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Introduction: Uganda is working toward eliminating HIV transmission by 2030. Yet in 2023, HIV infections among children accounted for 11% of all new HIV infections. We assessed trends and spatial distribution of diagnosed HIV incidence among children aged 0-14 years in Uganda from 2015 to 2023, to guide strategies toward achieving the 2030 goal of zero transmission. Methods: We analyzed routinely reported HIV surveillance data extracted from the electronic District Health Information Software version 2 (DHIS2), from 2015 to 2023. Diagnosed HIV incidence was computed as the number of newly diagnosed HIV-positive children divided by the corresponding population of children aged 0-14 years, expressed per 100,000, and stratified by region, sex, and age group. The significance of temporal trends was assessed using the Mann-Kendall test, and the magnitude of the trend using Sen’s slope test. To depict the spatial distribution of diagnosed HIV incidence from 2015 to 2023, we generated region- and district-level choropleth maps using Quantum Geographic Information System (QGIS) version 3.34. Results: During 2015–2023, 63,599 children aged 0-14 years were newly diagnosed with HIV, translating to an annual mean of 7,128 cases. The mean national annual incidence was 35 per 100,000 children, and diagnosed HIV incidence declined by 4.7 per 100,000 over the study period (95%CI: -7.9, -1.4; p=0.01). Kampala region consistently recorded the highest mean annual incidence (75 per 100,000), whereas Karamoja had the lowest (13 per 100,000). Kalangala District maintained a persistently high mean annual incidence (84 per 100,000) throughout the period. In contrast, diagnosed HIV incidence increased in Fort Portal (p=0.008) and Mbarara (p=0.03) in western Uganda, Lira (p=0.04) in northern Uganda, and Jinja (p=0.03) in eastern Uganda during 2015–2023. Conclusion: From 2015 to 2023, diagnosed pediatric HIV incidence declined, although the trend was non-linear, and geographical disparities persisted. Urban areas like Kampala and the fishing district of Kalangala persistently had high or increasing incidence. Some rural districts, including Kassanda and Luwero, and several cities showed an increasing incidence. Targeted interventions in high-burden districts and cities are needed to accelerate further reductions and support attainment of the 2030 goal of zero HIV transmission.
Wenani et al. (Fri,) studied this question.