Conference abstract

Evaluation of community-based HIV service delivery models for sex workers along Malaba, Kampala Highway, Uganda, 2016

Pan African Medical Journal - Conference Proceedings. 2017:6(26).21 Dec 2017.
doi: 10.11604/pamj-cp.2017.6.26.508

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Keywords: Sex workers, HIV, Uganda
Plenary

Evaluation of community-based HIV service delivery models for sex workers along Malaba, Kampala Highway, Uganda, 2016

Gerald Pande1,&, Shaban Mugerwa2, Alex Riolexus Ario1

1Uganda Public Health Fellowship Program, Kampala, Uganda, 2Ministry of Health, Kampala, Uganda

&Corresponding author
Gerald Pande, Uganda Public Health Fellowship Program, Kampala, Uganda

Abstract

Introduction: sex worker’s community-based HIV service delivery models currently implemented. Daily static facility services which are located in hotspot areas where sex workers can easily access services without incurring transport costs. Sex workers seek services without making prior appointment anytime between 9am-10am at bars outreaches, clubs, brothels & homes. Peer to peer mechanisms which involves selection of sex workers, training and equipping them with HIV skills encourages uptake of HCT, HIV care, condoms and linkage into care. However, since inception of these HIV service community based model no evaluation has been done to know the most efficient model used to reach sex workers. This evaluation aimed at assessing the effectiveness of these models and identifying challenges in the implementation of these models.

Methods: this assessment adopted a cross-sectional study design using quantitative (interview with sex workers) and qualitative (interview MoH staff, health workers, district health team members, program staff at different levels involved in delivery of HIV care services) data collection methods. The study was conducted along Malaba-Kampala highway. It included hot spot areas in six districts, namely: Malaba-Tororo, Malaba-Busia, Iganga, Bugiri, Jinja and Kampala. The effectiveness of the model was the proportion of sex worker who have had an HIV test in the last 12 months through different model and the proportion of HIV positive sex workers linked to care through different models.

Results: the majority of the sex workers 71.7% ( 327/456) reported to have taken HCT services in the past 12 months from a static facility. Of those linked into care, 90.1% (120/132) reported to have been linked through static mechanism and 88.6% (117/132) of those in linked into care were on ART. Challenges faced by the providers include: stock out of testing kits, some people do not trust results given during outreaches especially if the blood is picked from a finger, Most outreaches are monthly which makes linkage to care hard because FSWs are mobile. The sex workers also faced challenges that included: Long waiting hours (especially in static clinics), some places do not have specific clinic for FSW, stigma and discrimination is still high among FSW and low facilitation for peer educators.

Conclusion: all three service delivery models are being implemented and should be promoted. Static service delivery model had the highest number of FSWs tested and linked to care. Lack of supplies and unfriendly service providers is a threat to access to care. Training of service providers on provision of friendly services and constant supply of test kits is recommended.