Uganda’s gains in the war against HIV/AIDS have slowly declined over the years. The country reached its peak in its war against HIV/AIDS, in 2004-2006 where it was internationally recognized for the prevention of more infections using the ABC: Abstinence, Be Faithful and Use Condoms strategy. However, the emphasis has since shifted more to HIV/AIDS care where the government has put more resources behind enriching and prolonging the lives of people living with HIV/AIDS. This shift in focus has consequently led to the rise in number of people infected with HIV with each passing year, with the projected number of new infections put at 700,000 by 2016, according to the 2011 Uganda National HIV/AIDS Indicator Survey.
PACE has adopted the National HIV Prevention Strategy that combines service provision alongside addressing the socio-cultural behavioral issues facilitating the spread of HIV. To tackle the issue of behavioral change, PACE has a program, Community Driven Response (CDR) where it basically reaches out to communities through interpersonal communicators (IPCs) and Village Health Teams (VHTs). These IPCs and VHTs talk to families during home visits and communities at large in a bid to influence behavioral change that leads to prevention of HIV infection.
CDR, funded by the Civil Society Fund (CSF), has specific focus on vulnerable groups of people: female sex workers and their clients, uniform service personnel, pregnant women living with HIV/AIDS, prison inmates, long distance truck drivers, among others. The program has had notable success in the 17 districts in which it has been implemented, including Iganga, Jinja, Masaka, Lwengo, Kabarole.
The program works with Community Based Organisations (CBOs) that facilitate the training of Village Health Teams (VHTs) to carry out community mobilization, education of people about prevention of HIV/AIDS, testing, treatment and link them with various health facilities that offer these services. In 2012 alone, CDR worked with 42 CBOs and 7430 VHTs who also supported the Ministry of Health to move free government condoms from health facilities to the end users.
St Catherine Vocational Group, a CBO based in Kabale district, and is supported through the CDR project, focuses on giving life skills to such vulnerable women as part of HIV prevention efforts.
Composed of 11 women, mostly single mothers with small children, the group has been trained in candle making that has helped address one of the key drivers to HIV: poverty. These mothers make and sell these candles within their communities which has improved their livelihood and increased their confidence.
Martin, the head of the CBO, KADONE, that trains these women, says that the CBO usually conducts assessments to identify homesteads that need support and give that support. Comprehensive packages are offered in terms of income generating activities and life skills. Its priority groups are orphans and vulnerable children, poor households in Kabale.
CDR also works with VHTs who carry out dialogue sessions with different target groups where emphasis is placed on factors that have been proven through studies as key facilitators in the spread of HIV, for example, multiple concurrent sexual partners, polygamy, sexual-based violence, gender-based violence and socio-economic factors like poverty that pushes women to have sex for money.
The program has also enlisted clan and religious leaders to speak to these groups to bring about positive behavior change. Peer educators have also been trained to talk to their fellow people in closed off groups like sex-workers and prison inmates.
As a result of these interventions across the board with the combined efforts of CBOs, VHTs, IPCs, clan and religious leaders and peer educators, the CDR program in 2012, enabled 19,000 men to undergo safe male circumcision, 54,000 people to undergo HIV counseling and testing, more than 6,000 pregnant women were enrolled and adhered to Prevention of Mother to Child Transmission (PMTCT), 2.5 million male condoms and close to 500,000 female condoms were distributed; and as a result, 1,276 cases of HIV were averted.