As reflected in our strategic plan (2009-2013)the goal of our HIV & AIDS program is to contribute to the reduction in the number of annual new HIV infections in Uganda (estimated at 124,000 in 2009 and stagnant at 6.4% prevalence rate among adults aged 15-49 years), increase coverage, demand and utilization of quality HIV prevention and support services and promoting an environment free of fear, stigma and discrimination, where individuals, families and communities initiate actions that prevent transmission and acquisition of HIV. Following Uganda’s new national HIV Prevention Strategy, URHB’s HIV&AIDS interventions for 2011 have been premised on Combination HIV Prevention targeting the most at risk populations and the most underserved including the Lake Victoria Island communities.
The Combination HIV prevention entails prevention packages that combine various arrays of evidence-based strategies, tailored to the needs of diverse subgroups and targeted to achieve high coverage for a measurable reduction in population-level HIV transmission. This is because no single HIV prevention strategy will be sufficient to control the HIV pandemic yet many interventions have shown promise in partially protecting against HIV transmission and acquisition, including knowledge of HIV sero -status, behavioral risk reduction, condoms, male circumcision, treatment of curable sexually transmitted infections, and use of systemic and topical antiretroviral medications by both HIV-infected and uninfected persons among others.
According to the second phase strategy of the President's Emergency Plan for AIDS Relief (PEPFAR) - the U.S. Government initiative to help save the lives of those suffering from HIV/AIDS around the world, Data from country-specific incidence surveys has shown that there is not a single HIV epidemic within any given country. Rather, multiple epidemics exist within diverse populations and social networks, including concentrated epidemics within larger generalized epidemics. Identifying and targeting interventions to match the needs of multiple populations is difficult, especially when such epidemics involve groups that are often marginalized and discriminated against.
Stigmatized populations are frequently hidden and hard to reach with services. Effectively addressing a country's HIV epidemic must involve mutually reinforcing interventions targeted to populations based upon epidemiological and demographic data. This is one to the reasons advanced to support comprehensive combination prevention responses to HIV &AIDS. The combination prevention approach is expected to promote effectiveness of biomedical, behavioral and structural interventions when delivered simultaneously to an agreed scale and intensity and with clearly defined linkages/referrals.