of people newly diagnosed with HIV, with that person’s consent (called partner notification and index testing)
• targeted at people from groups that are most at risk of infection, through community-based testing campaigns.

Did you know?

In 2019, Uganda made free HIV self-testing kits available from public health facilities, and to buy from pharmacies. In 2022, an agreement was signed with international suppliers that reduced the cost of some self-test kits in pharmacies to US$1. 

Treatment for HIV is:

• free
• started as soon as someone tests positive
• monitored by viral load testing
• available as a 3-6 month supply and from community pick-up points (for people who have been on treatment for a stable length of time and have suppressed viral loads)
• available for group collection: up to six people can form a group then take turns in picking up treatment refills (for people on stable treatment with suppressed viral loads)
• available via drop-in centres and ‘moonlight’ (after hours) clinics
• first-line treatment is an antiretroviral regimen that contains Dolutegravir, which is recommended by the World Health Organization as it has fewer side effects than older generations of HIV drugs.

Did you know?

Uganda’s rapid scale up of its treatment programme is starting to slow. In 2022, 47,000 people with HIV began treatment in Uganda. This is only 66% of the 2022 target and is fewer than the 50,000 people who started treatment in 2021. 

Uganda began the first national AIDS control programme in 1986 and was the first African country to begin to reverse its HIV epidemic.

Over the past decade, the number of people getting HIV has fallen significantly, but Uganda’s HIV infection rate is still one of the highest in the world. UNAIDS modelling data released in 2023 suggests that even if Uganda meets its 95-95-95 targets by 2025, almost 40,000 people will still get HIV each year. This makes HIV prevention an essential part of the country’s efforts to end AIDS as a public health threat.

Most new infections occur among marginalised groups and adolescent girls and young women. Women are almost twice as likely as men to get HIV.

HIV infections are not declining as rapidly among young people (ages 15-24) as other age groups. More than two-thirds of young people diagnosed with HIV are girls.

HIV prevalence among sex workers is estimated to be as high as 35%, 14% among men who have sex with men and 23–35% among fishing communities.

Various laws and policies continue to hamper Uganda’s HIV response and people’s access to sexual and reproductive health services (for example, the transmission of HIV is criminalised and abortion is only allowed to save a woman’s life). Homosexuality has been criminalised for many years, and in 2023 Ugandan parliament passed the Anti-Homosexuality Act 2023, which increased the severity of punishment for homosexuality. The stigma and discrimination associated with the new act has further discouraged LGBT+ people from seeking HIV services for fear of attack, punishment and marginalisation.

Behaviour change efforts – including age-appropriate sex education, and targeted HIV prevention campaigns – have not been widespread enough to reduce HIV infections as much as is needed. While intimate-partner violence, which helps to drive HIV, remains common.

HIV-related stigma remains an issue. Around one-third of people in Uganda hold discriminatory attitudes towards people with HIV. The People Living With HIV Stigma Index (2019) found that around a third of people with HIV hide their status from others. But progress is being made, as it is now government policy to encourages workplaces to adopt HIV-sensitive policies and practices, for instance.

Ugandan’s HIV response faces significant resourcing challenges. This is partly due to a reduction in funding from international donors, which the country’s HIV programmes have previously relied upon. In 2014, the Ugandan Government set up the AIDS Trust Fund to raise more domestic resources for HIV. This has generated funds by taxing alcohol and bottled water. Other initiatives include the private-sector-led One Dollar Initiative (ODI), which began in 2018 and aims to raise one billion dollars. While such initiatives have contributed to funding, significant shortfalls remain. In 2022, a funding gap of 22% (US $185 million) for Uganda’s HIV response was reported.