In the heart of East Africa, a relentless struggle continues against an invisible yet formidable enemy –HIV. Despite global advances in the fight against this virus, Eastern Africa remains the second most affected region worldwide after Southern Africa and is grappling with alarmingly high prevalence rates that vary significantly by location, according to the UN Office on Drugs and Crime.
As communities strive to overcome the myriad challenges posed by this epidemic, the question lingers: what will it take to turn the tide?
The statistics in relation to the Prevalence Puzzle in Tanzania paint a troubling picture with an overall adult HIV prevalence rate of 4% but with stark regional discrepancies ranging from 0.5% in the beautiful islands of Zanzibar to an alarming 11.4% in Njombe.
Of deep concern, adolescent girls and young women in particular shoulder the greatest burden and account for 80% of new infections. However, Kenya has made commendable strides in its battle against HIV and has successfully reduced its adult prevalence from 10% in the mid-1990s to 4.5% in 2020.
In contrast, Uganda currently holds the highest adult HIV prevalence in the East African Community at 5%, despite having achieved the ambitious 90-90-90 targets by 2020. Rwanda boasts a stable adult prevalence rate of 3%, while Burundi struggles with an estimated rate of 0.9%, particularly among women.
Meanwhile, in South Sudan, an estimated 2.5% of individuals aged 15-49 are living with HIV, raising serious concerns about new infections and a lack of awareness, especially among at-risk groups such as female sex workers.
The underlying causes of crisis
What lies at the heart of this persistent public health crisis? To understand the challenges faced by East Africa in combating HIV, DevelopmentAid spoke with public health experts, sociologists, and representatives from local grassroots organizations. Their collective insights reveal a complex tapestry woven from societal norms, healthcare access disparities, economic instability, and educational deficiencies.
The stigma barrier
One of the most formidable barriers to combating HIV in East Africa is the stigma that clings to the virus-like a shadow. Many individuals living with HIV face discrimination and social exclusion, which discourages them from seeking testing and treatment.
Dr. Miriam Karanja, a public health expert specializing in infectious diseases, underscores the damaging effects of this stigma:
“It prevents individuals from disclosing their status or seeking vital healthcare services. This fear leads to late diagnoses and heightened transmission rates.”
Cultural attitudes toward sexuality and health are further complicating the crisis.
“In several East African cultures, open discussions about sexual health remain taboo,” notes Professor Ahmed Abdi, a sociologist researching the cultural factors surrounding HIV transmission. “This silence fosters misinformation and perpetuates behaviors that heighten vulnerability to the virus.”
Economic instability: A double-edged sword
The economic landscape in East Africa is exacerbating the fight against HIV. High poverty and unemployment rates limit access to healthcare services and treatment options thus pushing families towards decisions that increase their risk of exposure.
Engaging in transactional sex or multiple partnerships for financial gain becomes an unfortunate necessity for many. Organizations such as “Uganda Cares” are pioneering community-based approaches aiming to tackle these economic challenges.
Henry Magala, Uganda Cares’ Country Program Director, explained
“We provide vocational training and financial literacy programs to empower individuals, especially women, to achieve financial independence. When people are economically stable, they are less prone to engage in risky behaviors that could lead to HIV transmission.”
Healthcare access
Diminishing access to healthcare facilities represents yet another substantial obstacle in the ongoing battle against HIV. In many rural areas, health centers are scarce, understaffed, and often lack essential resources which results in long distances of travel for those individuals seeking testing and treatment.
Dr. Karanja emphasizes the need for actionable solutions:
“The government has made headway in providing anti-retroviral therapy, but access remains a critical issue, especially in remote regions. We must ensure that healthcare is not just available but also accessible to those who need it most.”
The COVID-19 pandemic further strained healthcare systems and diverted resources away from HIV initiatives.
“Many countries had to prioritize responses to COVID-19, leading to setbacks in HIV testing and treatment efforts,” warns Dr. Karanja. “We must awaken our collective consciousness and not allow the HIV crisis to take a backseat in our public health discussions.”
