Understanding and Preventing HIV

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The Human Immunodeficiency Virus (HIV) attacks the body's immune system, gradually weakening its ability to fight infections and diseases. Over time, HIV can lead to Acquired Immunodeficiency Syndrome (AIDS), a condition where the immune system is severely compromised.

Uganda has made significant strides in reducing HIV prevalence, but it remains a public health concern. The Uganda AIDS Commission (UAC) reports that as of December 2022, 1,400,000 people were living with HIV/AIDS in Uganda. Reports further show that from January 2022 to December 2022, 17,000 people died from HIV-related illnesses. 

What are the signs and symptoms of HIV?

HIV has different symptoms depending on the stage of infection. Many people with HIV don't experience any signs and symptoms during the early stages of infection. Some people may have the following symptoms: 

• fever
• headache
• rash
• sore throat

As time goes on, the infection weakens the immune system. The infected person may experience:

• swollen lymph nodes
• weight loss
• fever
• diarrhoea
• cough.

After HIV infection, there is a period known as the window period (18 to 90 days after exposure), during which the virus may not be detectable in standard blood tests but can still be transmitted to others.

Knowing your HIV status

While these symptoms can be signs of HIV, it's important to remember that the only conclusive way to know your HIV status is through a test. 

There are different HIV tests available. These include rapid tests that provide same-day results and HIV self-tests that people can use to test themselves at home. 

However, it is not enough to do a single HIV test. To have satisfactory results, a qualified and trained health worker should conduct a confirmatory test using World Health Organization prequalified tests.

Can HIV be cured? 

No. Today there is no cure for HIV.  However, it can be treated with antiretroviral therapy or ART which stops the virus from multiplying in the body.

ART treatment does not cure HIV but strengthens the immune system. It reduces the amount of HIV in the body. When people living with HIV take ART treatments as recommended by the doctor, there will be no evidence of the virus in blood tests. This means they cannot transmit HIV to their sexual partners over time.

Can pregnant women with HIV take ART treatment?

Yes. Pregnant women living with HIV should start antiretroviral therapy as early as possible during pregnancy. This protects the mother's health and significantly reduces the risk of transmitting HIV to the unborn baby. 

What happens if HIV is left untreated?

People with HIV who do not receive treatment are at risk of developing serious illnesses such as:

• tuberculosis (TB)
• cryptococcal meningitis
• severe bacterial infections
• cancers such as lymphomas and Kaposi's sarcoma.
• AIDS- Acquired Immunodeficiency Syndrome

How is HIV spread?

• Sexual transmission: HIV is mainly transmitted through unprotected vaginal, anal, or oral sex.
• Mother-to-Child Transmission: A pregnant woman living with HIV can transmit the virus to her baby during pregnancy, childbirth, or breastfeeding. However, with proper treatment and interventions, this risk can be significantly reduced and even prevented.
• Sharing Needles: Sharing needles or syringes contaminated with HIV-infected blood can also transmit the virus.
• Blood transfusion. There is a high risk (greater than 90%) of acquiring HIV through transfusion of infected blood and blood products. However, the implementation of blood safety standards ensures the provision of safe, adequate and good-quality blood and blood products for all patients requiring transfusion. Blood safety includes screening of all donated blood for HIV and other blood-borne pathogens, as well as appropriate donor selection

Protecting yourself from HIV

HIV is preventable. Several effective methods can significantly reduce your risk of getting infected with HIV:

1. Abstaining from sex: 

This is the most guaranteed way to prevent sexual transmission of HIV.

2. Correct and consistent condom use: 

Using condoms correctly every time you have sex significantly reduces the risk of HIV transmission.

3. Pre-Exposure Prophylaxis (PrEP): 

Pre-exposure prophylaxis (PrEP) is an HIV medication that significantly reduces the risk of HIV infection when taken daily as prescribed. It is primarily used by people who are HIV-negative but at high risk of exposure to the virus. This includes individuals who:

• Have multiple sexual partners
• Engage in unprotected sex
• Have a sexual partner who is HIV-positive
• Inject drugs

Recommended by the World Health Organization for individuals at substantial risk of HIV, PrEP offers over 90% protection against the virus. This highly effective prevention method provides an additional layer of defense against HIV transmission. To maximize its benefits, consistent daily use is crucial, as prescribed by a qualified health worker

4. Post Exposure Prophylaxis (PEP): 

PEP stands for Post-Exposure Prophylaxis. It's a short-term HIV medication that you take after you think you might have been exposed to HIV.  To be effective, PEP must be started within 72 hours (3 days) of exposure and should be taken for 30 days.

Examples of people eligible for PEP include:

1. People who had unprotected sex with someone who is HIV-positive or whose HIV status is unknown.
2. People who shared needles or other drug injection equipment.
3. Survivors of sexual assault.

It's crucial to start PEP as soon as possible after exposure for it to be effective. Please note that PEP is not a regular form of HIV prevention and should only be used in emergencies. PEP is free and available at all health centres in Uganda that offer HIV treatment.

5. Prevention of mother-to-child transmission

Antiretroviral Therapy (ART) is crucial in preventing the transmission of HIV from a mother to her child. When a pregnant woman living with HIV consistently takes ART as prescribed, the risk of transmitting the virus to her baby is significantly reduced. It’s important to note that early initiation of ART is key for optimal protection.

