Papers selected for retrieval were assessed by two independent reviewers for methodological quality and to determine the extent to which a study addressed the possibility of bias in its design, conduct and analysis, prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) [17] .

Data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. This review considered any studies that reported HIV prevention or control as an intervention. This review considered studies that included the following HIV intervention methods: Abstinence, being Faithful and Condom use (ABC), Post-exposure prophylaxis (PEP), Pre-exposure prophylaxis (PrEP,) and early antiretroviral therapy (ART). Data extraction tool was formulated around PICO (Population, Intervention, Comparator and outcome) elements of systematic reviews. Two reviewers used MS Excel spread sheets to extract and summarize the following information: authors, year of publication, and country of study, HIV intervention, study design, settings/context, study participants, key findings/outcomes, and main conclusions.

Abstinence, being Faithful and Condom use. The first cases of AIDS in Uganda were reported in 1982 from Rakai district in the south west of the country, bordering Tanzania [19] . The ABC strategy is credited for bringing the HIV/AIDS epidemic under control in Uganda. By promoting abstinence, being faithful, and condom use. Between the late 1980s and mid 1990s, at a time when HIV/AIDS was well on its way toward ravaging Sub-Saharan Africa, Uganda achieved an extraordinary feat [20] . The ABC strategy came into limelight of the world, when Ugandan President Yoweri Museveni, in his address to the International AIDS Conference in Bangkok [21] , July 14, 2004. Popularized ABC strategy as a success story for HIV control in Uganda. Museveni explained to the world the ABC strategy as “Abstain from sex or delay having sex if you are young and not married, be Faithful to your sexual partner (zero-grazing), after testing, or use a Condom properly and consistently if you are going to move around. Since then the strategy was globally popularized as the ABC strategy”. Uganda’s HIV prevalence steadily increased until about 1991, when it peaked at about 15% (30% among pregnant women in urban areas) [22] . It then turned sharply downward through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001, this was ABC at work.

The strength of the ABC strategy having been credited with much of the success in Uganda’s 2001 is that, the three components are closely inter twined, complement each other in much the same way like all the critical components of a car need to be in place for it to move. On the other hand, its limitation is that none of the components can independently bring down or reduce the HIV problem.

World Bank report 2003 on ABCs of HIV prevention evidence from other Countries show that, while Uganda provides dramatic effect of ABC behavior changes on slowing the spread of HIV infection, there is growing evidence from Thailand, the first Asian country to face a serious AIDS epidemic, prostitution was the main source of HIV infection. In the early 1990s, the government instituted a “100 percent condom use” policy in brothels, which was widely credited with sharply reducing the spread of HIV infection [23] . Analyzing the three ABC components independently, there is no doubt that Abstinence is 100% effective if “used” with perfect consistency. But common sense suggests that in the real world, it can and does fail.

Does condom use guarantee safety from HIV infection? The real and bitter truth is that condoms have a failure rate, however minimal. Some studies claim that “consistent and correct” male condom use only reduces infection by 90% [24] , while, Female condoms can reduce HIV transmission by as much as 94 percent when used correctly with every intercourse [25] . The second is that condoms institutionalize promiscuity, the behavior that is at the heart of the sexually transmitted epidemic. In Uganda Condoms are distributed in almost all public places except churches, but right use of the condom remains a mystery given increasing incidence of new HIV infections in Uganda and other countries. On the other hand, it should be noted that, In Uganda, condom use is affected by a range of socio-cultural factors. The negative attitude towards condom use in some families and in long-term relationship is seen as a lack of trust. While some people believe that, Condoms reduce sexual pleasure and may have physical side effects, using Uganda condoms that are free of charge is perceived as being cheap by women. According to Catherine Kemigabo, the district Health Educator Kabarole Uganda, some women claim that, men won’t pay for sex if a woman insist on condom usage. This implies that, some women are economically compelled into actions that could be easily avoided, but also reflects knowledge gap among men on HIV transmission. In our society, cultural reasons like polygamy also negatively impact on condom use. The need for periodic and intensified promotion of condom use across board could lead to positive behavioral change towards condom use in the African setting.

