(June 2000) In a region hungry for good news about HIV/AIDS, Uganda can relish its gains in beating back the epidemic.

Declines in HIV infection, first noted in the East African country in 1993, have continued steadily and are especially striking among young, pregnant women, says the Joint United Nations Programme on HIV/AIDS (UNAIDS).

“What we’re seeing in Uganda is that there are declines in overall prevalence among pregnant women, and (especially) among the age group 15 to 19,” says Karen Stanecki, chief of the Health Studies Branch at the U.S. Census Bureau’s International Program Center. “By looking at pregnant women, we can see what the trends are, what’s happening in general,” she adds, explaining that pregnant women are relatively easy to track, since they regularly enter the health system and undergo various blood tests.

In this country of roughly 23 million people where life expectancy is a modest 42 years and 81 infants die for every thousand live births, HIV infection levels among pregnant women in major urban areas climbed to about 30 percent in 1992, some 10 years after the first case was reported. By 1996, however, the levels had fallen by almost 50 percent, says the Census Bureau’s World Population Profile: 1998.

The declines have been even more dramatic for women 15 to19 years old. At two large clinics for pregnant women in the capital, Kampala, the number of HIV-infected women in this age group plunged from 28 percent in 1992 to just 8 percent in 1997 — a more than 70 percent drop in five years, UNAIDS reports.

What accounts for these gains?

“A lot of different things,” says the Census Bureau’s Stanecki. “The involvement of the government, the involvement of grassroots organizations, the involvement of religious groups, delays in sexual onset, reductions in the numbers of partners, increased use of condoms. It’s because everybody has made this a priority that people feel this is a success story.”

The Ugandan government of President Yoweri Museveni was the first in Africa to acknowledge they had an epidemic on their hands and ask for help. Now, the Uganda AIDS Commission coordinates a national AIDS control program. And, mindful that heterosexual transmissions account for most infections in Uganda, the program includes major education campaigns designed to promote safer sexual behavior and curb the spread of the disease.

Still, as of 1997, some 930,000 Ugandans were living with HIV infections or AIDS, with an estimated 160,000 people having died of the disease in 1997 alone, says UNAIDS. Farther south, the infection rate for sub-Saharan Africa’s most severely hit countries — Botswana, Namibia, Swaziland, Zambia, and Zimbabwe — is estimated at 18 percent to 26 percent of all adults.


Yvette Collymore is senior editor at the Population Reference Bureau.