Every day, roughly 100 Ugandans acquire HIV. That number is falling but not fast enough. According to the Uganda AIDS Commission (UAC), new HIV infections declined sharply from 52,000 in 2022 to 38,000 in 2023, a 26.9% drop. However, from 2023 to 2024, the decline slowed sharply from 38,000 to 37,000, representing just 2.6%.
National HIV prevalence among adults aged 15–49 has declined from 5.4% in 2020 to 4.9% in 2024, but this figure masks deep inequalities. Women bear a disproportionate burden (6.4%) compared to men (3.4%), and adolescent girls and young women face the sharpest risk, accounting for 78% of new infections in the 15–24 age group. Geographically, cities are hotspots: Fort Portal (14%), Mbarara (9.9%), and Gulu (9.6%). AIDS-related deaths stood at 20,000 in 2024, a 64% decline from 2010, but that is still 20,000 lives lost. With just four years to the 2030 deadline to end HIV/AIDS as a public health threat, Uganda stands at a critical crossroads.
The 2030 Targets and the Gaps
In 2015, the United Nations adopted the Sustainable Development Goals (SDGs), with SDG 3.3 explicitly calling for an end to the AIDS epidemic by 2030. At the June 2021 UN General Assembly High-Level Meeting on AIDS, member states, including Uganda committed to a 90% reduction in new HIV infections and AIDS-related deaths from 2010 baseline levels, and to achieving the 95-95-95 treatment targets.
Uganda has registered significant progress since 2010, but the country remains far from where it needs to be by 2030. The table below shows the targets against Uganda’s current position:
| Indicator | 2010 Baseline | 2030 Target | Uganda 2024 |
| New HIV infections | 96,000 | ≤9,600 (90% reduction) | 37,000 (61% decline) |
| AIDS-related deaths | 56,000 | ≤9,600 (90% reduction) | 20,000 (64% decline) |
| People Living with HIV (PLHIV) who know their status | — | 95% | 94% |
| PLHIV on treatment (of those who know status) | — | 95% | 90% |
| PLHIV virally suppressed (of those on treatment) | — | 95% | 97% |
On the treatment cascade, Uganda is close but not yet there. As of 2024, 94% of the People Living with HIV (PLHIV) know their status, 90% of those are on treatment, and 97% of those on treatment are virally suppressed. Viral suppression exceeds the target; the first two indicators fall just below 95%, meaning thousands remain undiagnosed or off treatment. On prevention, the gap is far wider: with 37,000 new infections against a target of fewer than 9,600, Uganda must cut new infections by another 74% in just four years. On AIDS-related deaths, Uganda recorded 20,000 in 2024 against a 2030 target of fewer than 9,600, still more than two times the target, underscoring that keeping people alive requires not just getting them on treatment, but ensuring they stay on it and are virally suppressed.
What is Driving New Infections and AIDS Deaths?
Risky behaviours and complacency. Multiple sexual partnerships, low condom use, and transactional sex drive new infections, compounded by a growing belief that antiretroviral therapy (ART) has made HIV manageable and therefore not a life-threatening disease. Additionally, many people delay or avoid care, increasing vulnerability to opportunistic infections and premature death.
Gaps in testing and prevention access. One in ten Ugandans living with HIV does not know their status. PrEP (pre-exposure prophylaxis), PEP (post-exposure prophylaxis), and HIV testing remain out of reach for many, particularly in rural areas and among key populations.
Disproportionate burden on young women and girls. Adolescent girls and young women account for 78% of new infections in the 15–24 age group. Poverty drives many into transactional sex, gender inequality limits their ability to negotiate safe sex, and gender-based violence strips away what little agency they have. Until these structural drivers are tackled alongside biomedical interventions, young women will continue to bear a disproportionate share of Uganda’s HIV burden.
Closing the Gap: What Uganda Must Do Now
Accelerate HIV prevention efforts. The Ministry of Health should urgently scale PrEP and HIV self-testing, prioritising adolescent girls and young women. Outreach must intensify in high-burden hotspots such as Fort Portal, Mbarara, and Gulu cities, as well as fishing villages and transport corridors. Critically, prevention must go beyond biomedical tools- it must address poverty, gender-based violence, and unequal power in relationships. This calls for targeted empowerment programmes that equip young women with economic opportunities through vocational training, microfinance, and income-generating initiatives so that financial independence, not transactional sex, becomes their path to survival.
Close the testing and treatment gaps. With one in ten Ugandans living with HIV still undiagnosed, the Ministry of Health should scale community-based testing through mobile units, door-to-door campaigns, and index testing. HIV testing and treatment should be fully integrated into routine healthcare settings, such as antenatal clinics, TB services, and outpatient departments, so that every health encounter becomes an opportunity to close the gap. The missing 5% of those not yet on treatment should be actively reached, not passively waited for.
Keeping PLHIV on treatment. Getting people on treatment is only half the battle, keeping them there is where Uganda’s 20,000 annual AIDS deaths are won or lost. SMS reminders and multi-month dispensing reduce clinic burden and drop-off. Peer support groups and adherence counselling should be expanded to combat stigma, and active tracing of those lost to follow-up should be treated with the same urgency as finding new cases.
Uganda has proven it can fight HIV. The 64% decline in AIDS-related deaths and 61% reduction in new HIV infections since 2010 are real, hard-won progress. But progress is not the same as finishing. With 37,000 new infections and 20,000 deaths still occurring in a year, the epidemic is not over; it has simply slowed. The 2030 deadline is now four years away, and the gap remains large. Closing it demands urgent, coordinated action from Uganda’s government, development partners, and communities: scale up prevention efforts, reach the undiagnosed, protect the most vulnerable, and treat every person lost to follow-up as a failure the system must correct. The clock is running and it will not wait.