Towards a national AIDS-control program in Uganda.

A national AIDS-control program was developed in Uganda to deal with a potentially serious epidemic of the acquired immunodeficiency syndrome (AIDS). A cumulative total of 1,138 cases of AIDS has been reported in Uganda between 1983-since AIDS was introduced into the country-and March 1987. More than 80% of the victims are sexually active persons whereas less than 10% are infants and children younger than 5 years. Virtually no cases or seropositivity is reported in persons between the ages of 5 and 14 years or after the age of 60 years. Most transmission has been through the heterosexual route, and, unlike in the United States, the male-female ratio is 1:1. Heterosexual high-risk behavior is cited as an important mode of transmission. A survey of household contacts showed that despite the closeness, only the sexual partners were seropositive.A five-year plan of action has been developed, and health education is the main thrust. It also includes blood screening, improved sterile procedures, improved surveillance and notification, research and terminal patient care. The plan stresses integration based on primary health care. There are unresolved moral issues of whether or not to tell the truth to an AIDS victim or any healthy seropositive person in developing countries, especially unstable persons. The best approach is to sensitize everyone so that they become guardians of their lives because sexual behavior is an issue of individual responsibility.