Background. Mother-to-Child Transmission of HIV accounts for more than 90% of all pediatric HIV infections. However, Prevention of Mother-to-Child Transmission (PMTCT) of HIV through provision of lifelong ART to HIV positive mothers faces various challenges which affect its success. One of such challenges is the loss to follow-up (LTFU) of mothers. Methodology. We conducted a cross-sectional study utilizing both quantitative and qualitative data collection methods. We were able to trace 279 HIV positive, pregnant, and lactating mothers among mothers who were initiated on lifelong ART for PMTCT in public health facilities in Ntungamo district, Western Uganda. The proportion of those who were lost to follow-up was determined, and Log binomial regression with stepwise backward elimination method was employed to identify factors associated with LTFU. Focus group discussions (FDGs) of women on lifelong ART and key informant interviews (KIIs) of peer educators were also performed. Results. Out of the 279 mothers that were successfully traced and interviewed, 103 (37%) were identified as lost to follow-up. The prevalence of LTFU was higher among those whose transport costs were above $2.75, adj (adjusted) PR (Prevalence Ratio) 1.6 (95% CI; 1.02-2.55); those who waited beyond one hour before being attended to, adj PR 1.74 (95% CI; 1.02-2.96); and those who assumed that their infant was already infected, adj PR 1.76 (95% CI; 1.15-2.70). On interviews, LTFU in these mothers was attributed to fear of swallowing antiretroviral drugs, HIV related stigma and discrimination, inadequate facilitation of the peer educators, long patient waiting time, and transportation to the health facilities. Conclusion. More than one-third of mothers initiated on lifelong ART for PMTCT in Ntungamo district were lost to follow-up over a period of 25 months. Recommendations. Provision of regular and adequate pre-ART and ART adherence counseling and provision of routine health education would reduce LTFU.

We report on the results of a respondent-driven sampling survey among men who have sex with men (MSM) in Kampala, Uganda, where same-sex behavior is criminalized and highly stigmatized. We enrolled 608 MSM aged 18 + years and residing in greater Kampala from June 2012-November 2013. Anonymous data were collected through audio-computer assisted self-interviews; blood was tested for HIV-1 antibodies, CD4 + T cell counts, and viral load. Estimated HIV prevalence was 12.2 % (95 % confidence interval [CI] 8.0-16.1), increasing with age. One in five (19.6 %) stated knowing their HIV-positive status and a similar proportion of HIV-infected MSM were virally suppressed (19.3 %; 95 % CI 3.3-33.1). HIV-related risk behaviors included unprotected anal sex (35.8 % at last sex act), selling sex (38.5 %), having multiple steady (54.3 %) or casual (63.6 %) partners, and ever injecting drugs (31.6 %). Forty percent experienced homophobic abuse; 44.5 % ever experienced suicide ideation. HIV prevalence among MSM remains high whereas knowledge of seropositive status and suppression of viral load remains low. MSM report a wide range of high risk behaviors, frequent homophobic abuse, poor mental health, as well as low levels of testing and treatment. Better access to tailored prevention and treatment services to improve population-level viral load suppression are warranted.

BackgroundWe investigated progress towards UNAIDS 90-90-90 targets among female sex workers in Kampala, Uganda, who bear a disproportionate burden of HIV.MethodsBetween April and December 2012, 1,487 female sex workers, defined as women, 15–49 years, residing in greater Kampala, and selling sex for money in the last 6 months, were recruited using respondent-driven sampling. Venous blood was collected for HIV and viral load testing [viral load suppression (VLS) defined as <1,000 copies/mL]. We collected data using audio computer-assisted self-interviews and calculated weighted population-level estimates.ResultsThe median age was 27 years (interquartile range: 23 to 32). HIV seroprevalence was 31.4% (95% confidence interval [CI]: 29.0, 33.7%). Among all female sex workers who tested HIV-positive in the survey (population-level targets), 45.5% (95% CI: 40.1, 51.0) had knowledge of their serostatus (population-level target: 90%), 37.8% (95% CI: 32.2, 42.8) self-reported to be on ART (population-level target: 81%), and 35.2% (95% CI: 20.7, 30.4) were virally suppressed (population-level target: 73%).ConclusionsHIV prevalence among Kampala female sex workers is high, whereas serostatus knowledge and VLS are far below UNAIDS targets. Kampala female sex workers are in need of intensified and targeted HIV prevention and control efforts.