The question is whether promotion of condom use will lead us to the promised land of a HIV free world by 2030 and beyond. It goes without saying that condom use plays a significant role in prevention of a number of other STIs as well as a contraception. It is on record that Female condoms are up to 95 percent efficacious in preventing pregnancy [26] , but even then, throughout all the aforementioned situations, high level consistent right use must be observed.

According to the Guttmacher Report on Public policy volume 7, issue 4, (B) of ABC could mean lifelong monogamy, serial monogamy, faithfulness within a polygamous marriage or an overall reduction in the number of one’s casual sexual partners. While being faithful is a moral obligation for married people. Society is slowly taking diversionary direction of unfaithfulness, and this occasionally lead to acquisition of HIV /AIDS. Whereas a lot has been done to popularize this concept with no doubt that people understand and appreciate the concept, it is evident that peoples’ practices do not much the concept’s knowledge. The question remains what has gone wrong? Shall we maintain the status quo and expect to save the world from HIV problem? Probably the answer is that, we need to do things differently.

This is yet another tested and proven HIV preventive strategy. PEP stands for post-exposure prophylaxis [27] . The word “prophylaxis” means to prevent or control the spread of an infection or disease. PEP means taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV to prevent HIV infection [28] . According to the Centers for Disease Control report 2022, PEP is the use of antiretroviral drugs after a single high-risk event to stop HIV seroconversion. PEP must be started as soon as possible to be effective—and always within 72 hours of a possible exposure. CDC explains exposure to HIV as a medical emergency because HIV establishes infection very quickly, often within 24 to 36 hours after exposure.

There are two recommend PEP preventive treatment regimen Tenofovir (TDF) (300 mg) + emtricitabine (F) (200 mg) once daily PLUS raltegravir (RAL) (400 mg) twice daily or dolutegravir (DTG) (50 mg) once daily TDF (300 mg) + F (200 mg) once daily PLUS darunavir (DRV) (800 mg) + ritonavir * (RTV) (100 mg) once daily [29] [30] . Note that, PEP is not recommended when care is sought > 72 hours after exposure. Where it is indicted, PEP duration is a 28-day course of a three-drug antiretroviral regimen. Furthermore, unlike a few other preventive measures, it is on record that PEP is an important method of protecting pregnant mothers from getting HIV as it is indicated to pregnant mothers at any time during pregnancy. Studies have demonstrated that, PEP is a safe method of HIV prevention [31] , a case-control study of occupational exposures demonstrated an 81% reduction in HIV infection in those who received AZT alone compared with those who did not receive any treatment. PEP was then strongly recommended/proposed for occupational exposure. However, it’s unclear whether HIV prevention key populations in resource poor settings can access PEP as and when they need it. According to Junyan Jin of Beijing Youan Hospital china, the study earlier cited shows that poor uptake of PEP is due to individual, social and structural factors including lack of awareness, stigma and timely access.

In view of what is discussed above, PEP remains a relevant and effective preventive measure for HIV in emergency settings, if guidelines and right steps are followed, this one way that may contribute to achievement of HIV free world by 2030 and beyond.

In September 2015, WHO recommended that people at substantial risk of HIV infection should be offered tenofovir disoproxil fumarate (TDF)-based oral PrEP as an additional prevention [32] . Pre-exposure prophylaxis (or PrEP) is medicine taken to prevent getting HIV. PrEP is highly effective for preventing HIV reduces the risk of getting HIV from sex by about 99%, and risk of getting HIV from injection drug use by at least 74%. This is in accordance with Centers for Disease Control on HIV prevention. We can be emphasized here that, Oral PrEP is highly effective at preventing HIV when used as directed and it remains an important choice as part of the comprehensive HIV preventive measure that can contribute to AHIV free world by 2030 and beyond.

Explore interventions, which will empower women and children with HIV/AIDS survival skills in African setting in order to end the AIDs HIV/AIDs scourge.

