Department of Defense HIV/AIDS Prevention Program Uganda (DoD Uganda URC Project)

The Challenge

Uganda is known for leading a rigorous response to the HIV epidemic in the 1990s and early 2000s, making significant headway against the disease. Unfortunately, HIV infections surged between 2005 and 2013. Since then, the Ministry of Health and other stakeholders have been working to address the drivers of the epidemic and reach zero new infections.

PEPFAR estimates that the HIV prevalence among key and priority populations – including military services – is between 15% and 37%, much higher than that of the general population, although the exact HIV prevalence rate for the military is not known.

Overview and Objectives

With a comprehensive HIV program implemented through 40 military-run health facilities, the Uganda People’s Defence Forces (UPDF) can strengthen HIV services and reduce HIV transmission among military personnel and civilian communities.

The DoD Uganda URC Project is scaling up the UPDF HIV response in Uganda to achieve epidemic control. The program supports 40 military health facilities – including 31 with antiretroviral therapy (ART) accredited clinics – by providing custom-designed technical assistance and material support. The DoD Uganda URC Project is helping military health facilities’ efforts to improve access and quality of care for clients accessing the UPDF HIV services.

The project’s objectives are to:

• Reduce new HIV infections among the military and surrounding communities by 65% by 2026;
• Increase access to and quality of HIV testing services in the UPDF towards achieving 95% of people living with HIV (PLHIV) knowing their status by 2026;
• Strengthen provision and coverage of quality HIV care and treatment services in the UPDF towards achieving 95% of people with HIV who know their status getting on treatment by 2026;
• Scale up viral load coverage to 100%, optimize HIV treatment services, and achieve 95% viral suppression among PLHIV served by UPDF facilities by 2026; and
• Strengthen institutional capacity of the UPDF to lead, plan for, and monitor the UPDF HIV/AIDS response.

Achievements

• Strengthened capacity of the institutional UPDF Directorate of HIV to manage and implement HIV response within the Ugandan military through technical assistance focused on establishing health systems to provide quality HIV care;
• Increased HIV testing services and ART coverage in UPDF facilities to more than 20,000, up from nearly 18,000 at project start;
• Provided technical assistance to 40 facilities on testing that has enabled these facilities to test 29,566 people and provided ART coverage in 31 facilities, reaching 20,734 PLHIV;
• Supported the accreditation of three new ART facilities within the Ugandan military;
• Improved HIV treatment outcomes with a viral load suppression rate above 95%;
• Increased patients using TB preventative therapy to more than 19,000, up from nearly 1,000 at project start in 2019;
• Enrolled 3,106 adolescent girls and young women and served more than 4,000 orphans and vulnerable children with a comprehensive service package, including health and survival, economic strengthening, financial literacy, and parenting support;
• Established virtual learning platform within the UPDF using the project ECHO model, which allows support, guidance, and feedback can be shared through a virtual community; and
• Scaled up an electronic medical records system to 31 military health facilities, providing hardware and software as well as building capacity of health service providers.