It is estimated that 1.6 million people in Uganda are living with HIV and AIDS, and of these 176,000 are children and adolescents (MOH 2014). Although just over half of those are on HIV treatment, according to the National HIV and AIDS strategic plan 2015-2020; there has been a significant increase in enrolment of HIV positive individuals on antiretroviral therapy (ART) resulting into a significant decline in HIV related deaths.
The COE clinic operations were mainly centered towards reaching the UNAIDS 90-90-90 goals to be attained by 2020. A total of 7,302 clients LHIV of whom 2,102 (29%) were children below the age of 10 years and 3,123 (43%) were adolescents aged 10- 19 years.
In line with the 1st UNAIDS goal where at least 90% of PLHIV should know their status, 5,430 (4,802 serological and 628 DNA PCR DBS tests) clients and caregivers were counseled and tested for HIV from the neighboring in- patient wards of Mulago Hospital. New clients were tested for HIV were identified through the community targeted out reaches to households of HIV/ TB index patients, OVC dwelling homes as well as MARPS and their families. The overall number that tested positive was 1, 008 with a prevalence of 19% (1,008/ 5, 430). In line with the Ministry of Health test and treat guidelines, those identified as positive were immediately initiated on ART. All children under 15 years of age, and 96% of adults enrolled in HIV care were on ART, a total of 98% of the clients in care. During the period, viral load monitoring was the preferred mode of assessing ART efficacy and of the 6, 760 clients on ART for at least 6 months, 6, 235 92% had one such test within a 12 months period. 85% of the clients that were monitored using viral load achieved viral suppression (less than 1000copies/ml). When disaggregated by age groups, children under the age of 5 years were the most virally suppressed standing at 99.9% while young people between the ages of 20-24 had the lowest at 80% viral suppression.
Efforts to improve viral suppression rates through client engagement in their care were stepped up; joint meetings were held among clients, caregivers, health workers and community volunteers to strengthen adherence and follow up.