Why HIV prevalence is highest among the middle-aged in Uganda

What the report says

The Independent Uganda reported that President Yoweri Kaguta Museveni recently used a coronation event for the Omukama of Tooro to call on local leaders to address the region’s high HIV prevalence, contrasting it with Karamoja, where prevalence is lowest. The article says that warning is supported by new national findings released at the Uganda Media Centre by Health Minister Chris Baryomunsi from the Uganda Population-based HIV Impact Assessment (UPHIA 2025).

According to the survey, HIV prevalence among adults aged 15 and older stands at 5.9%, with higher rates among women than men. The piece notes that the national rate has remained broadly stable across the last three UPHIA surveys, suggesting progress in prevention and treatment, while also showing that the epidemic remains significant. The report says HIV infection is now especially concentrated among middle-aged adults, with prevalence rising sharply in the 40s, and among women in particular.

The article links this pattern to structural and social factors, including economic dependence, power imbalances in relationships, mobility for work, and lower condom use or testing among adults in long-term partnerships. It also points to regional differences, with the lowest prevalence in North East-Karamoja and higher levels in the South Western region, Buganda, and parts of western and central Uganda.

The broader public-health message is that national averages do not tell the whole story. The author argues for more targeted prevention, testing, treatment support, and resource allocation in higher-burden areas, alongside continued prevention efforts among young people and stronger community discussion about HIV among older adults.