Epidemiology of AIDS in Uganda - Essay Example

Epidemiology of HIV/AIDS in Uganda Over the last three decades, the world has been facing the most challenging and complicated health problem in the history. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) which has come to be indicated not as an isolated syndrome, but as the serious manifestation of clinical and subclinical cases caused by HIV(Bokazhanova et al, 2006, p.3). In 1991, The AIDS is classified by the national commission on AIDS as the most deadly diseases transmitted sexually (Umeh 1997, p xv). However, several African countries have estimated as the most epidemic infection with HIV (Piolt et al, 1992,p.2). There are three primary modes for transmitting HIV: sexual contact (either homosexual or heterosexual) with an infected person, direct exposures to blood or body secretions such as semen or breast milk, sharing needles between intravenous drug users, and by perinatal route from HIV positive mothers to their babies (Devita et al, 1992, p. 111). Globally, the peak up of HIV infection was in late of 1990s and it declined between 2001 and 2008 from 3.2million to 2.7 million respectively. However, HIV infections still continue to prevail. More than 7,400 new HIV infections were identified in 2008 on daily basis (Kaiser Family Foundation 2009). According to the World Health Organisation (WHO) in 2009, 33.4 million people have been estimated as HIV positive; also about 2 million people have died by the illness related to HIV in 2008. In gender term, Women represent nearly half of the patients living with HIV worldwide, statistically about 15.7 million women. which means that HIV infection equally spread among the both genders male and female. In 2008, 2.1 million children who are still living with epidemic, 430,000 cases were indicated as new infections, and 280,000 AIDS deaths among children. Approximately 17.5 million AIDS conditions are orphans (children who have lost one or both parents to HIV). most of them live in sub-Saharan Africa nearly 81 %( Kaiser Family Foundation 2009). In Africa, 35% of children and adult who attended to the major hospital in central Africa were HIV infected (Piot et al, 1992,p.2). Furthermore, the worst epidemic region is sub-Saharan Africa where 25.3 million people living with HIV. In Southern Africa resides more than one-third of AIDS sufferers worldwide. HIV/AIDS has been considered as a main cause of deaths among young people in Southern Africa and current surveys show that most incidences were among individuals below 16 years. (Gouws et al.2008). In Africa, The main risk factors for HIV infection involve multiple heterosexual partner which consider as dominant mode of HIV transmission fallowed by blood transfusions and finally mother to infant before or after birth (during breastfeeding)(Piot et al, 1992,p.13). In addition, about 97% of the HIV cases belong to the low or middle income countries including the countries where the conditions are much like sub- Saharan Africa. Also, poor education conditions and lack of awareness, limited access to health care and treatment are associated factors for the increase in HIV incidence in most African countries including Uganda, that is one of the most infected countries by HIV and the conditions there were as poor as the rest of Africa until now when they started resisting and fighting back the dilemma. Furthermore, this paper will focus on the epidemiological situation of HIV/AIDS within Uganda. Firstly, the population composition the nature and condition of the region will be considered and some HIV history throughout Uganda. Secondly, addressing the conditions among the women and children affected and their issues are discussed in this paper. At the end, it will address the decline, situation among high-risk groups with poor lifestyle choice as well as dangerous sexual behaviour and the numeric success experiences. Uganda was one of the earliest countries which has experiences AIDS epidemic and it is still suffering from its effects. Uganda is one of the African country which is surrounded from west to Kenya and from east to the Democratic Republic of the Congo (both of them have a significant incidence of HIV/AIDS). The population is estimated in 2011 at 34,612,250 whereas male and female account is approximately the same. In addition estimated life span of the population in 2011 is about 52.17years for men and 54.33 for women (CIA 2011). In 1983, the first AIDS case was diagnosed at Kasensero village, after two years of which definition the AIDS condition in the United States and central Africa was laid (Kisekka, M 1990). According to the history, HIV epidemic in Uganda, the AIDS was referred as SLIM as a consequent symptom of weight loss. According to a survey which was done in 1988; the AIDS rate in Uganda, also named as a third highest African countries and seventh in the world of the 5455 cases, that 48% of them were male and 52% were female where in most of these cases HIV was transmitted