Build soldiers capacity to combat the HIV epidemic

On the same day we commemorated World Aids Day 2024, I was at the vigil of a former classmate and fallen soldier who died of HIV related illnesses in Kenya.

Amid the sadness of the demise of a younger soldier it was an opportunity to take stock of the situation and renew our commitment to the fight against HIV/Aids.

In 2023, there were 39.9 million people living with HIV, while the death rate was 630,000 from HIV related illnesses, according to the World Health Organisation. Some 30.7 million people were on antiretroviral therapy by 2023. And about 1.3 million people acquired HIV.

Of the 39.9 million living with HIV, 20.8 million are in Eastern and Southern Africa, where  260,000 HIV related deaths occurred. Close to 5.1 million people are living with HIV in West and North Africa, with about 130,000 Aids related deaths occurring. 

Among the statistics are the armed forces. 

The UNAids report on HIV among armed forces states that there are 22 million people globally in the armed forces and four out of 10 are exposed to HIV/Aids unknowingly.

HIV prevalence among uniformed men and women is underestimated, and large numbers of soldiers and police officers have died while others are living on antiretroviral treatment.

Some of the conditions that exposed uniformed men to HIV include alcohol and substance abuse, prevalence of sexually transmitted infections, economic deprivation, mobility and a mindset about their mortality.

Philly Bongole Lutaaya, a Ugandan musician who publicly declared back in 1988 that he was HIV positive. He travelled around the country opening up discussions about the disease. He died the following year and his song, Alone, became an anthem. The chorus goes: “Today it’s me, tomorrow someone else. It’s me and you, we’ve got to stand up and fight, We’ll shed a light in the fight against Aids.”

Soldiers and all uniformed men need the same courage and wisdom. 

According to a Sonke Gender Justice report, “In societies most affected by HIV/Aids, it is a country’s military institutions, and the men and women who serve in them, that are often hardest hit. The rate of HIV infection is often much higher in the armed forces than it is in the rest of the population.

“In many African countries, including South Africa, the defence forces are not merely the most vulnerable to HIV infection; they are also the most likely to spread the infection.”

Some of the problems include irregular testing Linkage to prevention services, Linkage to treatment and care, Adherence and retention, Viral load monitoring, Lost follow up, Inadequate supply of testing Kits and drugs and Economic deprivation.

It’s important to track HIV prevalence, retention, care and treatment and viral load suppression among the armed forces to achieve the 2024 Global Aids Strategy targets of 95-95-95 (access to HIV services) and 10-10-10 (removing social and legal obstacles to using HIV services). 

Soldiers are psychologically at the front line of danger, and this has led them to risky behaviour such as random sex without any form of protection and not being tested for HIV.

This attitude and other cultural beliefs have exposed our guardians to HIV; they need to change their mindset and adopt the gift of life.

The mobility of soldiers from one station to another, as well as occupational hazards, escalates the spread of HIV. If those on treatment miss taking antiretrovirals, it will affect their viral load suppression. 

The issue can be addressed through a number of measures.

• Addressing healthcare disparities without involving the army bases, police barracks and host communities is a waste of time; they must be included in initiatives to control and manage the HIV epidemic.
• Having a number of testing points can be used to address the problem of irregular testing.
• The timely use of pre-exposure prophylaxis medicine to prevent getting HIV, and taking post-exposure prophylaxis medicine within 72 hours of exposure; ATM points that disburse condoms; and the distribution of HIV self-testing kits hold a huge potential.
• Sending SMS messages as reminders and multi-month dispensing of antiretrovirals also play a crucial part. 
• Using Vistec to spur viral load monitoring and redistribution and timely ordering can address the kits and drugs shortage.
• HIV thrives a lot in a poverty environment, therefore increasing the wages of the armed forces and scaling up social uplifting programmes will change lives and help unplug economic deprivation from African armies.
• Leveraging technology will protect the data of members in the armed forces, ensuring confidentiality in the fight against HIV.
• Rescinding discriminatory laws that target priority populations is essential to attain the 95-95 UNAids targets.
• Forging partnerships with HIV-centered civil society organisations and local host communities.
• Working to shift behavioral risk factors among uniformed men and women.

Reducing the acquisition and transmission of HIV is critical to attain control over the HIV epidemic.

Robert Kigongo is a sustainable development analyst.