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By Aggrey Baba
Despite years of progress in the fight against HIV, the epidemic in Uganda continues to wear skirts and dresses. National data shows that out of an estimated 1.5 million Ugandans living with HIV today, nearly two-thirds are women and girls.
Among young people aged 15 to 24, about seven in every ten new infections occur among adolescent girls, painting a troubling picture of how poverty and gender inequality still determine who bears the heaviest burden of disease.
Health experts say the imbalance is not biological but social, rooted in inequality, dependence, and vulnerability. The Uganda AIDS Commission explains that poverty remains one of the biggest drivers of new infections among women.
In many villages, a young woman’s ability to make independent choices about her body is limited by her economic situation. When food runs out or school fees can’t be paid, survival frequently depends on men who can offer financial help.
A UNAIDS strategist notes that many girls and young women are drawn into risky sexual relations out of economic necessity rather than desire. In such circumstances, condom negotiation becomes nearly impossible because rejecting unsafe sex might mean losing vital support such as rent or school fees.
Women’s rights advocates have long warned that the power gap between men and women remains a major challenge in ending new infections, arguing that the struggle is not about ignorance but the inability of women to make decisions that protect them. Many women at the lower end of the economic ladder can’t influence what happens in their sexual relationships because they depend entirely on men for basic needs.
Officials from the Uganda AIDS Commission, point out that women with no access to land, stable jobs, or financial independence remain at the highest risk. This group represents the intersection of poverty and powerlessness, two forces that continue to fuel the epidemic among women.
District health officers in high-prevalence regions such as Kyotera report that the economic challenges facing women and girls have driven many into commercial sex work. In Kyotera District, where prevalence is currently the highest in the country, a health officer observes that sex work offers faster money compared to other available jobs, especially for school dropouts and young mothers.
The promise of quick earnings often outweighs the fear of infection, as women are forced to make choices based on immediate needs like food, rent, and school fees for their children.
In Gulu City, health officials estimate that over 5,000 sex workers (most of them young girls and single mothers) operate daily. For many of them, hunger and survival remain stronger motivators than health concerns. The HIV story, therefore, can’t be told without acknowledging the deep link between poverty and exposure to risk.
While Uganda has made progress in introducing new HIV prevention tools such as Pre-Exposure Prophylaxis (PrEP) and the dapivirine vaginal ring, access remains limited. Ministry of Health data indicates that the country recently received only 2,400 vaginal rings for nationwide use, far below the actual need. According to Dr. Herbert Kadama from the Ministry’s HIV Prevention Division, logistical gaps and funding limitations have slowed down the scale-up process.
He says that while these tools can empower women to protect themselves without depending on male cooperation, many women in rural areas are not yet aware of them or can’t access them due to supply shortages.
Women’s rights organizations argue that distribution should prioritize those at highest risk, particularly in border districts and urban centers where infection rates remain high.
They have also urged the government to fund more community-level education to help women understand and trust new prevention technologies.
Education remains one of the strongest shields against new infections. Research shows that girls who stay in school are far less likely to engage in early sexual activity or transactional relationships, with UNAIDS Executive Director Winnie Byanyima emphasizing that keeping girls in school protects them from both economic desperation and sexual exploitation.
She believes that policies to reduce school dropout, delay early marriage, and improve access to menstrual hygiene materials can significantly reduce HIV vulnerability among adolescent girls. (For comments on this story, get back to us on 0705579994 [WhatsApp line], 0779411734 & 041 4674611 or email us at mulengeranews@gmail.com).