Background: Compared to the general population in Uganda, fishing communities suffer greater burden of HIV/ AIDS. We determined the level of comprehensive knowledge on HIV prevention and its associated factors among fishing communities of Lake Kyoga. Methods: We conducted secondary analysis of data from the Lake Kyoga Behavioral Survey, a population-based sample survey on behavioral risk factors for HIV, syphilis, and schistosomiasis among adults in fishing communities of Lake Kyoga in 2013. We defined comprehensive knowledge as having correct knowledge on HIV prevention (consistent condom use, faithfulness, a healthy-looking person can have HIV, and HIV cannot be transmitted through food-sharing, witchcraft or handshake). We used logistic regression to determined potential factors associated with comprehensive knowledge on HIV prevention and control for confounding. Results: Of 1780 persons in the sample, 51% (911/1780) were females. The mean age was 32 (range: 15-97) years. Overall, 51% (899/1780) of persons had comprehensive knowledge on HIV prevention. Level of comprehensive knowledge on HIV prevention was similar between females (52%, 449/911) and males (49%, 450/869). Males (76%, 658/869) had lower knowledge on HIV transmission from mother to child during breast feeding compared to females (81%, 738/911) (p-value 0.019). Fishermen (46%,324/711) who lived > 5 km away from a health center compared to 54% (572/1066) who lived within 5 km radius were less likely to have comprehensive knowledge on HIV prevention (PRR adj = 0.8; 95%CI = 0.5-0.92). Those who had ever tested for HIV were more likely to have comprehensive knowledge of HIV transmission (PRR adj = 1.1; 95% 1.03-1.70). Conclusion: Half of the population of Lake Kyoga fishing community had comprehensive knowledge of HIV prevention. Long distances from health facilities reduced the level of comprehensive knowledge on HIV transmission. HIV testing increased the level of comprehensive knowledge on HIV transmission. Ministry of health should ensure that HIV/AIDS information; education and communication and HIV counseling and testing activities are intensified in fishing communities of Lake Kyoga, with more emphasis on communities living in distances of more than 5 km away from the health facility.

BackgroundOn 12 October, 2016 a measles outbreak was reported in Mayuge District, eastern Uganda. We investigated the outbreak to determine its scope, identify risk factors for transmission, evaluate vaccination coverage and vaccine effectiveness, and recommend evidence-based control measures.MethodsWe defined a probable case as onset of fever (≥3 days) and generalized rash, plus ≥1 of the following: conjunctivitis, cough, and/or runny nose in a Mayuge District resident. A confirmed case was a probable case with measles-specific IgM (+) not explained by vaccination. We reviewed medical records and conducted active community case-finding. In a case-control investigation involving probable case-persons and controls matched by age and village, we evaluated risk factors for transmission for both cases and controls during the case-person’s likely exposure period (i.e., 7–21 days prior to rash onset). We estimated vaccine effectiveness (VE) using the formula: VE ≈ (1-ORprotective) × 100. We calculated vaccination coverage using the percentage of controls vaccinated.ResultsWe identified 62 probable case-persons (attack rate [AR] = 4.0/10,000), including 3 confirmed. Of all age groups, children < 5 years were the most affected (AR = 14/10,000). The epidemic curve showed a propagated outbreak. Thirty-two percent (13/41) of case-persons and 13% (21/161) of control-persons visited water-collection sites (by themselves or with parents) during the case-persons’ likely exposure period (ORM-H = 5.0; 95% CI = 1.5–17). Among children aged 9–59 months, the effectiveness of the single-dose measles vaccine was 75% (95% CI = 25–92); vaccination coverage was 68% (95% CI = 61–76).ConclusionsLow vaccine effectiveness, inadequate vaccination coverage and congregation at water collection points facilitated measles transmission in this outbreak. We recommended increasing measles vaccination coverage and restriction of children with signs and symptoms of measles from accessing public gatherings.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3304-5) contains supplementary material, which is available to authorized users.