December 1, 2008: World AIDS Day

The country of Uganda was highlighted in the 2008 UNAIDS World AIDS Day Report. Related information from the document can be found below:

"It is important to note yet again that the epicenter of the epidemic remains in sub-Saharan Africa. Two-thirds of all people living with HIV are African. Three-quarters of the deaths in 2007 were in Africa. And if 100 random adults in sub-Saharan Africa were tested, the average number of those found to be HIVpositive would be five(UNAIDS, 2008)...

...With the estimated number of people living with HIV so high a pressing concern today is whether donors and countries will continue to support a wide range of initiatives against AIDS that would sustain and build upon past successes. If funding is in doubt, how will treatment programmes stay ahead of the growing demand for antiretroviral therapies? If funding is cut, where will the support come for a host of invigorated prevention initiatives? The answers will affect millions of lives...

66% of all people living with HIV are in sub-saharan Africa
75% of HIV related deaths were in sub-saharan africa

...Uganda’s “modes of transmission” analysis showed that approximately 43% of new HIV infections were estimated to be occurring among “low-risk” couples in which one partner was HIV positive and the other negative. An estimated 44% of the infections came from those who have multiple sex partners, including their regular partners, and about 11% were related to sex work. These findings underscored the need to focus prevention efforts at people in marriages or long-term relationships. Such prevention strategies would include promoting couples counselling and testing, in which both reveal their HIV status; efforts to reduce the number of sexual partners; and emphasizing consistent condom use for couples that are discordant—one HIV positive, one HIV negative—along with access to HIV treatment for the positive partner (Government of Uganda, 2008).

“We found in Uganda that we should really monitor new infections and focus our response among the people who are seemingly in long-term, monogamous relationships,” said Professor Fred Wabwire-Mangen, the team leader of the Uganda modes of transmission study and an associate professor of infectious disease epidemiology at the Makerere University School of Public Health in Kampala. “A number of things are happening with those couples in longstanding relationships. First, they don't use condoms. Second, they do not test as much. We need to encourage them to test—and not only to test, but also to disclose to their partner.” Now, said Wabwire-Mangen, Ugandan policymakers will take the results and examine whether current programmes match the spread of the epidemic, in order to check if they are spending money in areas that desperately need interventions.

“You ask yourself, ‘Are we putting the resources in the right place? Are we putting resources where the infections are occurring?’ The study should tell you whether you are on course,” he said. “The challenge for our countries is to prevent new infections, as well as to provide treatment, care and support, and to reintegrate HIV-positive people in the economic and social activities.”

2009—LOOKING TO THE YEAR AHEAD
IN 2009, THERE WILL BE NEW OPPORTUNITIES TO CHANGE THE PACE OF THE AIDS EPIDEMIC. WHILE ONE GLOBAL GOAL IS TO PUT MORE PEOPLE ON TREATMENT, THE WORLD CAN ALSO AIM TO SEE FEWER PEOPLE INFECTED—BY BUILDING ON THE MANTRA OF ‘KNOWING YOUR EPIDEMIC’. THROUGH UNDERSTANDING HOW THE MOST RECENT HIV INFECTIONS WERE TRANSMITTED AND UNDERSTANDING THE REASONS WHY THEY OCCURRED, COUNTRIES CAN CHOOSE AN EFFECTIVE COMBINATION PREVENTION APPROACH. NOT ONLY WILL THIS APPROACH HELP PREVENT THE NEXT 1000 INFECTIONS, BUT IT WILL ALSO MAKE MONEY FOR AIDS WORK MORE EFFECTIVELY AND HELP PUT FORWARD A LONG TERM AND SUSTAINABLE AIDS RESPONSE."

The entire USAIDS World AIDS Day report can be found at http://data.unaids.org/pub/Report/2008/20081128_aids_outlook09_en.pdf