New Study Faults Uganda Government on HIV Resource Allocation

A recently released report, "The Analysis of Prevention Response and Modes of Transmission," finds Uganda's HIV/AIDS policies and programs are not targeting the populations most at risk. The study, commissioned by UNAIDS and the World Bank in partnership with the Uganda AIDS Commission, was carried out from 2007 to 2008.

Over the past 15 years, prevention campaigns in the country have targeted young, single people engaging in casual sex. Uganda has spent billions of shillings promoting the "ABC" model: Abstaining, being faithful to one sex partner, and using condoms. However, the study found 43 percent of HIV infections occurred among persons reporting monogamous relationships, while 46 percent were among persons reporting multiple partnerships.

The nation's much-heralded decline in prevalence from the peak of 18 percent in 1992 ended in 2002, when prevalence reached 6.1 percent. HIV prevalence now stands at 6.1 to 6.5 percent, testing at antenatal sites indicates.

Uganda's epidemic has also shifted from young to older individuals: The highest prevalence for men is among those ages 35-39 (9.9 percent), while for women it is among those ages 30-34 (12 percent).

"The synthesis shows a mismatch between the epidemiology, policies and programs, and the resource allocation," according to the report. "Despite the evidence of the risk factors and drivers of the epidemic, there are no policies targeting most at-risk populations, circumcision, and the contextual factors."

The report recommended "a realignment of prevention efforts to where the new infections are occurring and to the populations most in need." Prevention spending, it added, should focus on married people and those in long-term relationships.

Overall, just 31 percent of the $249 million used to combat HIV/AIDS went to prevention with the bulk of money (53 percent) spent on treatment and care, the report said. Program management and mitigation each claimed 8 percent.

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