Browsing by Author "Tumwebaze, Mathias"

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    Appraisal of Existing HIV/AIDs Prevention and Control Measures and Presentation of Innovative Strategies to End HIV/AIDS Epidemic by 2030
    (Open Journal of Epidemiology, 2023-07-14) Tumwebaze, Mathias; Rubaihayo, John; Mpairwe, Harold
    Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.
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    Prevalence and Predisposing Factors of Human Immunodeficiency Virus Infection among the Boda-Boda Riders in Mbarara Municipality-Uganda
    (Open Journal of Epidemiology, 2020) Tumwebaze, Mathias; Otiam, Emmanuel O.; Rukindo, Kakwezi Margaret; Mwesigwa, John
    Boda-Boda is a well-known and booming motorcycle taxi that employs youths to earn a living. They transport passengers at a faster rate where other means of transport are inaccessible or would be time consuming. Global statistics show that HIV has continued to be a major global Public Health issue especially among the “Most At-risk Populations” (MAPs) that include commecial transporters and Boda-Boda riders. Aim: This study aimed at assessing the prevalence and predisposing factors for HIV/AIDS among Boda-Boda riders living in Mbarara Municipality. Specifically, the study determined the prevalence of HIV among the Boda-Boda riders, identified social demographic predisposing factors for HIV and determined knowledge of Boda riders on prevention of HIV. Study setting: Boda-Boda operators in the transport sector are at high risk of HIV infection but the HIV status of the Boda Riders in Mbarara was not known a reason why the study was instituted: Study design: This was an analytical and descriptive cross-sectional study that employed quantitative methods of data collection. The study population comprised the registered Boda-Boda operators from two divisions of Kakoba and Kakiika in Mbarara municipality. Sample size and sampling methods: Using Morgan’s table (1970), the population of the registered Boda Riders was 15,041; this corresponded to a sample size of 375 respondents by Morgan Table. Systematic sampling procedure was used to get every 3rd registered rider on the list. Data collection: A pre-tested structured tool aided data collection after group pretest counseling. Individual counseling was also done prior to testing and giving results. The laboratory technologists drew blood to determine the sero-status of the respondents. Results were recorded as tested reactive (TRR) or tested non-reactive (TR). Unigold was used as tie breaker to confirm their diagnosis in order to ascertain those who were HIV positive on determine. Data analysis: Analysis was done at univariate, bivariate and multivariate using STATA version 13, Statistical significance of the relationship was determined for the p-value (p ≤ 0.05). Significant variables were then considered at multivariate level of analysis. Results: More than half 195 (52%) of the Boda-Boda cyclist had attained primary level of education and 36.5% secondary education. HIV prevalence among Boda-Boda riders was 9.9%. Riders who had never heard of VCT/HCT screening for HIV were three times likely to acquire HIV compared to those who ever heard of VCT/HCT screening (OR = 3.35; 95% CI 1.14 9.83; p = 0.027). Those with multiple partners were six times more likely to acquire HIV/AIDS compared to those who buy sex from prostitutes (OR = 6.13; 95% CI 1.54 24.38; p = 0.01). The level of awareness of VCT was found high at (94.7%), and the gen general knowledge about utilization and importance of VCT services was at 80%, however condom use as a preventive measure was found low at 44.3% among the respondent Boda-Boda riders. Conclusion: Boda-Boda riders had high HIV prevalence of 9.9% compared to that of Mbarara district at 6.1% and much higher than 5.7% national HIV prevalence level. The predisposing factors to acquire HIV/AIDS were having multiple sexual partners, not having heard of HIV counseling and testing as well as low and inconsistent condom use at 44.3%. The study recommends health service providers and HIV counselors to intensify awareness and behavior change campaigns on condom use among the Boda-Boda riders as preventive measure against HIV.