Morbidity and mortality as HIV prevention indicators; empowering LGBTIQQ in Uganda to manage HIV

MARPs in Uganda a local NGO, embarked on synthesizing reports from all its activities and uses standard knowledge development methods. Under the program “structural barriers to ART adherence in the Global South,” one of the themes that the NGO is obsessed about is morbidity and mortality from HIV/STIs. According to scholars, researchers and reviews form reports. Mortality from HIV is at higher rates and biologically aggressive in the Global South than the West. This disparity reflects social barriers that disproportionally hinder prevention and control efforts and modify the biological expression of disease. The political-social ecology contexts delineate social, economic, and cultural factors that are potentially responsible for the disparities. 

MARPs in Uganda will generate reviews from which content reports can be developed. This particular review is therefore guided by the social determinants of health disparities model, a model that identifies barriers associated with poverty, culture, and social injustice as major causes of health disparities. 

Barriers, genetic, biological, and environmental factors, influence differential outcomes along the entire HIV Prevention continuum, from prevention practices, housing, food supply, recreation, medical circumcision, ART adherence, screening and early detection to treatment and survival. Barriers related to poverty include lack of money for to pay user fee charges, transport means and inability to pay for treating opportunistic infections. Barriers related to culture include perceived invulnerability, folk beliefs, and  low social-economic status that impacts social or political mobility. Barriers related to social injustice include stigma, discrimination due to an HIV+ve diagnosis compounded by low social status. 

Many of these barriers are potentially modifiable. Thus, in addition to biomedical promotion, future efforts to reduce disparities should address social barriers that perpetuate disparities faced by those with HIV +ve diagnoses. It has been demonstrated that improving population health and achieving health equity requires addressing the social determinants of health. Recovering HIV care from the wayside and returning it into the hands of caregiving requires understanding the link between Structural barriers to ART adherence, challenges and potential ways forward. Further research into how these challenges are identified will link interests to solutions.