Country Specific Approach to HIV/AIDS Prevention; basic Problems Encountered in Implementating Prevention and Control Strategies

ABSTRACT

"Two questions are avanced as regards prevention strategies and control - ""Are interventions effective in preventing HIV infection?"" and ""Are the current interventions having an impact on the epidemic in Uganda?"" ""Yes"" is the answer to the former and ""no"" to the latter. Experiences from several developing countries have demonstrated a variety of approaches that to some extent have yielded results in HIV infection prevention. Indicators of the result include number of condoms sold or distributed; reported condom use; reduction in STD rates; and somewhat a reduction in HIV incidence. The approaches include- national media programs from the Ministry of Health; TASO; AIC; to mention but afew; condom social marketing e.g. protector; community mobilisation approaches (e.g. Peer Education by the AIDS challenge Youth Club and other youth organisation); HIV counselling and testing by AIC and/or clinic based programs (TASO). Lessons Learned While these interventions may slow down the epidemic in selected groups (e.g. Prostitutes in selected locations like Kampala); there is little evidence to indicate that any of these interventions has had a significant impact in slowing the epidemic at country level. Several reasons are advanced for this- Inadequate financial and political commitment for large-scale programs; social; cultural and religious norms and political resistance to implementing effective interventions; and lack of comprehensive approaches and strategic planning at the country level. Conclusions: therefore even if an AIDS vaccine were produced tomorrow; priority should be emphasised on prevention as the most important method of controlling the HIV epidemic."