Public health specialists have called for new strategies to identify Ugandans who are living with HIV but remain unaware of their status, warning that traditional facility-based testing alone may not be enough as the population continues to grow.
The call follows the release of preliminary findings of the 2025 Uganda Population-based HIV Impact Assessment (UPHIA), which show that although Uganda has made significant progress in HIV treatment and viral suppression, a sizeable number of people living with HIV still do not know their status.
Kenneth Mwehonge, the Executive Director of the Coalition for Health Promotion and Social Development, says health authorities need to move beyond conventional facility-based testing and deliberately target communities and population groups where new and undiagnosed infections are concentrated. He says the country already has information on the geographical and population hotspots with the highest HIV burden, which should be used to guide targeted testing.
Mwehonge says Uganda could also borrow from the public health response used during outbreaks such as Ebola, where health workers trace and test contacts of confirmed cases.
The UPHIA survey was conducted between July and September 2025 by the Uganda Bureau of Statistics, the Ministry of Health, Makerere University School of Public Health and the Uganda Virus Research Institute. The survey covered 94.4 per cent of the 6,283 eligible households selected across the country, with all participants tested for HIV regardless of whether they already knew their status.
At the launch of the preliminary findings on Thursday, Health Ministry Permanent Secretary Dr Diana Atwine said the people living with HIV who remain unaware of their status and are therefore not on treatment represent the country’s biggest remaining gap in the HIV response. She said the survey findings provide important pointers on where health authorities need to concentrate their efforts. Atwine said an estimated 150,000 or more people remain unaware of their HIV status.
However, Dr Sam Biraro, a researcher at Makerere University School of Public Health who participated in the survey, said the assessment suggests the number could be significantly higher.
Speaking to URN on Friday, Biraro explained that for every 100 people who tested positive for HIV during the survey, 85 already knew their status, while 15 were unaware that they were living with the virus.
He said this translates to about 225,000 people who may be living with HIV without knowing their status and, consequently, are not receiving treatment. The survey also shows significant regional differences in HIV prevalence. Southwestern Uganda recorded the highest prevalence at eight per cent, compared with the national average of 5.9 per cent. It was followed by the Central 1 region, comprising Wakiso, Mpigi and greater Masaka, at 7.3 per cent.
Karamoja recorded the lowest prevalence at 1.3 per cent, followed by West Nile at 1.4 per cent. HIV prevalence in Kampala stood at 5.4 per cent.
Women continue to carry a higher burden of HIV, with prevalence estimated at 7.3 per cent compared with 4.1 per cent among men, a pattern that has remained largely unchanged since 2020. Overall, the findings estimate that about 1.496 million adults aged 15 years and above are living with HIV in Uganda.
Health Minister Dr Chris Baryomunsi said the country is encouraged by the progress made in ensuring that people who know their HIV status are enrolled on treatment and achieve viral suppression. “Almost everyone who knows they are living with HIV is on treatment, and almost everyone on treatment has suppressed the virus. Our biggest remaining gap is at the very start: about one in seven people living with HIV do not know their status,” Baryomunsi said.
Baryomunsi said the survey covered 11 geographic regions and revealed considerable variations in HIV prevalence, requiring health authorities to tailor interventions to the needs of different populations.
He said Uganda can increase the proportion of people who know their HIV status from the current 85 per cent to the national target of 95 per cent by 2030 if people are given more options for testing. He particularly pointed to HIV self-testing as one of the approaches that could help close the remaining testing gap and enable the country to identify more people living with HIV who are currently unaware of their status-URN. Give us feedback on this story through our email: kamwokyatimes@gmail.com
