An app, which acts as a one-stop centre for information on HIV prevention and treatment, has been upgraded and enhanced with data on the latest interventions in the fight against the disease.

Among the additions to the Prep Uganda app, which was initially launched in 2018, is information on injectable Prep, HIV self-testing, mother-to-child transmission of HIV, voluntary male circumcision and gender-based violence.

Director of Preventive Care International, James Brown, who is also a member of the Prep working group at the health ministry, made the revelations while briefing journalists in Kampala on Friday, October 28, 2022.

“We incorporated into the app information on how someone can carry out HIV self-testing to ensure that they are sure of their status before continuing with Prep. We have also included information on voluntary male circumcision. We realised that behavioural issues like gender-based violence were big drivers of HIV. So, we included information about it, too,” he added. 

The app which was a culmination of efforts between the health ministry and the United States Agency for International Development (USAID), also contains a list of the 350 health facilities where one can access Prep and HIV treatment services free of charge.

Access to information key

Brown said the Prep Uganda phone application was one of the ways of helping people to access information about the spread and control of HIV.

“All this aimed at accelerating the uptake of HIV interventions. We want to ensure that once we have done trials and it is confirmed that trials are effective against HIV, we put out interventions in the communities so that they are taken up," Brown added.

"Some of these interventions are the oral and injectable prep. Most of the potential users of these interventions find challenges in accessing these services in public health facilities. So, we do this to ensure they access them from the comfort of their homes,” he said.

Injectable prep

Speaking during the same briefing, Dr Flavia Kiweewa, a medical researcher from Makerere University - Johns Hopkins University Research Collaboration, briefed journalists about the latest research findings on the advantages of using injectable prep as opposed to the traditional oral method. 

Prep is a treatment that prevents HIV infection in the initial stages of exposure to the virus. The most usual form of treatment is the oral tenofovir disoproxil fumarate/emtricitabine, but the injectable is being touted by experts as more effective. 

Kiweewa said recent research showed that the injectable long-acting cabotegravir was more effective than the oral oral TRUVADA (combination of emtricitabine and tenofovir disoproxil fumarate) in preventing HIV infection. 

Experts have fronted the recently approved bi-monthly injectable Prep as the magic bullet to adherence among people who may fail to swallow drugs on time.

“It does not mean that the oral (tenofovir disoproxil fumarate/emtricitabine in) prep is not effective. The reason the injectable is more effective is because of adherence. That is the strongest justification for moving on from oral prep to the injectable,” she said while commenting on the results of a recent study that put the injectable Prep ahead of the oral drug in preventing HIV infections in people who are at risk of getting the disease.

Dr. Kiweewa said another study to investigate the efficacy and safety of lenacapavir injection in preventing and HIV infections among girls aged 16 to 25 was being done in Uganda and South Africa. In Uganda, it is being done in Mubende, Kalangala, Mityana and Kassanda districts.

"Participants have already been recruited in Uganda. South Africa started earlier than us. They started in July, "she said.

Lenacapavir belongs to a group of HIV drugs called capsid inhibitors. Capsid inhibitors can disrupt HIV capsid during multiple stages of the viral life cycle. This prevents HIV from multiplying and can reduce the amount of HIV in the body. 

Ruth Akulu from the International Community of Women Living with HIV called for the extension of Prep services to private health facilities.

“Prep sites are few. We are about 45 million people yet prep sites are only about 350. What are we doing to ensure that people, especially the young ones, get services? Right now, we have focused on the public sector. How about the private sector? There are those people who use private facilities. For example, you will not find a celebrity going to Wakiso Health Centre IV. They will feel comfortable going to those private health facilities to access these services. What are we doing for such people who access services in private health facilities?” she asked.

HIV prevalence in Uganda

According to the Uganda Population-cased HIV Impact Assessment survey 2020, the prevalence of HIV among adults in Uganda was 5.8%. HIV prevalence is higher among women (7.2%) than among men (4.3%).

The report showed that 80.9% of adults living with HIV (aged 15 years and older) were aware of their HIV-positive status: 83.5% of women and 76.1% of men.

Among adults living with HIV who were aware of their status, 96.1% were on treatment: 96.7% of women and 94.7% of men.