§ The Earl of Sandwichasked Her Majesty's Government:
Whether they have any new evidence of a reduction in the incidence or prevalence of the HIV virus (a) in Uganda, and (b) in any other country in East Africa; and, if so, whether the reduction can be quantified. [HL3465]
§ Baroness AmosIn Uganda, the latest published figures (March 1998) of HIV prevalence rates reported from sentinel sites based in antenatal clinics show a consistent, if slow, decline since their peak in 1992. In urban Kampala, rates have fallen from a high of around 30 per cent. of all pregnant mothers attending clinics being positive in 1992 to around 15 per cent. in late 1997, while in rural areas the fall has been from a high of around 15 per cent. in 1992 to around 7 per cent. in late 1997. This downward trend is confirmed from a long term population-based study being conducted by the Medical Research Council in a rural area of Uganda where rates show a fall from 8.2 per cent. of the population studied being positive in 1990, to 6.9 per cent. in 1997. Early evidence also suggests a decline in prevalence in the urban areas of Kenya from 20.3 per cent. to 16.6 per cent. between 1995 and 1996, and we expect that 1997–98 figures will confirm this decline. We do not as yet have similar data for Tanzania but we are working closely with the Government of Tanzania on their response to the epidemic.
Incidence rates—that is the rate at which new infections are being acquired rather than what percentage of a population is positive—are much more difficult and costly to measure. However, evidence from the work done by the Medical Research Council in Uganda, while not reaching statistical significance, indicates that the general trend for incidence is also downwards. If true this is also good news, but there is some concern that the fall may be more pronounced in older age groups and that efforts to target preventive measures towards children and adolescents may need to be increased.