Many people living with HIV in rural areas are developing drug resistance due to lack of access to their daily antiretroviral drugs (ARVs), lack of food and drug stock-outs and shortages.
Some of the patients especially in rural areas lack the transport to take them to health centres to pick the drugs or buy the required food. Margret Kakembo, the chairperson, National Forum of People Living with HIV Network Uganda (NAFOPHANU) said according to their own survey, many people living with HIV in rural areas, are facing a lot of challenges of missing meals yet the ARVs can't work effectively without food.
Moreover, she said, most couples in rural areas only find out about their HIV status when the women go for antenatal visits. Kakembo revealed this while meeting with different Ugandan HIV health activists that are heading to South Africa to pitch on the demands in key priorities that are needed by the People Living with HIV (PLHIV) in order to support their health to live longer.
The key priorities that are demanded by Ugandan health activists from U.S. President's Emergency Plan for AIDS Relief (PEPFAR) include supporting People Living with HIV (PLHIV), to get transport facilitation to pick drugs from health centres. Others are; avoiding stock-outs and shortages of ARVs, introducing youth friendly facilities at health centres, fighting stigma and discrimination which continue to fuel the spread of HIV in the country.
"At the moment many PLHIV are developing drug resistance, Tuberculosis (T.B), cancer and children living with HIV also don't have viral load suppression, due to lack of transport to pick their drugs from the long distance health centres," Kakembo said.
The health activists are using information gathered in February 2019 during community consultations and additionally through facility monitoring carried out at seven PEPFAR support sites in different parts of the country with high HIV burden such as Mbale, Jinja, Lira, Tororo among others.
Kakembo said, some children in boarding schools, miss out their ARVs because they don't have support from their teachers and matrons which causes drug resistance among them and also causes stigma.
"Due to stigma at schools, especially boarding section, sometimes children take drugs at different time and the drugs end up not working well hence it causes drug resistance," she says.
The health activists also advocate for empowering PLHIV to understand their own viral load and what it means for their long-term health and their risk of transmitting the virus to another people through sexual intercourse.
"There is a clear evidence that early treatment benefits the health of PLHIV and HIV related diseases like cancer, T.B and others can be prevented," Kakembo says.
According to UNAIDS country director, Karusa Kiragu, about 1.3 million Ugandans are living with HIV/Aids and about 1.1 million of them have access to antiretroviral treatment. However she says despite this important achievement, much more needs to be done to achieve epidemic control in Uganda and truly defeat HIV.
"In 2018 alone, 28,322 people died needlessly of HIV/Aids related illnesses in the country and still each year 48,254 people newly acquire HIV. PEPFAR's most recent program data indicate persistently low retention and poor quality treatment program performance at a level that is gravely concerning," she says.
Kiragu says, according to current UNAIDS statistics, 223 new infections occur among girls on yearly basis and this means that there is an urgent intervention by PEPFAR to fight the HIV pandemic. Substantial barriers are obstructing attainment of the goal of defeating HIV as an epidemic by 2030 in the country.