Uganda is one of the countries in the world with the highest number of new HIV infections. The country is second to South Africa in the world and
the highest in East Africa with at least 2,363 people getting infected with HIV per week, compared to 468 for Kenya, 491 for Tanzania and 25 for Rwanda (UNAIDS gap report, 2016). According to the Uganda Population
Based HIV Impact Assessment (UPHIA) 2016, there an estimated 1.3 Million Ugandans living with HIV and although a significant achievement was
made in reducing new infections among children, 83,000 new HIV
infections were recorded in the year. The current trend of the epidemic
shows the need to reinvigorate the existing interventions if the country is to
achieve the global Fast Track targets of 90 90 90 by 2020 and end of
epidemic as a public Health threat by 2030.
Over the last decades of HIV in Uganda, the prevalence has remained persistently higher in urban areas compared to rural areas. The Uganda AIDS Indicator Survey (UAIS) 2011 showed the urban prevalence at 8.3% compared to the rural prevalence at 7.0%; the 2014/5 National Sero Behavioural Survey showed the urban at 10.1% compared to the rural at 5.7%. The recent UPHIA 2016 findings indicate that HIV prevalence in urban areas is 7.1% while in rural areas, it is 5.5%. There are only about 18% of Ugandans who are living in urban areas and yet more than 50% of new HIV infections in Uganda occur in urban areas (UNAIDS, 2016).
The high burden of HIV in urban areas is mainly due to risky behavior such as multiple and concurrent sexual relationships, transactional and cross-generational sex, sex work, alcohol and drug abuse among key populations (MARPs) and other high risk groups. This is further worsened by low uptake of HIV and AIDS services due to the nature of livelihoods of most urban dwellers (60%) living and working in informal sector, such as boda boda trade, market vending, street vending as well as office workers leaves limited time to seek health services.
Fast Track Initiative is a comprehensive global strategy launched in October
2014 and globally championed by UNAIDS. The strategy is aimed at achieving the 90-90-90 targets by 2020 and eliminating HIV-related stigma and discrimination so as to end AIDS epidemic as a Public Health threat by2030.
This means that by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have attained viral suppression.
The Alliance of Mayors and Municipal Leaders’ Initiative for Community Action on AIDS at the Local Level (AMICAALL) is an association of African Mayors and other Urban Leaders formed to support sustainable solutions to the HIV and AIDS.