Uganda hosts Africa’s largest refugee population, about one and a quarter million, mostly South Sudanese. Health workers warn that the refugees infected with HIV, the virus that causes AIDS, are not being properly tracked for treatment. They say the problems include ignorance, stigma, and refugee mobility.
Forty-five-year-old South Sudanese refugee Rose Amony knows how damaging HIV can be – she’s lived with it for 20 years.
Her husband infected her and then died of AIDS, leaving her to care for herself and an HIV-positive daughter.
“I have other children. Because of difficulties of school fees, most of them got married. They got married when they were still young. There was nobody to pay for their school fees,” Amony said.
Poverty is the biggest challenge for HIV-positive refugees in Uganda like Amony who acknowledge their status and get treatment.
But Ugandan health workers in Adjumani district say fewer than 1,000 refugees are on record as being HIV positive while at least double that number are believed to be infected.
Dr. Dolorence Mane Inyani, who leads the district HIV response team, blames ignorance for many refusing to be tested or dismissing test results.
"They have beliefs that HIV and AIDS is a disease of Ugandans and it may not affect them as South Sudanese," Dolorence said.
Refugee flows to and from Uganda make checking the spread of HIV a challenge.
Dr. Patrick Adrani is the coordinator of the NGO Medical Teams International.
"When you start somebody on treatment, they first go to Sudan, the other side. So, they come back after some time when they are very ill, so it becomes very difficult in terms of control. Also, again, that has contributed to resistance,” Adrani said.
Two-thirds of HIV positive refugees are women, whose families rely on them for a dowry payment from a prospective husband when they marry.
“So, once you diagnose a female as having HIV, it’s like you’re depriving them of having wealth. We have had scenarios where it became very difficult for the counselors to declare results to some of these communities, especially the female,” Adrani said.
