THE REPUBLIC OF UGANDA GLOBAL AIDS RESPONSE PROGRESS REPORT COUNTRY PROGRESS REPORT UGANDA Uganda AIDS Commission April 2012 Kampala Global AIDS Response Progress Report: Uganda Jan 2010-Dec 2012 TABLE OF CONTENTS TABLE OF CONTENTS ..................................................................................................................................... ii List of Tables ....................................................................................................................................................... iv List of Figures ....................................................................................................................................................... v ACKNOWLEDGEMENTS ................................................................................................................................. vi ACRONYMS ...................................................................................................................................................... vii 1. STATUS AT A GLANCE ................................................................................................................................. 1 1.1 The Report Writing Process .......................................................................................................................... 1 1.2 The Status of the Epidemic ........................................................................................................................... 1 1.3 The Policy and Programmatic Response ....................................................................................................... 2 1.4 The Indicator Table ...................................................................................................................................... 4 2.OVERVIEW OF THE AIDS EPIDEMIC......................................................................................................... 6 2.1 HIV Prevalence ........................................................................................................................................... 6 2.2 Incidence of HIV Infection ......................................................................................................................... 10 2.3 The Impact of the Epidemic ........................................................................................................................ 11 3. NATIONAL RESPONSE TO THE AIDS EPIDEMIC ................................................................................. 13 3.1 National Commitment and Action ............................................................................................................... 13 3.1.1 Sources of Funds ................................................................................................................................ 13 3.1.2 Spending of Funds .............................................................................................................................. 15 3.2 Policy / Strategy Development and Implementation..................................................................................... 15 3.2.1 Government Officials Assessment ....................................................................................................... 15 3.2.2 Non-Government Assessment ............................................................................................................. 16 3.3 Prevention ................................................................................................................................................. 17 3.3.1 People Living with HIV ...................................................................................................................... 17 3.3.2 HCT ................................................................................................................................................... 19 3.3.2 PMTCT .............................................................................................................................................. 20 3.3.3 HIV Prevention Programmes for MARPs ............................................................................................ 25 3.3.4 Knowledge and Behaviour .................................................................................................................. 27 3.4 Care and Treatment ................................................................................................................................... 34 3.4.1 ART ................................................................................................................................................... 34 3.4.2 Tuberculosis and HIV Collaboration ................................................................................................... 36 3.5 Social Support ............................................................................................................................................ 36 3.5.1 Physical and Sexual Violence.............................................................................................................. 36 3.5.2 School Attendance among OVCs and Non-OVCs ................................................................................ 37 3.5.3 Economic Support .............................................................................................................................. 38 4. BEST PRACTICES ........................................................................................................................................ 40 5. MAJOR CHALLENGES ............................................................................................................................... 42 ii Global AIDS Response Progress Report: Uganda Jan 2010-Dec 2012 5.1 Challenges in UNGASS Report 2010 and Remedial Actions ........................................................................ 42 5.1.1Challenges ........................................................................................................................................... 42 5.1.2 Remedial Actions ............................................................................................................................... 42 5.2 Challenges faced January 2010-December 2011 ......................................................................................... 44 5.3 Remedial Actions January 2012-December 2013 ........................................................................................ 46 6. SUPPORT FROM DEVELPMENT PARTNERS ........................................................................................ 48 6.1 Key Support from AIDS Development Partners ........................................................................................... 48 6.2 Actions Needed from AIDS Development Partners ...................................................................................... 50 7. MONITORING AND EVALUATION ENVIRONMENT ........................................................................... 52 7.1 Overview of Current Monitoring and Evaluation System ............................................................................. 52 7.2 Challenges in Implementation of Monitoring & Evaluation System ............................................................. 52 7.3 Planned Remedial Actions .......................................................................................................................... 53 7.5 M&E Technical Assistance and Capacity Building Needed ......................................................................... 53 ANNEXES .......................................................................................................................................................... 54 Annex 1: Consultation / Preparation Process ................................................................................................... 54 Annex 2: National Commitments and Policy Index (NCPI) ............................................................................... 57 Part A ......................................................................................................................................................... 57 Part B .......................................................................................................................................................... 58 Annex 3: National Funding Matrix ................................................................................................................... 59 REFERENCES ................................................................................................................................................... 60 iii Global AIDS Response Progress Report: Uganda Jan 2010-Dec 2012 List of Tables Table 1: National Policies and Guidelines produced, 2010-2011 .................................................3 Table 2: Global AIDS Response Progress Indicators ...................................................................4 Table 3 : Trends in HIV incidence 2007–2010 using mathematical modelling ........................... 10 Table 4: Trends in People Living with HIV2007–2010 using mathematical modelling .............. 11 Table 6: Projection Figures using Spectrum Model ................................................................... 23 Table 7: Annual Procurement and Distribution of Male Condoms in Uganda, 2007/08-2010/11 33 Table 8: Distribution of ART Accredited Sites by Level, 2010 and 2011 ................................... 35 Table 9: Distribution of Clients on ART after 12 Months of Treatment Initiation