By Aggrey Baba
New data from the Ministry of Health shows that some cities and districts in Uganda are still facing very high HIV rates, even as the country celebrates progress in reducing the overall number of new infections.
The 2025 National HIV Estimates Report shows that Fort Portal City has the highest HIV prevalence in Uganda at 14.3%, followed by Kyotera (12.6%), Kalangala (12.0%), and Soroti City (11.6%). These numbers are nearly three times higher than the national average of 4.9%.
Other areas with high HIV rates include Mbarara City (9.9%), Gulu City (9.6%), Lira City (9.1%), Buikwe (8.8%), and Hoima City (7.7%).
Health experts have warned that these hotspots are mostly located along busy transport routes, border towns, and islands (places where sexual activity is high due to poverty, long)distance travel, and tourism).
As reported in today’s Weekend Vision,Jotham Mubangizi, an advisor with UNAIDS, said fishing communities, truck drivers, and young women in slums are most at risk.
“There is a lot of risky sexual behaviour in these places. Some people have money, others are poor and desperate, and there is not enough condom use or testing,” explained, adding that the route from Nairobi to South Sudan via Kampala, and other roads connecting to Rwanda and the DRC, are areas where HIV is spreading fast due to mobile populations and poor access to prevention.
He added that many young women working in cities like Fort Portal and Mbarara earn very little and are forced into transactional sex to survive.
The report also links high HIV rates to problems such as gender-based violence, wife inheritance, teenage pregnancy, and school drop-out, especially among young people in town areas.
Uganda has made progress overall, with new infections dropping from 97,000 to 37,000 over the past 15 years. But many of the new infections are still happening among young people. In 2024, 14,000 young people aged 15–24 got infected, and 70% of them were girls and young women.
A doctor from the Uganda AIDS Commission, said while adult HIV services are improving, children and men are still being left behind, adding that they have tested 94% of adults living with HIV, and 90% are on treatment. But only 80% of children aged 0–14 have been tested, meaning 1 in 5 infected children may not know they are sick.
20,000 people died of AIDS-related illnesses in 2024, despite the availability of antiretroviral drugs in public health centers. Experts say stigma, late testing, and poor access to treatment are to blame.
Government is working toward the 95-95-95 target by 2025, where 95% of HIV-positive people should know their status, 95% of them should be on treatment, and 95% of those on treatment should have a suppressed viral load.
To stop the spread, health experts are calling for targeted services in high-risk areas like slums, fishing villages, and border towns. They also want condoms made more available and stronger action from cultural and religious leaders to stop harmful practices like wife inheritance.
