Mukono District Partners with UVRI and HIV Vaccine Programme to Pilot Monthly PrEP Pills in Koome Islands Amidst Mobility and Access Challenges.

Mukono District Headquarters:

Mukono District has partnered with the Uganda Virus Research Institute (UVRI) and the HIV Vaccine Programme to carry out a vital research study in Koome Sub- County, focusing on the safety and effectiveness of monthly Pre-Exposure Prophylaxis (PrEP) pills for adolescent girls and young women (AGYW). The study is part of a broader initiative to find more effective HIV prevention strategies for vulnerable populations in hard-to-reach island communities.

The research will assess whether the monthly PrEP pill is a safe and practical HIV prevention option for young women in Koome, where HIV prevalence remains significantly high. However, health officials acknowledged several implementation challenges, including the area's highly mobile population—particularly sex workers—geographic isolation, lack of healthcare facilities on some islands, and difficulties faced by staff in staying and working in such remote locations.

This engagement meeting, held at Mukono District Health Department Headquarters, brought together senior health officials, district councillors, and other key stakeholders. The meeting was part of a broader stakeholder engagement strategy led by UVRI, in line with its mandate to conduct research, surveillance, diagnostics, and community education related to viral infections and public health threats.

Dr. Isaac Dumba, the Mukono District HIV Focal Person, noted that AGYW in Koome remain disproportionately affected by HIV due to both biological and socio-economic factors. “Access to prevention services is limited, and introducing new interventions like the monthly PrEP pill is a critical step in mitigating HIV transmission among this vulnerable group,” he emphasized.

Mathias Wambuzi, the Liaison Officer from UVRI’s HIV Vaccine Programme, explained that one challenge in conducting HIV research in Uganda is low public literacy about research processes. “Communities often expect instant results without understanding that scientific studies take time. Many previous participants have been volunteers, and we encourage more young women to engage meaningfully in this process as a way to contribute to the fight against HIV,” he said.

Dr. Mulindwa, speaking on behalf of Mukono District, stressed the logistical and environmental challenges of implementing health programs in Koome. “We are dealing with a scattered, mobile community, difficult terrain, and islands lacking basic infrastructure. Even traversing from one island to another poses a major challenge for our health teams,” he noted.

Ms. Gertrude Nanyonjo, a social behavioral scientist and community engagement specialist from UVRI, reiterated that involving local leaders is a fundamental aspect of ethical and effective research. “It is our duty to engage all stakeholders before beginning a new study to ensure transparency and community ownership,” she said.

The study, led by five research institutions, will also be conducted in Wakiso, Kalangala, Mityana, and Mukono districts, targeting young women aged 16 to 30.

Closing the meeting, the Speaker of Mituba IV Kawuga of Kyaggwe Ssaza County, Hon. Frank Ssekayiba, raised concern over early sexual activity among children in the community. “We have observed an increase in teenage pregnancies, often caused by economic hardships and lack of guidance. Parents often warn girls about pregnancy but don’t educate them about sex itself,” he said. He called for increased sensitization efforts, especially through motivational speakers, to guide young people toward responsible behavior.

The introduction of monthly PrEP pills in Koome Islands represents a hopeful step toward improving HIV prevention among high-risk populations. While challenges such as mobility, access, and health infrastructure remain, Mukono District, UVRI, and the HIV Vaccine Programme are committed to working with community leaders to ensure the study’s success. This initiative underscores the importance of research, stakeholder engagement, and youth-centered interventions in the broader fight against HIV/AIDS in Uganda’s hard-to-reach communities.