Women and children are targeted in this objective, because world over, women are disproportionately infected and affected by HIV/AIDs [37] . This is mainly due to Gender in equality and harm social norms, gender based violence, the high school dropout rates for girls, the sugar daddy culture and transactional sex, limited access to Health survives, the age restrictions to access services and last but far from least poverty and economic issues. In line with the above mentioned situation, one can assert that, an intervention which targets a woman in HIV control would to a greater extern succeed in reducing the spread as women appear to be a big pool or source of HIV infection that occasionally lead to sustained transmission in society.

Children are just the victims of the circumstance. They are either infected vertically from mother to child, raped when still young while others are lured into sex by men at a time when they have great social needs, but are financially disadvantaged. Recent Publications by Elizabeth Glazer Pediatric foundation [38] show that, more than 90 percent of HIV infections in children result from mother-to-child-transmission, where the virus is passed from a mother living with HIV to her baby during pregnancy, childbirth, or breastfeeding.

The risk of this form of transmission increases in direct relation to the severity of the mother’s HIV infection. UNAIDS estimates show that 1.8 million children below the age of 15 years are living with HIV worldwide [39] Sub-Saharan Africa (SSA) is heavily burdened by HIV, with 85% of new infections among adolescents happening in the region. According to a report by Winnie Byaminyima a United Nations official in 2021 UN report. Gender inequalities increase women’s HIV risks more especially in sub-Saharan Africa, where women accounted for 63 per cent of new HIV infections in 2021. Adolescent girls and young women (aged 15 to 24 years) are three times more likely to acquire HIV than adolescent boys and young men of the same age group in sub-Saharan Africa. In view of the situation highlighted above, prioritization of resources anywhere in the world to provide high-quality HIV prevention, care and treatment services targeting women and children, in families living with and affected by HIV and AIDS could save the world from the HIV pandemic.

Innovative modalities of limiting children’s access to destructive technologies. This calls for policy reforms that limit access and use of mass media technologies that display pornographic materials that motive children engage in sex discovery at a young age.

Discussion: we appreciate the global technological advancement in Use of mass media, social media TVs, phones and computers. However, we cannot continue burying our heads in sand like an ostrich. Our children in homes, schools, and communities, level of awareness on sexual matters is extremely high. From what they see, watch and hear and copy from technology access. By nature and environment that encircles them, they experience inner propelling force, towards discovering what they perceive as hidden pleasures in sex not knowing that, “the bees that keep the sweet honey also have the stings that punish those who sip the honey”. Therefore, children acquiring HIV at an early stage through sex discovery and experimentation is now inevitable in the 21^st century at the expense of global technological advancement. Recent children surveys in England to explore their interest in pornography and feelings toward it [40] show that, 53% of the 11 - 16 years surveyed reported viewing online pornography. The percentages increased by year from 28% of 11 - 12-year-olds to 65% of 15 - 16-year-olds.

The situation is more upsetting in the USA [41] . A study of 1501 children and adolescents (aged 10 - 17 years) in the USA, found that 87% of youth seeking sexual images online are 14 years of age or older. No such/similar studies have been conducted in Uganda, despite the overwhelming evidence in society about children access to internet and pornographic material.

As parents, leaders, technocrats, Development partners and any interested stakeholder reading this report there is urgent need more than ever before to develop strategies and policies that limit our young children access to bad technology at home and in schools? Can we use technology to make phones, computers and TVs with inbuilt commands to limit children access adult content? Can we introduce policies in various countries that dictate the type of phone, computer or screen one is to buy on proof of proper age certification? I implore scientists to help the world to Re-use advances in technology in fight against HIV/AIDs in young people other than having an open policy to accessing pornographic material that consequently fuel HIV transmission.

Develop and identify innovate crowd pulling and demand driven HIV/AIDs control interventions.

