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The Hiv and Aids Uganda Country Progress Report 2014

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The Hiv and Aids Uganda Country Progress Report 2014 THE HIV AND AIDS UGANDA COUNTRY PROGRESS REPORT 2014 The First Lady of the Republic of Uganda and national EMTCT champion taking a public HIV test at Kololo grounds at the launch of the EMTCT campaign in KCCA Plot 1-3 Salim Bey Road, Ntinda Nakawa Division; P.O.Box 10779, Kampala- Uganda Tel: +256-414288065 Fax: +256-41-Email:[email protected] Website:http://www.aidsuganda.org 15th June, 2015 2014 Uganda HIV and AIDS Country Progress report Pagei NAFOPHANU National Forum of People with ABBREVIATIONS AND ACRONYMS HIV/AIDS Network in Uganda NASA National AIDS Spending Assessment ACP AIDS Control Program NDP National Development Plan AIDS Acquired Immune Deficiency NGO Non-Governmental Organization Syndrome NMS National Medical Stores AIS AIDS Indicator Survey NPAP National Priority Action Plan (for ANC Antenatal care HIV/AIDS) ART Antiretroviral Therapy or Treatment NSP National Strategic Plan (for HIV/AIDS) ARVs Antiretroviral Drugs NTLP National TB and Leprosy Control BCC Behaviour Change Communication Program CDC Centres for Disease Control NTRL National TB Reference Laboratory CPHL Central Public Health Laboratory OI Opportunistic Infection CSO Civil Society Organization OVC Orphans and Vulnerable Children DHS Demographic and Health Survey PACE Program for Accessible health, EID Early Infant Diagnosis Communication and Education eMTCT Elimination of Mother-to-Child PCR Polymerase Chain Reaction Transmission (of HIV) PEP Post-Exposure Prophylaxis FBO Faith Based Organization PEPFAR US Presidential Emergency Fund for GARPR Global AIDS Response Progress AIDS Relief Report PITC Provider Initiated HIV Testing and GFATM Global Fund to Fight AIDS, Counselling Tuberculosis and Malaria PLHIV People Living with HIV GOU Government of Uganda PMTCT Prevention of Mother To Child HBC Home Based Care Transmission (of HIV) HC Health Centre PNC Post Natal Care HCT HIV Counselling and Testing PREFA Protecting Families Against HIV/AIDS HIV Human Immunodeficiency Virus PrEP Pre-Exposure Prophylaxis HMIS Health Management Information QPPU Quantification and Procurement System Planning Unit HRH Human Resources for Health SCM Supply Chain Management IRCU Inter Religious Council of Uganda SRH Sexual and Reproductive Health JAR Joint AIDS Annual Review STI Sexually Transmitted Infection JMS Joint Medical Stores SWs Sex Workers M&E Monitoring and Evaluation TASO The AIDS Support Organization MAAIF Ministry of Agriculture, Animal TB Tuberculosis Industry and Fisheries THETA Traditional and Modern Heath MARPs Most-at-Risk Populations Practitioners Together against AIDS MDGs Mellineum Development Goals TWG Technical Working Group MEEPP Monitoring and Evaluation of PEPFAR UAC Uganda AIDS Commission Progress UNAIDS Joint United Nations Program on MOES Ministry of Education and Sports HIV/AIDS MOGLD Ministry of Gender Labour and Social UNFPA United Nations Population Fund Development UNICEF United Nations Children’s Fund MOH Ministry of Health UPDF Uganda People’s Defence Force MOIA Ministry of Internal Affairs USAID United States Agency for International MOLG Ministry of Local Government Development MSM Men who have Sex with Men VCT Voluntary Counselling and Testing MTCT Mother to Child Transmission VHT Village Health Team MTR Mid-Term Review WHO World Health Organization NACWOLA National Community of Women Living with HIV/AIDS 2014 Uganda HIV and AIDS Country Progress report Pagei Table of Contents ABBREVIATIONS AND ACRONYMS ................................................................................................. i 1 Executive Summary ................................................................................................................... iv I STATUS AT GLANCE .............................................................................................................. vii 1.1 Introduction ....................................................................................................................... vii 1.2 The Report Writing Process .............................................................................................. vii 1.3 The Status of the Epidemic ............................................................................................. viii Indicators Summary Table.............................................................................................................. i II Overview of the AIDS epidemic .................................................................................................. 8 1.1.2 HIV burden .................................................................................................................... 9 1.2.1 Key drivers of HIV incidence ...................................................................................... 11 II National response to the AIDS epidemic in 2014 .................................................................. 12 2.1 Overview ............................................................................................................................. 12 2.2 Progress under Prevention thematic areas ..................................................................... 13 2.2.1 Delivery of HIV prevention services in 2014 ............................................................ 13 2.3 Treatment, Care and support thematic areas ................................................................. 25 2.3.1 Treatment and Care ................................................................................................... 26 2.4 Support for PLHIV, HIV-affected families and other vulnerable households ................. 29 2.5 System Strengthening ....................................................................................................... 34 2.5.4 Community systems strengthening ........................................................................... 38 IV. BEST PRACTICES ..................................................................................................................... 39 V MAJOR CHALLENGES AND REMEDIAL ACTIONS .................................................................... 41 4.1 Progress made on key challenges reported in the 2013 Country Progress Report ..... 41 4.2 Challenges in 2014 and remedial actions for 2015 .................................................. 46 4.2.4 Infrastructure, Governance and Leadership .................................................................... 51 4.2.5 Monitoring and Evaluation ............................................................................................ 52 4.2.6 Financing and Costing ....................................................................................................... 53 Gender- priorities ......................................................................................................................... 54 5.0 Support from AIDS development partners .......................................................................... 55 5.1 Key support received from ADPs ...................................................................................... 55 5.2 Key concerns in relation to ADP support ......................................................................... 56 5.3 Actions that need to be taken by ADPs to ensure achievement of targets ................... 57 VII Monitoring and evaluation environment ............................................................................... 58 6.1 Overview of the current monitoring and evaluation (M&E) system ............................... 58 6.2 Challenges faced in the implementation of a comprehensive M&E system ................. 60 2014 Uganda HIV and AIDS Country Progress report Pagei 6.3 Remedial actions planned to overcome the challenges ................................................. 61 6.4 Need for M&E technical assistance and capacity-building ............................................ 62 ANNEX 1: Consultation and preparation process for the country report ................................. 62 LIST OF TABLES Table 1: Indicators summary table ................................................................................................ i Table 2: Estimation of burden of HIV in Uganda ........................................................................ 10 Table 3: Trends in HIV Incidence 2010–2014 using mathematical modelling Error! Bookmark not defined. Table 5: Number of Targeted Individuals Reached with Sexual and Behavioural Change Interventions: ............................................................................................................................... 23 Table 6 Coverage of ART Services by level of Facility as of Sept 2014, MoH 2014 ............... 26 Table 7: Retention on ART for Treatment cohorts completing 12 months in the first 3 quarters of 2014, MoH 2014 ..................................................................................................... 28 Table 8: PSWO OVC SERVED PER Core Programme Area for the period 2013/2014............ 33 Table 8: Progress in addressing challenges from 2013 GARPR and the June 2014 MTR..... 42 Table 11: AIDS Development partners Contribution to the national AIDS response .............. 56 Table 12: Projected Resources Availability and Funding Gap .................................................. 57 LIST OF FIGURES Figure 1: HIV Prevalence by region: 2004/5 and 2011 .............................................................. 8 Figure 3: Data from selected ANC sites in Uganda ..................................................................... 9 Figure 4: Trends of new infections, Net ART increase and
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