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ARVs access, complacency to blame for rising Aids prevalence in Uganda

Friday December 09 2016

After years of progress in the fight against HIV/Aids, statistics now show that Uganda is retrogressing, with experts saying that access to anti-retroviral drugs (ARVs) could be the reason for new infections.

Although Uganda has seen a 68 per cent decrease in mother-to-child transmission through use of ARVs, HIV experts argue that the same drugs are also responsible for furthering the spread — as people have become complacent, believing that they have available medication.

Again, some of the people already on medication often fail to adhere to the prescription, leading to secondary problems like drug resistance and new infections.

There is no vaccine against HIV, but research has led to discoveries of medication that can suppress the amount of virus in the blood (viral load). When the viral load is low, HIV-positive persons do not fall sick. With medication, the virus becomes undetectable and a person’s capacity to infect others is reduced.

“That does not mean that you have healed, because the virus escapes to the lymphatic system, where it hibernates for years and gradually changes in form,” said Alex Ario, a medical doctor. “The lymphatic system at one point mixes with blood so, when HIV detects that it is not containing drugs, it ‘wakes up’ and that is why stopping antiretroviral treatment is dangerous: The earlier medication becomes ineffective and one becomes resistant.”

“Adherence is not only taking the drugs every day, but also taking them consistently,” said Dr Mary Kiconco, clinical services coordinator.

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Close to 2.6 million Ugandans have been infected with HIV, but fewer than one million are on treatment.

Uganda was commended as the most successful story globally for bringing down prevalence from 30 per cent in the 1980s to 18 per cent in the 1990s and 6.4 per cent in 2006. But today, the country’s prevalence rate is on the rise, standing at 7.3 per cent.

“In the past, the anti-HIV messages were strong and vigorously communicated. Those days it was easy to communicate strategies like abstinence because HIV-positive persons looked sickly. Today, with medication, you can barely tell who is positive and who is not. ARVs are responsible for the spread,” said Florence Awor, senior counsellor at Reach Out Mbuya.

Experts note that the current messages are numerous but lack focus, which makes them unsuitable to fight stigma, protection of HIV-negative persons and prevention of spread of new infections.

People are even hiding ARVs from their sexual partners to conceal their status. Some keep the drugs at their places of work or with neighbours or disguise the original drug packaging as medicine for curable diseases.

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