through heterosexual relations and it had consequently effected the younger generation more devastatingly then the older people, causing the high mortality rate among the youngsters (Kisekka, M 1990). The important stage is 1990s where the HIV epidemic was in its peak across the world, also in Uganda had serious circumstances regarding the prevailing disease. During 1991, when there was the highest percentage of HIV among adult which was more than 20%. This percentage was undeviating connected to increase in the number of orphans and birth rates as well as financial and social crisis (Low-Beer et al, 1997). In 1999, it is believed that about 110000 people have died due to AIDS and its related diseases (Kironde et al, 2002). It is estimated that between 1992 and 2004, the HIV prevalence significantly decline from 12.3% to 6.4% respectively which explain successfully change in population behaviour and communication response to restrict the HIV prevalence (Hladik et al, 2007). the country of Uganda has the success story of backtracking the wave of AIDS/HIV, having reduced the prevalence of the disease, which was one of the most severe disease from late 1980s till early 1990s.Human immunodeficiency virus is the cause of Acquired immune deficiency syndrome .it can be transmitted by direct contact of mucous membrane or blood stream by a body fluid having HIV such as blood semen viginal fluids, breast milk , preseminal fluid, so if some of the causing factors could be controlled the spread of the disease could be prevented. Origin of AIDS was from Africa and it is still causing devastating effects all over the continent. Uganda was the very first country which experienced the impact of the AIDS and started showing its resistance against the prevailing epidemic .It needed a lot of strength, energy, care and commitment to prevent and aware the population of this prevailing and ravaging disease. In 2003, the estimated magnitude of the population to be infected with AIDS was 4.1% which is lower than the highest AIDS affected African country (sub-Saharan) which is overall 7.5%, while it is still above the global rate which is 1.1% (Kaiser Family Foundation 2009). More than 60% of adult women are accounted to having HIV/AIDS and more than 78,000 Ugandans died of HIV/AIDS in 2003. In addition, the Percentage of young men, ages 15-24, estimated to be living with HIV/AIDS is 1.6 – 2.4%, whereas young women at the same age is 3.7 – 5.6%. However, the rate of HIV prevalence among young people ages 15-24 is lower than those ages 25-29 and 30-34(Kaiser Family Foundation 2009). Comparing between rural and urban areas, there are significant increase in HIV incidences in urban areas. According to seven-year trends study from 1990 to 1997, the HIV/AIDS condition had a significant decline from 8.2% to 6.9% and it is clear that it is decreasing among men between the age group of 20-24 years from 11.7% to 3.7%. These changes gave the evidence of behaviour alteration and increase in awareness related to the deadly virus, that caused the increase use of protection during sexual intercourse by condom use, any other type of contraceptive, and decline in physical relationships before marriage which is supported by Abstinence approach and other comprehensive sexual education programmes. It is widely clear that the epidemic impact throughout Uganda was devastating, starting with the highest in Gulu city to the lowest in Moroto in HIV prevalence rate (Kaiser Family Foundation 2009). In addition, women and children have a high incidence of HIV/AIDS in Uganda. In 2005, 7.5% of women aged 15-49 years become infected with HIV and it is estimated that new infection may be found among younger female group aged between 15-24 years, while among men in the age group of 25- 34 years (Hladik et al, 2007). young women are more disproportionately affected by HIV/AIDS, they are more likely to acquire the condition four times more than men in the same age of 15- 24 years which means 5 percent of them in this age are HIV positive and susceptibility is more among younger women of this age. The cultural discrimination and social inequalities between genders play a main role to make Ugandan women more vulnerable to HIV than men. Moreover, early marriage and the pressure of poverty can lead young women to take risks with their health in order to provide the basic needs for herself or for her family (Nicholas, R 2010). This also can be demonstrated by that women have abundant sexual harassment consequences and reproductive issues. For example, there was no AIDS condition defined in the north of Uganda until 1986 when the battle shifted to this area. The prevalence of HIV was with one of the soldiers which combined with their habitual harassment of women caused the spread of the allment. In addition, there were several cases of babies born with AIDS virus and many of them did not survive a long time. This perinatal rout of HIV transmission during the positive HIV pregnant leads to many negative