The global response to HIV/AIDS has achieved some incredible results. Between 2001 and 2014, new HIV infections dropped 35% globally. The number of people accessing treatment increased to over 15 million, and AIDS-related deaths decreased from 1.7 million to 1.2 million in 2014. In 83 countries, the number of new HIV infections has notably decreased or has remained the same.
That’s the good news. And it is incredible news. But this progress sometimes means that pockets of high infections in specific countries are overlooked. So yes, the global infection rate today represents extraordinary progress when compared with infections in 2001. But the vast majority of infections occur in just 15 countries. If you live in one of these countries, it is harder to celebrate.
One such country is Uganda. Although progress has been made in Uganda since the 1980s, when the crisis looked as though it was running away from the world, the risks remain extremely high. In 2013 alone, Uganda had 140,000 new infections. That represents 7% of the world’s total increase in new cases of HIV and really highlights the inequitable nature of global progress.
Ugandan progress is unequal when compared with the rest of the world. In addition, within Uganda, progress is completely unbalanced. If you are a young person, a sex worker, a gay man, an injecting drug user, or an adolescent girl, you experience higher risk compared with the wider population. The HIV prevalence rate amongst sex workers, for example, is an astonishing 34%.
The reasons for the high rates of infection amongst these groups are, of course, diverse. But a key element is that conventional interventions, run by social services or large NGOs, are not reaching them, or are not reaching them in a format appropriate to the needs of the given population. This means that groups that need HIV services the most are being left behind by wider progress.
So how can we ensure that marginalised, high-risk populations can access key services? MTV Staying Alive’s answer is quite simple: we partner with youth-led, grassroots initiatives, who have close ties to the populations they serve, and give them the resources they need to deliver those services. Working in partnership like this, we create relevant interventions, honed to the needs of the target population.
For example, in July we will begin working with United Katuna Youth for HIV/AIDS Prevention (UKYHP) in southwest Uganda. UKYHP is a grassroots group, run by school drop-outs, students and former sex workers. They have close ties to the local population, an understanding of the challenges they face, and a level of access to high-risk young people that larger NGOs simply cannot replicate.
Between July 2016 and June 2017, we will support UKYHP as they go into high-risk locations, such as night clubs and lodges, and provide peer-delivered HIV education to 11,000 young women, adolescent girls, and commercial sex workers. Working in partnership like this, we can effectively reach out to populations, like sex workers and young women, with relevant and impactful services.
It is important that the successes of the global HIV movement do not conceal the huge amount of work still to be done. Uganda is an example of the challenges that still face the world. However, to see the full extent of the inequitable nature of progress, we should look within countries, to see the high concentration of infections amongst specific ages, genders, sexualities and social and economic statuses.
At MTV Staying Alive we have an effective methodology for reaching those that need help the most, but the scale of the problem means there is a huge amount to be done. We therefore urge the world to trust and invest in local, grassroots interventions. Working through local initiatives, we can reach those that have been left behind, and truly work towards the end of HIV/AIDS.