Teddy Chimulwa - TASO, Uganda
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Transcript of Teddy Chimulwa - TASO, Uganda
Innovating for effective HIV Prevention Outcomes: The TASO Capacity building peer-to-peer model for Key
Populations supported by Civil Society Fund, 2011-2012
Presentation at the 2nd HIV Capacity Building Summit, Johannesburg, South Africa
March 19-21, 2013
Author: Teddy N. Chimulwa (Ms.)Team Leader, Psychosocial Services,
TASO Uganda Limited
Background and context• HIV prevalence in Uganda was estimated at 7.3%, an increase
from 6.4% in 2004 (UAIS, 2011).
• New infections were estimated to be on the increase, with about 134,000 people newly getting infected annually (MoH, 2010)
• “Know your Epidemic’, ‘Know your Response’ 2009, clearly articulates key populations as one of the key drivers of the HIV epidemic in Uganda
• TASO Mission:– To contribute to a process of preventing HIV infection, restoring hope
and improving the quality of life of persons, families and communities affected by HIV infection and disease.
Intervention • In 2011, TASO with support from the Civil Society Fund (CSF),
implemented HIV prevention interventions in 4 districts of Wakiso, Masaka, Mbale and Masindi for 18 months.
• Key population groups targeted were: – Commercial Sex Workers (CSWs), – Uniformed populations (Police and Armed Forces), – Fisher folk, – Truckers, – Incarcerated persons (IDPS) and – Out-of school youths.
• The peer-to-peer model for capacity building of key populations was adopted.
Methodology and strategiesConsultation with
district health office
Linkage to key population group
contacts
Sensitization of key population group
leadership
As gate-keepersTo obtain buy-in
Selection of participants to attend
Peer Educator’s training
Selection criteria jointly developed
Initial training conducted
3-days focusing on risk-reduction
strategies
Target setting for performance measurement
10 peers per Peer Educator per month
1-day Monthly mentorship and
performance review
Delivery of HIV Prevention service package to peers
BCC, RRC, Condom education &
distribution & Referral & Linkage to Care &
Treatment
End of Project Evaluation
Resources used• Meals, stationery and transport during training-
($6 per day per person)
• Monthly transport refund and lunch for mentorship and refresher meetings (approx. $4 per person per month)
• Only Uniformed personnel shared the costs of the training venue
Results (1)- 340 trained
Peer Educators trained by Category
CSWs
Fisher F
olk
Incarce
rated
Uniform
ed
109
29 33
169
Peer Educators trained by sex
Male; 137
Female; 203
Results (2) - The Cascade
340 Peer
educators
trained
296,980 pieces
of condoms were
distributed
3,353 (1620 males and 1733
females tested for HIV
4.6% positive
100% positive linked
to care-
87,010 (47,835 males and
39,175 females
) reached
with Risk
reduction
messages
HTC being conducted for the Armed forces
Results (3)
HIV Prevalence among Key Populations
HIV Results
CSWFisher Folk
Incarcerated
Population
Truckers
Uniformed men
& Partners
Youths out of school
TOTAL
Positive Col %
44.8
314.1
136.9
268.8
104.9
703.8
1544.6
Negative Col %
7995.2
72495.9
17693.1
27191.2
19495.1
175596.2
319995.4
TOTALCol %
83100.0
755100.0
189100.0
297100.0
204100.0
1825100.0
3353100.0
Results (4)• Each peer educator
reached 256 peers with key prevention messages
• HIV Prevention service package comprised ;– safer sex, – Sexual and Reproductive
Health (FP/STI), PMTCT, – HCT and – ABC– Condom education and
distribution
Challenges and counter strategies (1)
• Commercial sex work is not legal in Uganda– Initial efforts targeted their leaders, who then mobilized
their peers
• Engaging CSWs in training interrupted income generation – TASO provided a transport refund and lunch to each CSW
each time they were engaged for a full day
• Penetration of the uniformed personnel is bureaucratic– TASO engaged the leadership of the various uniformed
personnel categories to counter this
Challenges and counter strategies (2)
• Transfers amongst the uniformed– Training new Peer educators has been prioritized
in the new project
• Condom and HIV testing kits stock-outs– Better ordering and forecasting by implementing
sites adopted
Lessons learnt (1)
• Civil-Military partnerships
• Modular training - convenient; enhances better acquisition of knowledge and skills and eases Monitoring of progress
• Increased acceptability and uptake of HIV Prevention services
• Sustainability
• Strengthened referrals and linkage for SRH services and prevention technologies
Conclusion • Targeting key populations where majority of new
HIV infections are occurring increases uptake of HIV prevention services,
• Focus on the most affected Key population group (Truckers)
• Peer to Peer methods radically enhance acceptability of HIV prevention interventions
Acknowledgements • Co-Authors: Celestine, Madina, Hannington & Gorretti,
TASO Uganda Limited
• The Uganda AIDS Commission (UAC)
• Civil Society Fund (CSF)
• TASO Management, Staff, and Volunteers
• District Health Offices in the 4 districts
• Target Population groups in the implementing sites
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