Addressing the Burden of HIV/AIDS among Adolescent Girls and Young Women (AGYW) in Ntungamo District, Uganda

Adolescent girls and young women (AGYW) in Ntungamo District, Uganda, are disproportionately affected by the HIV/AIDS epidemic. Despite national and global efforts to curb the spread of HIV, AGYW between the ages of 15-24 continue to bear the brunt of new infections. In Uganda, HIV prevalence among AGYW remains significantly higher compared to their male counterparts. In Ntungamo District specifically, cultural, social, and economic factors exacerbate their vulnerability, resulting in higher infection rates and limited access to necessary prevention, treatment, and care services.

Several underlying issues contribute to the increased vulnerability of AGYW to HIV/AIDS in Ntungamo. First, gender inequality and cultural norms hinder AGYW's ability to negotiate safe sex practices, resulting in early marriages, transactional sex, and sexual violence. These factors put them at higher risk of HIV exposure. Second, economic instability forces many AGYW into transactional relationships with older men (sugar daddies), increasing their risk of HIV infection due to power imbalances and limited autonomy over their sexual health. Third, limited access to accurate sexual and reproductive health education means many AGYW are unaware of preventive measures like condom use, HIV testing, and the availability of Pre-Exposure Prophylaxis (PrEP).

Additionally, stigma and discrimination against those living with HIV deters AGYW from seeking testing and treatment services. Many AGYW fear social exclusion, further reducing uptake of preventive services and increasing the risk of spreading the virus. This situation is compounded by inadequate youth-friendly healthcare services in Ntungamo, which are either inaccessible or poorly equipped to cater to the unique needs of this demographic.

Without targeted interventions, the HIV epidemic in Ntungamo will continue to undermine the health and socio-economic progress of AGYW, perpetuating cycles of poverty, stigma, and gender-based violence. It is essential to implement holistic, youth-centered, and community-driven approaches that address the root causes of HIV vulnerability while empowering AGYW through education, access to healthcare, and advocacy initiatives. Interventions must focus on building resilience, promoting gender equality, and ensuring AGYW have the tools to make informed decisions regarding their sexual and reproductive health.

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Uganda faces a persistent challenge in combating HIV/AIDS, with an estimated 1.4 million people living with HIV as of 2022. Although the country has made significant strides in reducing HIV prevalence and AIDS-related deaths over the years, key populations, including adolescent girls and young women (AGYW), remain disproportionately affected. AGYW between the ages of 15 and 24 are particularly vulnerable, accounting for a large portion of new infections due to social, cultural, and economic factors such as gender inequality, limited access to education, poverty, and inadequate sexual and reproductive health services. AGYW, particularly those between the ages of 15-24, account for a disproportionately high number of new HIV infections across the globe and in Sub Saharan Africa. In Uganda, around 34% of all new HIV infections are reported among young people aged 15-24, with AGYW representing the majority of these cases. The high rate of new infections is often linked to early sexual debut, age-disparate relationships (often with older male partners), gender-based violence, and inadequate access to HIV prevention services. AGYW in Uganda often have limited access to comprehensive sexual and reproductive health services, including HIV testing, counseling, and prevention options like PrEP (Pre-Exposure Prophylaxis). Fear of stigma and discrimination also hinders many AGYW from accessing these services, in Ntungamo district alone, in three health centres of Ntungamo Health centre iv, Butare HCIII and Ruhoko HCIII, the report for June to August 2024 indicates that Only 676 AGYW aged 15 to 24 years turned up for HIV test whereby among these 11 were positive living, 142 gave birth and 423 are teenage mothers. Considering the population of Ntungamo district with 34 lower local government units and the number of sex workers in the district, AGYW have challenges in accessing  HIV testing services hence low turn up which pose a very big risk to the general population. Ntungamo district has had a number of implementing partners like CARE Uganda, USAID, among others, but there is no partner that has so far invested in advocacy and AGYW HIV services hence low turn up for HIV testing and low intake of HIV/AIDS services. Support Disabled Uganda therefore seeks support to increase advocacy and uptake of HIV/AIDS services in Ntungamo municipality and Ntungamo Sub County by 10% by December 2024.