Discussion and overview innovative 3: we cannot continue doing business as usual delivering ABC strategy and expect to eliminate AIDS by 2030. We must develop creative, interesting, attractive efficient and cost effective interventions targeting the most vulnerable (youth). We share one “business unusual innovation” used in Fort Portal City, Kabarole District Western Uganda to attract youth take up HIV testing services. According to Uganda HIV/AIDs burden, 2022 Fact sheet, the HIV prevalence among adults (15 - 49 years) in Uganda is 5.5% [42] The prevalence is higher among females 6.8% and low in males 3.9% In contrast however, Fort Portal city located in western Uganda, the prevalence is over and doubles the national figure [43] .

According Catherine, the Kabarole district health educator, the Uganda AIDS Commission, 2020 report ranked Kabarole district in Western Uganda as the district with the second-highest HIV/AIDs prevalence rate, at 14.6%. Previously, the district’s prevalence rate had reduced to 7.3%. Kabarole district comes second after Kalangala district, at 18.8% followed by Mbarara 13.1%.

The Fort Fest Music concert, held in Fort Portal city every quarter. This is a youth gathering event (music concert by local musicians) the idea behind the Fest is to gather over 1000 youths and other people in one place. The music is tailored to HIV prevention and control. The concert leaves no one behind. Over 700 HIV tests are done in one day, the sick linked to care, none sick empowered by music to stay HIV free. Assuming such events are done in the entire Africa setting, how long would it take us to stamp out new infections of HIV? We implore the rest of the African countries to emirate the Fort Fest innovation which is more inclusive and leaves no youth behind in accessing HIV preventive services. Only then shall the world realize what seem to be overambitious target of ending HIV/AIDS by 2030.

Strengthen Governance structures in service delivery in the context of HIV/AIDs control and elimination in African setting. The need for community centered governance, political commitment and support, community participation and engagement in the eradication phase of HIV/AIDs is needed more than ever before.

Discussion. We need to strengthen the service delivery systems in our respective countries at all levels of service delivery in the context of HIV/AIDS control and eradication. This requires, leaders, political wing, technocrats, governance bodies and structures to work together and create a responsive Health system that will result in HIV/AIDs demand driven services. Countries with good governance appear to have low, stable HIV prevalence rates with stronger health systems [44] . It is evident that, developing stronger health systems and good governance leads to a lower more stable HIV prevalence rate. Our clients therefore, need first to trust and believe in health technocrats, the leaders and partners that, we care about them and every one with HIV and that we are doing everything possible to put to an end AIDs scourge. People will understand that we need to protect future generations against HIV and that the resources invested in HIV control could be used to provide services for other unavoidable challenges like cancer. Let’s ensure a more inclusive Community Leadership approach, a sustained leadership that includes women and key populations and ensure the available resources now and in the future are appropriated accordingly as suggested here above. This innovation if adopted and implemented; i.e. Good governance, political support, caring Human resource for health, community involvement with positive behavioral change will drive all of us to the Promised Land and new era of HIV free society post 2030.

To empower, invest and turn Key populations into strong allies in the fight against HIV other than reporting them in every forum as HIV transmitters or broadcasters.

Discussion. Available data in Uganda show that, Key populations bear the highest burden of HIV. Globally, such individuals and their partners could constitute over 70 percent of new HIV infections. In Uganda, recent studies [45] show that, 25% of new HIV infections are among the key populations and their partners. It is estimated that key populations in Uganda total approximately 310,000 individuals; of whom: 130,000 are female sex workers, 22,000 are men who have sex with men, 7500 are people who inject drugs, and more than 150,000 are people in prisons. In an event that no African nation at the moment, can meet 100% the needs of the key populations and therefore eliminate this category in society. Can we therefore innovatively turn the key populations into our strong allies in the fight against HIV/AIDs?

We implore the global community that time is today not tomorrow when we should develop modalities of working with Key populations, sex workers, MSW and Boda Boda riders [46] who have a high HIV prevalence of over 9% reported in recent studies. All should be actively engaged in the fight against HIV/AIDS. The big monies we share in HIV+ workshops, the fuel we burn in the land cruisers and Road master vehicles to attend HIV review meetings and conferences. Why not invest such resources in empowering the Key populations in the world to spear head the HIV fight among their peers and enable them have equal access to life saving combination HIV prevention and treatment services including PrEP and PEP.