Despite facing displacement, poverty, and prolonged uncertainty, refugees in Uganda are achieving HIV treatment outcomes comparable to those of their host communities—an outcome that highlights the effectiveness of the country’s inclusive public health system.
The findings, published this year in The Lancet Global Health, draw on two large population-based surveys conducted between 2020 and 2021 among refugees and the general population living in refugee-hosting regions.
The study found that HIV prevalence among refugees is significantly lower than among Ugandan host communities, standing at 1.8 percent compared to 7.4 percent.
“This difference persisted across sexes, with lower prevalence among both refugee women and men compared with women and men in the general population,” study authors wrote.
Researchers attribute the lower prevalence largely to epidemiological patterns in refugees’ countries of origin rather than to displacement itself. Most refugees in Uganda come from South Sudan, the Democratic Republic of Congo, Burundi, and Rwanda—countries that generally have lower HIV prevalence rates than Uganda.
Despite these differences in prevalence, refugees were found to perform just as well as Ugandan nationals across the HIV care cascade. More than 86 percent of refugees living with HIV were aware of their status, over 97 percent were receiving antiretroviral therapy, and nearly 90 percent had achieved viral load suppression. These outcomes closely mirror those observed in the general population.
Uganda’s integrated health system emerged as a key driver of these comparable results. Refugees are able to access the same public health facilities as citizens, receiving HIV services through Ministry of Health facilities both within refugee settlements and in surrounding districts. This approach has helped ensure continuity of care and reduced disparities in treatment outcomes.
However, the study also highlighted persistent gaps in HIV service delivery, particularly among young people aged 15 to 29 years. In both refugee and host communities, youth were less likely to know their HIV status and less likely to achieve viral suppression. Men similarly lagged behind women in HIV awareness and treatment outcomes.
Geographical disparities were also evident. Viral suppression rates were higher in South-Western Uganda than in the West Nile region, pointing to variations in health system capacity, resource availability, and service delivery across regions.
The study underscore Uganda’s progress in delivering equitable HIV care while drawing attention to areas that require targeted intervention.
Researchers emphasise the need for youth-focused and gender-responsive strategies, particularly in refugee-hosting districts. Strengthening district health systems, ensuring sustained funding, and expanding community-based HIV services were identified as critical steps toward closing remaining gaps.
Photo source–>AFI