Background:  We estimated the HIV-related burden of disease including incidence, prevalence, disease, and death in Uganda and the effect of existing and potential interventions to mitigate the epidemic’s adverse effects.

Methods:  We analyzed ante-natal clinic surveillance data (1986-2002) and a recent population-based survey (2004-2005). Using the WHO Estimation and Projection Package software, we modeled the adult national HIV prevalence from 1981-2004 and assumed a stable prevalence of 6.4% from 2004-2010.  Using Spectrum and spreadsheet software, as well as census, survey, and prevention and treatment program data, we estimated incident and prevalent infections, and the magnitude of HIV disease and related deaths. 

Results:  The 2005 Uganda national HIV prevalence among 15- to 49-year-olds was 6.4%, resulting in an estimated 915,400 HIV-infected adults and children. We estimated 2005 adult HIV incidence to be 0.94%, corresponding to 115,800 adult and 19,600 pediatric (vertical) incident infections. Using survey data on respondents’ HIV testing history, we estimated that 647,000 (80%) HIV-infected adults were unaware of their infection in 2005. While 67,300 HIV-infected persons received ART in 2005, HIV still accounted for 76,300 deaths; one-third of all adult deaths were HIV-related. ART averted an estimated 14,400 deaths; estimated ART coverage was higher for adults (38.9%) than for children (15.4%). The use of single-dose nevirapine may have averted approximately 800 vertical infections. Complete coverage with co-trimoxazole prophylaxis for all HIV-infected adults could have saved 28,600 lives in 2005 and could save 283,300 life-years during 2005-2010.
Conclusions:  HIV/AIDS continues to be a leading cause of adult disease and death in Uganda. Prevention and treatment programs have a substantial effect on the burden of HIV/AIDS and, if scaled up, have potential to further mitigate it.