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Lancet Examines Status of HIV/AIDS Prevention, Treatment Programs in Uganda

May 2, 2006

The Lancet on Saturday examined the Ugandan government's HIV/AIDS prevention and treatment programs, as well as the country's "condom crisis" that "seems to be reversing the country's fortunes" in reducing HIV prevalence. Uganda has a "longstanding" ABC prevention policy -- which stands for abstinence, be faithful and use condoms -- and reduced its HIV prevalence from 17% in the early 1990s to about 6% in 2005, the Lancet reports. However, according to a national survey released earlier this year, national HIV prevalence increased to 6.4% from 6.2% just over one year ago, with about 1.4 million Ugandans now living with the virus. President Yoweri Museveni and his wife Janet have led a campaign to remove condom use from the country's prevention strategy, with Museveni saying that condoms promote promiscuous behavior and do not always prevent HIV transmission, the Lancet reports. Some brands of condoms sold in the country were recalled in 2004 and 2005 because of quality issues, which led to a shortage in the country, according to the Lancet. Although a potential increase in HIV prevalence is a "worrying trend, Uganda continues to make good progress in boosting access to antiretroviral drugs," the Lancet reports. The country has increased the number of HIV-positive people receiving antiretroviral treatment from 25,000 in June 2004 to nearly 100,000 currently, and the government aims to have 120,000 on antiretroviral treatment by 2007. According to some observers, the treatment figures are the highest of any African country, but about half of the HIV-positive people in the country who need antiretrovirals are not receiving them. According to the Lancet, the reasons for the increase in antiretroviral drug access include lower drug prices and funding from the President's Emergency Plan for AIDS Relief and the Global Fund To Fight AIDS, Tuberculosis and Malaria. Some health officials said that Uganda already had the health infrastructure needed to "roll out" the program, the Lancet reports. Some local and international health groups have called on the government to offer viral load testing at no cost for HIV-positive people (Wakabi, Lancet, 4/29).

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