Presentation at the 2 nd HIV Capacity Building Summit, Johannesburg, South Africa

1. 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

2. 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.

3. 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.

4. Methodology and strategies

5. 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

6. Results (1)- 340 trained Peer Educators trained by Category Peer Educators trained by sex

7. Results (2) - The Cascade

8. Results (3)

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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