What Is HIV?
Standing for Human Immunodeficiency Virus, HIV leads to AIDS, which stands for Acquired Immune Deficiency Syndrome. When someone has AIDS, their immunity is attacked by HIV, gradually weakening it. This puts the person with the virus at higher risk of developing tuberculosis, lung cancer, high blood pressure, nerve damage, and other chronic illnesses.
HIV can be contracted through intercourse and the sharing of syringes, but is not transmitted through saliva or sweat.
What the virus does is damage or destroy T cells (also known as helper cells or CD4 cells) by merging with them, making them unable to fight off viruses or diseases that attack the body. After this, the virus produces more of itself to continue attacking the cells. This can go on for up to 15 years without detection, and that’s what makes HIV deadly. It is a silent killer.
The most common symptoms experienced by those suffering from HIV are flu-like symptoms, diarrhoea, mouth or genital ulcers, skin sores, itchiness, cracked lips, and boils. Note that HIV does not cause pink lips, so the superstitious belief that anyone with pink lips is HIV-positive is false. I actually grew up believing this myth because of how often I heard people associate pink lips with HIV.
Early discovery and early treatment automatically save a life. Not everyone with HIV will develop AIDS, but this is only possible if detection and treatment occur at an early stage. Treatments such as ARVs (Antiretroviral drugs) have gone a long way in supporting those with HIV to live more comfortably. These ARVs preserve and repair the damaged immune system, renewing the body’s ability to fight off infections. With ARVs, it is possible for the HIV infected to live till old age.
How Did HIV Enter Uganda?
It is unknown what the exact cause of the spread of HIV is, but in Uganda, it was first reported in Rakai District in 1982. According to research supported by USAID, Uganda was one of the first sub-Saharan African countries to experience the epidemic.
In the 1990s, Uganda had one of the highest prevalence rates, with locals blaming truck drivers for bringing the disease into the country.
How Did Ugandans React to the HIV/AIDs Epidemic?
Firstly, Ugandans nicknamed the disease ‘silimu,’ the Luganda version of the English word slim, because of how it slimmed its host. There was widespread fear because once you got the disease, death followed.
The government and organisations within the country started awareness campaigns. These campaigns helped educate Ugandans on how to stay safe. Since prevention is better than cure (and there was no existing ‘cure’ yet), all focus was on reducing the number of infections. Out of this, entities like TASO (The AIDS Support Organisation) were established. Straight Talk (1997) and Young Talk are some of the newspapers that circulated during that period, giving youth and adolescents unfiltered sex education appropriate for their age.
In the 1900s, Sarah Birungi, an educationist, was instrumental in spreading HIV awareness through plays like The Hydra, which she co-authored and The Riddle, which she edited.
Celebrated Ugandan musician Philly Bongole Lutaaya was also instrumental in the fight against AIDS and ending stigmatisation. He became the first prominent Ugandan to publicly disclose his HIV-positive status. Not long before he passed away in 1989 from the virus, he released an incredibly touching and relatable album entitled Alone & Frightened. His lyrics in the title track, “Today it’s me, tomorrow it’s someone else,” urged and still encourage collective action as one of the ways to deal with HIV and AIDS.
What Treatment works for HIV
Antiretroviral treatments are daily tablets taken to restore damaged helper cells. Since 2004, ARVs have been available to the public for free in Uganda. Once an individual registers for medication at any health centre in the country, they are eligible to receive free treatment from that centre. This has led to a significant reduction in HIV-related deaths and longer life expectancy for those infected.
Post-exposure prophylaxis (PEP) is also another method of treatment; however, it is not to be taken for extended periods. It is only used for emergencies. “Prophylaxis” means to prevent or control the spread of an infection or disease. PEP prevents the spread of HIV but only within 72 hours after possible exposure.
Lenacapavir was introduced this year. It does not require swallowing daily pills; instead, all one needs is an injection every six months. It’s the next best thing to a vaccine.
Most Prominent Reasons for Growing HIV Infections in Uganda Today
Sex education and condom promotion have been hushed due to the controversies surrounding them, especially within schools. Yet, during the peak years of HIV, these two practices greatly helped in curbing the number of infections.