impacts including mental and physical association and more childbearing attrition in women (Kisekka, M 1990). Furthermore, the number of children becoming HIV infected has increased in Uganda. In 1999, there were one million children under 15 years, who were living with HIV/AIDS and they were AIDS-orphans (the children who lose their mother or their father or both of them in AIDS condition) (Sarker et al, 2005). In addition, 84,000 Ugandan children were estimated to be living with HIV/AIDS and it was estimated that 940,000 of them were orphans at the end of 2003(Kaiser Family Foundation 2005). In central of Kampala in Uganda, there were 41% of AIDS orphans in 2005. This finding supported that most of the AIDS orphans lost both their parents and they become a major public economical and social problem considering their numbers. The positive aspect is that a number of relatives or family members such as grandmothers and aunts usually care well for the orphan children until they become old enough to support themselves (Sarker et al, 2005). However, these results demonstrate that women and children are facing many challenges to cop up with the HIV consequence as well as suffering from violence, poor education, poverty and sexual crimes and this can contribute to rise HIV rates among both women and children group. They are the true victim of the calamity. However, Uganda has become a successful example to reducing the HIV/AIDS prevalence by different methods. Communication, behaviour change and caring response were the first step to tackle with the epidemic of HIV/AIDS in the most regions in the Uganda. The first sign for stability and decrease in the HIV/AIDS rate was determined in the early 1990s. This is demonstrated by reduction of HIV cases among pregnant women attending antenatal clinic sentinel surveillance sites (ANC) peaked at 21,1% in 1991 and dramatically declined to 9.7% at the end of 1998 (Low-Beer et al,1997). In the city of Kampala the level of HIV positive pregnant women fell from 31% to 14% during the years of 1993 to 1995. According to the Kyamulibwa Medical Research Council cohort that a significant decline of the HIV prevalence across adult group of all ages from 8.00/1000 persons in 1990 to 5.2/1000 persons in 1999(Samson H et al, 2002). In addition, these declines were across Africa. Nearly 15 antenatal clinic states that HIV prevalence decrease from 21.1 % to 9.7% nationally between 1991 and 1998(Low-Beer et al, 1997). According to the World Health Organisation, non-regular sexual partners decreased in urban areas from 41% to 20% among men and from 22% to 8% among women, and in rural areas the decline was from 37% to 13.5% for men and from 17% to 5% for women over the period 1989 -1995. In June 2005, The Number of people who receiving antiretroviral therapy (ART) are accounted at 52,000 – 64,000 and those who cannot obtain (ART) estimated at 90,000(Kaiser Family Foundation 2005).The “social vaccine” has 75% efficacy than other medicinal approaches for many reasons. First reason is an epidemic alternation course during the matter of years despite the poor resource in this country. Secondly, a remarkably change in the population behaviour in order to avoiding and reducing epidemic risk (Low-Beer et al, 1997). In conclusion, African countries have been facing a severe condition HIV/AIDS which has a huge impact on all the communities and even on social and economic aspects of the societies. The situation in Uganda is not different from the other African countries. New infection cases and the death rate are still most challenging in front of Ugandan people who engage in risky heterosexual behaviour. Moreover, Women and children are more vulnerable and they are considered as the group at highest risk, as well as victim of social violence and community ignorance. However, in last years, Uganda is successful in decreasing the number of HIV/AIDS infection, reducing the incidences of deaths as well as improved women and children protections ways. Therefore, the government of Uganda should try to continue this improvement and they should implement new legislations which encourage the government and non-government organisations to provide such as information, treatment, and free (ART) vaccine for those who cannot access the health sources. Hence, with good awareness and good cooperation between all individual and all government sectors, the epidemics of HIV/AIDS may be limited and resolved in Uganda and in other African countries. Refrences: 1- Umeh, D 1997, Confronting the AIDS epidemic: cross-cultural perspectives on HIV/AIDS education, 1st edn, African world Press, Inc. Canada. 2- Piot, P, Kapita,BM,Ngugi,EN, Mann,J M, Colebunders,R & Wabitsch,R 1992, AIDS in Africa: a manual for physicians, 1st edn, World Health Organisation, England. 3- Devita, VD, Hellman, S, Rosenberg, SA, Curran, J, Essex, M, Fauci, AS 1992, AIDS Etiology, Diagnosis, Treatment and Prevention, 3rd edn, J. b. 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