KAMPALA — Kampala recorded an average of 211 new HIV infections every week over the 12 months to June 2026, according to a study by the Kampala Capital City Authority (KCCA), raising fresh concern over the city’s HIV prevention efforts.
The findings, presented during the 2026 Kampala HIV/TB Stakeholders’ Meeting, are based on HIV testing conducted among 649,570 people across health facilities between July 2025 and June 2026.
The study translates to about 30 new infections a day, 844 a month and 11,241 a year if the observed weekly rate is maintained.
The figures come at a time when Uganda has expanded its HIV prevention arsenal, including the introduction of lenacapavir, a twice-yearly injectable form of pre-exposure prophylaxis (PrEP). Yet the Kampala findings suggest that access to treatment has not eliminated the underlying drivers of new infections.
Dr Douglas Tuhumwire, KCCA’s Care and Treatment Lead, said the suspected factors include unregulated sexual activity in massage parlours, spas and lodges, domestic violence, structural inequalities and exposure influenced by digital and social media.
He cautioned, however, that the factors require further investigation before they can conclusively be established as the causes of the increase.
Women account for majority of new infections
Women accounted for 62 percent of the new HIV-positive cases, according to the study, while men accounted for 38 percent.
Although people aged 20 to 24 made up the largest proportion of those tested, the greatest concentration of new positive cases was among people aged 30 to 39. Women also represented 64 percent of all those tested.
The pattern is significant because it complicates the familiar framing of HIV as primarily a problem of adolescents and young adults. Kampala’s latest data point instead to a broader epidemic in which women in their thirties are carrying a substantial share of new infections.
Josephine Kaleebi, Executive Director of Reach out Mbuya Community Health Initiative, described the findings as alarming.
She said some adolescents who were protected from HIV transmission at birth are now acquiring the virus later in life because they have grown up in an era in which HIV treatment is widely available and may therefore perceive the disease as less dangerous.
Kaleebi called for renewed prevention messaging and greater efforts to engage young people.
Treatment gains masking prevention gap
Kampala’s treatment indicators remain comparatively strong.
The KCCA study found that 88 percent of people living with HIV know their status, while 78 percent of those diagnosed are enrolled on antiretroviral therapy. Among people on treatment, 97.5 percent have achieved viral suppression.
The high suppression rate reflects the progress Uganda has made in keeping people living with HIV healthy and reducing the likelihood of onward transmission.
But it also exposes a difficult contradiction: Uganda can become increasingly successful at treating HIV while continuing to struggle with preventing people from acquiring it in the first place.
Kampala’s stakeholders are therefore calling for prevention to receive renewed attention alongside treatment.
Dr Christopher Oundo, the KCCA HIV/TB Focal Person, acknowledged the progress in HIV care but said stigma, discrimination and continuing new infections remain major obstacles. He called for greater collaboration among institutions involved in the HIV response.
Calls for wider prevention choices
The findings come months after Uganda introduced lenacapavir, a long-acting HIV prevention injection administered once every six months.
The Ministry of Health launched the drug nationally in April 2026, adding it to existing prevention options such as daily oral PrEP, injectable cabotegravir and the dapivirine vaginal ring. Clinical evidence from trials in Uganda and South Africa found lenacapavir to be more than 99 percent effective at preventing HIV acquisition when used as prescribed.
KCCA said in May that six of its health centres were among public facilities providing lenacapavir in Kampala. The drug was initially supplied through a donation of 19,200 doses, while the Ministry of Health has planned to expand the programme to 300 facilities nationally.
The question now is whether prevention technologies can reach the people and environments where new infections are occurring.
Lord Mayor of Kampala Ronald Balimwezo urged government and development partners to increase funding for HIV programmes in the city, arguing that Kampala’s large day and night population places unusual pressure on its health system.
He also called for a coordinated referral network among non-governmental organisations, greater digitisation of health facilities and increased HIV testing.
The study’s findings are ultimately less about a single number than about a persistent problem in the HIV response: treatment can keep people alive, but treatment alone cannot stop transmission.
Kampala has demonstrated that it can suppress the virus in people already receiving care. The harder question is why thousands of people are still becoming infected in a city where testing, condoms, PrEP and now a six-monthly preventive injection are increasingly available.
That is the prevention gap Kampala must now confront.