After the baby is born, they are given a preventive medication called PEP (Post-Exposure Prophylaxis) for six weeks and the mother continues to breastfeed the baby during this period. This additional step helps further lower the risk of HIV infection. Following this period, the baby undergoes an HIV test to determine their status. If the test is negative, it’s excellent news. However, if the test comes back positive, the baby will start appropriate HIV treatment tailored for infants.

6. Treatment as Prevention (TasP): When people living with HIV receive effective antiretroviral treatment (ART), it reduces the amount of virus in their blood to undetectable levels, making it extremely difficult to transmit the virus to others.

Frequently Asked Questions

i. How often should I get tested for HIV?

The World Health Organization (WHO) recommends that everyone aged 15-64 should be tested for HIV at least once in their lifetime. However, the frequency of testing can vary based on individual risk factors. People engaging in high-risk behaviours, such as multiple sexual partners or injecting drug use, might benefit from more frequent testing. You are free to test for HIV whenever you feel that it is necessary.

It's essential to consult with a healthcare provider to determine the appropriate testing frequency based on your specific circumstances.

ii. If I get tested, should my partner get tested too?

Yes, it is recommended that both partners get tested for HIV. Knowing your HIV status as a couple can help you make informed decisions about your sexual health and prevent HIV transmission.

iii. What happens if I test positive for HIV?

If you test positive for HIV, you will be linked to care and support services which include counselling to help you cope. In addition to this, the health worker will get you started on antiretroviral therapy (ART).  Early initiation of treatment (ART) is crucial for managing HIV, preventing AIDS, and reducing the risk of transmitting the virus to others.

iv. Are HIV test results confidential?

HIV test results are strictly confidential. Your test results will only be shared with your consent.

v. How can I live with my HIV-positive partner when I am HIV-negative?

Open communication, trust, and adherence to HIV prevention measures are essential for couples where one partner is HIV positive and the other is HIV negative. These measures include the consistent use of condoms, and proper use of medication (antiretroviral treatment, pre-exposure prophylaxis and post-exposure prophylaxis) can significantly reduce the risk of HIV transmission. 

Additionally, if the HIV-positive partner achieves and maintains an undetectable viral load through ART, the risk of transmission is significantly reduced.

vi. Can mothers living with HIV breastfeed their babies?

Yes. The World Health Organization recommends breastfeeding for HIV-positive mothers consistently taking their ART exclusively for six months, followed by continued breastfeeding while introducing complementary foods until the child is two years old. This practice provides essential nutrients for the baby’s growth and development.

vii. Is it safe for two people living with HIV to engage in unprotected sex with each other?

If both partners are HIV positive and on effective ART, achieving and maintaining an undetectable viral load significantly reduces the risk of transmitting HIV to each other through sexual contact. However, it is important to consult with a healthcare provider for personalized advice.

Resources for More Information:

• World Health Organization (WHO): https://www.who.int/news-room/fact-sheets/detail/hiv-aids 
• Uganda AIDS Commission (UAC) https://uac.go.ug/

Health facilities in refugee settlements

Uganda has established health facilities specifically dedicated to serving refugees. These facilities are in refugee settlements across the country. These facilities offer a range of free services such as primary healthcare, maternal and child health, and HIV/AIDS treatment.

Accessing healthcare in Kampala

Urban refugees based in Kampala are free to receive healthcare at all government health facilities in the city and metropolitan areas. These include Mulago National Referral Hospital located at Mulago Hill in Kampala, Kiruddu National Referral Hospital, located along Salaama Road in Makindye Division, and Kawempe National Referral Hospital, located in Kawempe Division. The Kampala Capital City Authority (KCCA) has also established 10 health centres in the different divisions of Kampala. 

Non-Governmental Organizations (NGOs)

Numerous NGOs operating in Uganda provide healthcare services to refugees. These organizations often establish clinics or mobile health teams within refugee settlements and in Kampala to ensure access to healthcare. NGOs may focus on specific health issues such as reproductive health, nutrition, or mental health.

The AIDS Support Organization (TASO) is a leading Ugandan NGO dedicated to combating HIV/AIDS. Its services include prevention, care, treatment, and support for people living with HIV. TASO's work has significantly impacted the lives of countless Ugandans, making it a cornerstone of the country's HIV response.

NOTE: HIV/AIDS treatment and counselling services are free in all the TASO branches located in  Kampala, Entebbe, Jinja, Gulu, Masindi, Rukungiri, Mbarara, Masaka, Mbale, Tororo, and Soroti.

Contact TASO;

Mulago Hospital

P.O.Box 10443

Kampala-Uganda

[e-mail]

[phone]/1

Other organizations offering support include Transcultural Psychosocial Organisation (TPO), which offers mental health services, Medicins Sans Frontiers (Doctors Without Borders) offers reproductive health services HIV and tuberculosis prevention services, and many others. You can identify a health service organisation through our service map here.

Partnerships and Coordination

In Uganda, the Ministry of Health works collaboratively with multiple stakeholders, including the United Nations High Commissioner for Refugees (UNHCR), international donors, and other development partners. These partnerships help to strengthen the health system and ensure the provision of health services to refugees. Through these partnerships and coordination, the refugees have been included in the HIV/AIDs, malaria, TB, nutrition, immunization and other health programs.

If you have any questions, please contact Tubulire  on Facebook via https://www.facebook.com/Tubulire.Info or send us a message on WhatsApp [phone]  from Monday to Friday from 08:00 a.m. to 5:00 p.m.