HIV response has continued to attract different approaches towards eliminating the epidemic, well knowing no single approach has been found effective enough to bring down the rate of new infections and spread of the disease. Uganda currently has an average of 7.3% prevalence rate among adult population aged 15-49 years. Compared to other African countries, this still presents a daunting task to the government and other stakeholders in the HIV response. The ambitious 90 90 90 target in global HIV response by 2020 implies a total decrease in HIV infection; that 90% of all those tested are enrolled on Anti-Retroviral treatment, and 90% of those having their viral loads suppressed is such an expeditious means to realization of a world free of HIV. Much as this has begun accumulating some positive results it is anticipated to hit a snag if prevention strategy is not encompassed.
There is need to institute the fourth 90% target, which should purely target prevention. In other words, we start with 90% of those who have not tested being reached with adequate prevention messages, 90% tested positive are enrolled on treatment and 90% have their viral load suppressed. The rationale is that bringing on board the other lot not targeted at all under the proposed 90 90 90 target will lower cases of new infection and reduce chances of those on treatment getting back to interfere with the neither positive nor negative individuals in the general population and vice vasa.
Imagine Uganda with 1.5 million infected individuals, with the 90 90 90 approach, where then do the rest of the population fall in the current HIV response. The answer to this is simple, the greater percentage of the population that is still free of HIV should be targeted with prevention through massive awareness and provision of HIV preventive materials including condoms for both male and female, lubricants for Key Populations among others.