In a recent report on HIV prevalence, it was observed that certain high-risk groups in the country, particularly truck drivers, were experiencing a notably higher rate of HIV infection compared to the national average. Dr. Nelson Musoba, the executive director of the Uganda AIDS Commission, emphasized the elevated risk among vulnerable groups, such as truck drivers, fishermen, sex workers, and farm laborers. While the national HIV prevalence stands at 5.4%, these specific groups are grappling with a prevalence rate ranging between 15-20%.
Dr. Musoba stressed the urgent need for increased awareness and interventions targeted at these key populations to combat the rising HIV risk.
Introduction to Mobile Men Program
For the first time, a groundbreaking initiative is set to offer men in Uganda and South Africa a choice in HIV prevention methods. This innovative program is evaluating the effectiveness of La-Cabotegravir in men who frequently move for work, and it will draw participants from locations where such mobile working men can be found, including fishermen, farm laborers, truck drivers, long-distance taxi drivers, and casual laborers, among others.
Dr. Eugene Ruzagira, the director of HIV prevention at UVRI in Entebbe and the leader of the study in Uganda, expressed his enthusiasm: “Finally, a study that will provide choice of HIV prevention options in Africa!”
Despite the presence of effective and readily available HIV testing, antiretroviral therapy, and oral PrEP, South Africa continues to witness new HIV infections, particularly among young mobile men who struggle to engage with existing interventions. Professor Maryam Shahmanesh highlighted the importance of the Mobile Men Program in providing evidence to support the expansion of effective biomedical HIV prevention for this at-risk demographic.
The program’s approach involves a mixed-method, multi-setting, open-label randomized study that will involve 400 HIV-negative men who frequently move for work in East London and KwaZulu-Natal, South Africa, and in Masaka, Uganda. These men will be randomly assigned to receive either oral TDF-FTC PrEP (event-driven or daily) or injectable PrEP (CAB-LA) over a period of nine months. After this initial phase, all participants will have the opportunity to choose their preferred PrEP option for an additional nine months, with the flexibility to switch as desired. Recruitment for the program is expected to commence in April 2024.
A study conducted by the National Library of Medicine in 2020 revealed that while uptake and retention of HIV pre-exposure prophylaxis were high among key and priority populations in South-Central Uganda, retention remained a challenge, especially among high-risk groups like fisher folk, sex workers, truck drivers, and adolescent girls. Male and female fisher folk were less likely to accept PrEP compared to HIV-discordant couples.
In 2022, over 52,000 new HIV infections were recorded, with 70% of these cases occurring in young girls aged 15-25, putting men at a heightened risk of HIV infection.
