HIV community prevention delivery system in Uganda
| Country | Uganda |
|---|---|
| Type | Community-based HIV prevention |
| Coordinated by | Uganda AIDS Commission Ministry of Health |
| Delivered by | Community health workers, Village Health Teams, NGOs, faith-based organizations |
| Key services | HIV testing, counselling, condom distribution, PrEP, VMMC, PMTCT, health education |
| Major funders | PEPFAR Global Fund |
| Partners | UNAIDS, WHO |
The HIV community prevention delivery system in Uganda refers to the network of community based mechanisms usedd to deliver HIV prevention services in Uganda. Rather than relying solely on hospitals and health centres, this approach brings prevention services, such as HIV testing, counselling, condom distribution, pre-exposure prophylaxis (PrEP) and health education directly into communities through community health workers, villages health teams, non-governmental organizations andt faith based organizations.[1]
Community based delivery has long been part of Uganda's national HIV response, which is coordinated by the Uganda AIDS Commission and the Ministry of Health and supported by international partners including UNAIDS, the World Health Organisation (WHO), PEPFAR and the Global Fund.[2][3][1]
Background
Uganda was one of the first African countries to mount a large scale public response to the HIV/AIDS epidemic in the late 1980s and early 1990s. The national response of that period, often summarised by the "ABC" message (Abstain, Be faithful, use Condoms), has been widely discussed in public health literature, and HIV prevalence in Uganda declined during the 1990s.[1][4] [5]The epidemic later stabilised, and attentionshifted toward sustaining prevention gains and reaching populations harder to serve through facility based care.[1]
Delivery mechanisms
Community health worker and village Health Teams
Community health workers, including members of Uganda' village Health Teams (VHTs), provide health education, referrals and basic prevention services at the village level, linking communities to the health systems.
Community-based testing and self-testing
HIV testing is delivered outside health facilities through door to door campaigns, outreach events and mobile clinics. HIV self-testing has been promoted to increase uptake and reach people who do not attend clinics.[6][7]
Other prevention services
Community channels also support condom distribution, pre-exposure prophylaxis, voluntary medical male circumcision (VMMC), and the prevention of mother-to-child transmission (PMTCT), as part of a combination-prevention strategy.[6][1]
Outcomes and challenges
Community-based delivery has been credited with extending the reach of prevention services and improving test uptake.[7][8] In the Rakai region, the scale-up of combination prevention has been associated with a decline in HIV incidence.[9] Reported challenges include reliance on external funding, retention of community health workers, stigma, and reaching key populations.[10]
References
- 1 2 3 4 5 User, Super (2021-02-23). "National HIV and AIDS Strategic Plan 2020/21 – 2024/25". Uganda AIDS Commission. Retrieved 2026-06-09.
{{cite web}}:|last=has generic name (help) - ↑ "Uganda". The Global Fund to Fight AIDS, Tuberculosis and Malaria. Retrieved 2026-06-09.
- ↑ Mezei, Alex; Trawin, Jessica; Payne, Beth; Rawat, Angeli; Naguti, Priscilla; Orem, Jackson; Murray, Melanie C.M.; Nakisige, Carolyn; Ogilvie, Gina (February 2024). "Acceptability of Integrated Community-Based HIV and Cervical Cancer Screening in Mayuge District, Uganda". JCO Global Oncology. 10 (10) e2200324. doi:10.1200/GO.22.00324. ISSN 2687-8941. PMC 10805429. PMID 38237095.
- ↑ Green, Edward C.; Halperin, Daniel T.; Nantulya, Vinand; Hogle, Janice A. (July 2006). "Uganda's HIV prevention success: the role of sexual behavior change and the national response". AIDS and Behavior. 10 (4): 335–346, discussion 347–350. doi:10.1007/s10461-006-9073-y. ISSN 1090-7165. PMC 1544373. PMID 16688475.
- ↑ Maganda, Albert; Hearst, Norman; Kajubi, Phoebe; Hudes, Esther S.; Green, Edward C. (2011). "Prevention messages and AIDS risk behavior in Kampala, Uganda". AIDS Care. 24 (1): 87–90. doi:10.1080/09540121.2011.582478. ISSN 0954-0121. PMID 21711168.
- 1 2 "Consolidated guidelines on HIV testing services, 2019". www.who.int. Retrieved 2026-06-09.
- 1 2 Organization, World Health (2016-11-24). Guidelines on HIV self-testing and partner notification: supplement to consolidated guidelines on HIV testing services. World Health Organization. ISBN 978-92-4-154986-8.
- ↑ Havlir, Diane V.; Balzer, Laura B.; Charlebois, Edwin D.; Clark, Tamara D.; Kwarisiima, Dalsone; Ayieko, James; Kabami, Jane; Sang, Norton; Liegler, Teri; Chamie, Gabriel; Camlin, Carol S.; Jain, Vivek; Kadede, Kevin; Atukunda, Mucunguzi; Ruel, Theodore (2019-07-18). "HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa". The New England Journal of Medicine. 381 (3): 219–229. doi:10.1056/NEJMoa1809866. ISSN 1533-4406. PMC 6748325. PMID 31314966.
- ↑ Grabowski, M. Kate; Serwadda, David M.; Gray, Ronald H.; Nakigozi, Gertrude; Kigozi, Godfrey; Kagaayi, Joseph; Ssekubugu, Robert; Nalugoda, Fred; Lessler, Justin; Lutalo, Thomas; Galiwango, Ronald M.; Makumbi, Fred; Kong, Xiangrong; Kabatesi, Donna; Alamo, Stella T. (2017-11-30). "HIV Prevention Efforts and Incidence of HIV in Uganda". The New England Journal of Medicine. 377 (22): 2154–2166. doi:10.1056/NEJMoa1702150. ISSN 1533-4406. PMC 5627523. PMID 29171817.
- ↑ Zakumumpa, Henry; Paina, Ligia; Ssegujja, Eric; Shroff, Zubin Cyrus; Namakula, Justin; Ssengooba, Freddie (2024-01-01). "The impact of shifts in PEPFAR funding policy on HIV services in Eastern Uganda (2015–21)". Health Policy and Planning. 39 (Supplement_1): i21–i32. doi:10.1093/heapol/czad096. ISSN 1460-2237. PMC 10803197. PMID 38253438. Archived from the original on 2026-05-16.