Kampala —

Concern over young girls and women dropping from HIV care programs undermines efforts

Despite significant strides in HIV treatment availability, a silent enemy lurks within communities -stigma. A recent surge in HIV infections in Uganda, particularly in areas like Mbarara, is linked to missed Antiretroviral Therapy (ART) doses perpetuated by persistent HIV-related stigma, raising concerns about treatment effectiveness and potential drug resistance.

Early this month, the Uganda AIDS Commission revealed that young girls between 16 - 28 years are increasingly getting HIV in Mbarara city and district with the prevalence rate standing at 8.4% and 14% respectively.

Michael Matsiko, the head of the Uganda AIDs Commission for the Southwestern region, expressed concern that the drop in young girls and women from HIV care programs undermines efforts to control the virus. He emphasised that the goal of suppressing HIV to reduce transmission risks is compromised when individuals discontinue their treatment.

"When HIV medications are delayed, even by small margins, the incomplete medication dosage creates a partial suppression of the virus, which promotes the production of treatment-resistant strains of HIV,"

He said that this is mostly caused by the stigma surrounding HIV which often drives people to keep their condition a secret, further complicating consistent treatment adherence.

"Many people remain unaware of the severe risks associated with discontinuing HIV treatment, leading them to make uninformed decisions about their health care,"

Derick Mbalya the Communication and PR Uganda Network of Young People Living with HIV (UNYPA) says that stigma can lead to depression, anxiety, and low self-esteem in people living with HIV (PLWHIV)

"These psychological effects can reduce their motivation and capacity to adhere to ART consistently. PLWHIV who experience stigma may withdraw from social support networks, which are crucial for emotional support and reminders to take medication,"

"This isolation can decrease adherence to ART,"

He adds that stigma often discourages people from disclosing their HIV status.

"This fear can prevent individuals from taking their medication in the presence of others or seeking help when facing challenges with their treatment,"

According to studies, less than half of those in HIV care in Uganda achieve 85% adherence to their ART medication required for clinically meaningful viral suppression, leaving them at higher risk of transmission.

Since the start of HIV, negative social attitudes have hurt efforts to fight the disease. People fear being judged if they get tested or treated, making it harder to control the virus.

Adherence to ART is considered the most effective way of handling HIV to prevent opportunistic infections and complications for People Living with HIV (PLWHIV). ART programs are conducted long-term; therefore, they require patients' commitment to taking medication regularly throughout their lives

Mbalya advises that ending AIDS must be premised on ending fear, stigma, discrimination, and other relevant conditions that fuel infections and to address HIV-related stigma requires a comprehensive approach involving education, policy, community engagement, and individual support.

"Public health campaigns such as the YPlus Beauty Pageant aim to increase awareness about HIV, how it is transmitted, and how it is not transmitted. These campaigns often seek to dispel myths and misinformation about HIV/AIDS including stigma and discrimination,"

He adds that incorporating comprehensive HIV education in school curriculums informs young people early on about the disease and promotes understanding and empathy.

"This would allow young people to gain a comprehensive understanding of the disease from a young age, fostering empathy and chipping away at the stigma that hinders progress,"

He added that enacting and enforcing anti-discrimination laws to protect PLHIV from being discriminated against in employment, healthcare, and other areas.

"We are advocating for policies that promote the rights and dignity of PLHIV, including access to treatment and care,"

At least 1.4 million people are living with HIV in Uganda. The government has set ambitious targets to reduce new HIV infections by 65% by 2025 and ultimately achieve zero new cases by 2030.