Ojambo Emmanuel, a student at Mildmay Institute of Health Sciences, shares his take on why there is still a prevalence of HIV today, especially among the youth.
A 2013 study carried out on the reasons behind the growing rate of HIV infections amongst adolescents in Hoima aged 13-21, highlights unplanned sex, fear of buying condoms, attractive partners and presence of ARVs, as the most prominent factors. These reasons are not only limited to Hoima, but can also be seen as contributing to the spread in other regions within the country and across the globe in 2025.
Unplanned sex was seen in 35% of cases, making it the highest reason for the rise in infections. Spontaneous (unplanned) sexual relations barely give room for protection or caution. The heat of the moment leads to rushed decisions that both parties will end up regretting, but only after they are both satisfied. When sex is planned, it allows both parties to be more cautious and to take the necessary steps, such as purchasing condoms.
Fear of buying condoms was seen as the second-highest reason, at 29%. Buying condoms means one is sexually active; for some, they wouldn’t want the public, or even just the shop attendant, to know they are active. Purchasing condoms equates to harsh judgment from onlookers, especially for an adolescent. Why is a child buying condoms? This has paved way for lengthy debates on the introduction of condoms to children. The fact is that many are sexually active, so equipping them with knowledge of the availability of protection goes a long way in curbing STIs, HIV and early pregnancies.
Others, however, believe these children should be taught abstinence and nothing else. In other words, the argument goes that if children are taught not to have sex, they will follow that guidance. I’ll let you decide which side of the debate makes more sense.
On the flip side, many do not use condoms because they feel condoms spoil the sweetness of sex. Protection is instead seen as a barrier, leaving them exposed to contracting or spreading the virus.
At 22%, attractive partners were seen as another huge reason for rising infections. It could be your partner or someone else’s partner that triggers the desire within. Even today, beautiful people cause others to stumble and make rash decisions. A fire waist, a chiselled body, and all sense is thrown out the window, leading to the biggest reason for the continued spread of the virus: unplanned sex.
The other very common reason, at 10%, is the presence of ARVs. Since their introduction, ARVs have provided a sense of relief, and indeed, they have turned the tables. Because of their availability, many have thrown caution aside and continued living carefree lives devoid of any caution. Today, many say they’d rather get HIV than any other disease because there is treatment that allows one to live a comfortable life with no limitations.
Mutesigensi Ivan, a nutritionist at Kayunga Regional Referral Hospital, says the biggest reason infection rates are still high today is the availability of treatment, making the disease seem like a cold or malaria.
A 2023 HIV and AIDS fact sheet revealed that infections among women aged 15-49 were 6.5%, while the percentage of infected men was 3.6%. This shows that women are at a higher risk of contracting the virus in comparison to men. On the other hand, these numbers could also indicate that some men are less likely to visit health centres or get tested, which may result in their infections being underreported.
Another reason for HIV prevalence that isn’t part of the study is the fear of testing. Many Ugandans have died or lost loved ones because of the deeply rooted fear of finding out they were HIV-positive. Individuals experiencing all the symptoms of the virus stubbornly refused to get tested or even just start taking the ARVs. The fear is so strong that some say they would rather get pregnant than have HIV.
Eradicating HIV/AIDs Stigma in Uganda
Since the 1980s, a great deal has been done to provide key stakeholders and the public with guidance on stigma and discrimination, enabling them to take appropriate actions to protect themselves and their communities. For this very reason, the National Policy Guidelines on Ending HIV Stigma and Discrimination were developed.
One of the policy measures from these guidelines ensures that all citizens and residents share a responsibility to prevent HIV stigma and discrimination within their families, communities and society. This highlights the importance of collective effort in eradicating stigma around HIV and AIDS.
HIV and AIDS have gradually become normalised within the country. A significant decline in stigma, together with a substantial increase in awareness, has helped ensure that the number of cases decreases each year.
While treatment has made living with HIV possible, no Ugandan should let it replace caution. Prevention through testing and using protection remains the best defence. Ultimately, the fight against HIV and AIDS relies on all of us working together, just as Philly Lutaaya urged: “Let’s stand together to fight AIDS.”
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