The roadblock to Uganda’s HIV/Aids prevention efforts is the outdated HIV & AIDS Prevention and Control Act 2015.
Despite recent funding disruptions to Uganda’s health system, the country has been listed among those receiving support from the Global Fund and the United States government for the rollout of long-acting Lenacapavir, a twice-yearly injection offering six months of protection against HIV.
Science has delivered an HIV prevention tool that complements existing options in Uganda, such as the ABC approach, oral PrEP, the dapivirine ring, and long-acting Cabotegravir.
Lenacapavir offers six months of protection, meaning people at risk of HIV no longer need to take a daily pill. This convenience reduces the “pill burden,” which may improve adherence, strengthen continuity of prevention, and ultimately lower new HIV infections, contributing to a better quality of life.
Lenacapavir is also discreet and offers a genuine choice. Young women and girls exposed to HIV can now select a method that fits their realities. This freedom of choice is empowering, naturally reducing stigma because prevention becomes a private, dignified, and self-directed decision.
The economic benefit of Lenacapavir for Uganda’s health budget is significant: every infection prevented is a treatment avoided. The more people who remain HIV-free due to long-acting prevention, the fewer resources the country will spend on lifelong HIV treatment.
Now, this scientific advancement arrives in Uganda and meets a law that criminalizes having HIV. Such a law creates fear, which drives people away from testing because they do not want to be labelled criminals.
When the law makes testing feel dangerous, people stay away from the very services meant to help them. Without testing, they cannot know their status. And without knowing their status, they cannot make informed decisions about whether to start HIV treatment or use prevention tools, especially if they are at risk.
Science has provided effective tools: treatment that suppresses the virus, and prevention options that protect people before exposure. But without testing, none of this reaches the people who need it.
A lack of testing also reduces disclosure, breaks trust, and eventually affects adherence because people operate in secrecy instead of safety. The result is that the law keeps people away from protective systems.
Instead of slowing HIV transmission, it drives it underground. Instead of supporting prevention, it actively undermines it. The law creates the very silence that science is trying to break.
Uganda stands at a moment when science is offering a new beginning. Long-acting prevention is here. Global partners are ready. Communities and young women are ready. The only part of the system still living in 2014 is the law.
If we want available resources to reach their intended recipients, we must clear the legal roadblock ahead. As Uganda moves toward the polls to choose a new parliament, this issue cannot be forgotten. The HIV legislation must be at the top of the legislative agenda.
The next parliament must decide whether Uganda will move forward with science or remain anchored to a past that no longer protects us.
The author is a communications professional pivoting to public health
Thank you for the article. Yesterday, December 01, the U.S. didn’t commemorate World Aids Day. I guess HIV/AIDS is no longer considered a national emergency in the United States. Significant funding cuts have been made to both domestic and international organizations fighting HIV/AIDS.
In the case of Uganda, legislation, yes but there’s need for continued robust national actions e.g addressing cultural/social/economic factors that make folks, especially females vulnerable to HIV/AIDS. Gains have been made in HIV/AIDS fight, relenting at this time would serve to wipe out all the gains.