17 August 2017

Uganda: Sex Workers Embrace Night HIV/Aids Testing Campaign

Photo: Daily Monitor
Under the Moonlight HIV/Aids Testing campaign, health workers visit places where sex workers work and convince them to take HIV/Aids tests. (file photo)

Kakumiro/Kagadi — After divorcing her husband in February 2013, Agatha (not real name), left her village and started living in Igayaza Trading Centre in Birembo Sub-county on the Kakumiro-Hoima Road in Kakumiro District.

Agatha, a mother of two, dropped out of school in Senior Two.

Life became very hard since she didn't have a job at the busy trading centre where she was living.

Given the life difficulties that she was going through, she was forced to find a job at one of the busy bars where she was offered accommodation and a monthly pay of Shs60,000.

"As you can see, I couldn't let my children die of hunger. I decided to work at the bar to raise some money for food," she reveals.

She says as time passed by, she was influenced by her peers and slowly, she was introduced to prostitution by her peers at the bar.

Agatha adds that her peers had convinced her that her new job was to provide her with side income to supplement her salary.

The idea of a side income job sounded good and without hesitation, she joined her peers and indulged in sex without minding about contracting HIV/Aids and other Sexually Transmitted Diseases.

"We could sleep with men at any fee just to supplement our salary, which was not even enough to meet my needs as a mother," Agatha reveals.

After about three years as a sex worker, Agatha started feeling weak and sickly, but did not seek medical attention.

Moonlight HIV/Aids Testing campaign

In mid-March 2016, the Health ministry, through Kibaale District Local Government health department, in partnership with Infectious Disease Institute (IDI), a non-governmental organisation, extended to the area a campaign dubbed Moonlight HIV/Aids Testing, which had started back in 2015.

Under the campaign, health workers visit places where suspected prostitutes carry out their business during the night and they convince them to do an HIV/Aids test.

The service is extended to the prostitutes' clients too.

Agatha narrates that when the health workers pitched camped at her trading centre for a night, she reluctantly accepted to have a blood test.

As suspected, the results showed she had HIV/Aids.

"That night became horrible for me. I feared and started sensing death around me. I had slept with many men without protection and little did I know that I was going to contract the virus," Agatha recollects.

As Agatha was contemplating her next move, health workers and counsellors convinced her to start taking ARVs at one of the nearest health centres, which advice she embraced.

Like Agatha, several sex workers have found hope in this campaign after testing and knowing their HIV/Aids status.

About the campaign

According to Dr Robert Senteza, the Kakumiro District health officer, the Moonlight HIV/Aids Testing campaign, which started in 2015 in greater-Kibaale, targets populations described as key and vulnerable to contraction and spreading of HIV/Aids virus.

He says the campaign has for the last two years been carried out in areas described as hotspots for sex workers.

He says the sex workers are categorised under the HIV reservoirs, referring to people who are highly suspected of being HIV-positive and with high chances of spreading it to others because of the nature of their work.

"The strategy of Moon light HIV/Aids Testing majorly aims to help the highly vulnerable people such as sex workers know their HIV/Aids status and access treatment and other services. Because of the nature of their work and lifestyle, night time is the only opportunity they get to be tested and linked to other HIV/Aids services," Dr Senteza explains.

HIV/Aids fight

Government, working closely with other organisations such as the World Health Organisation and UNAIDS, among others, kick-started a campaign dubbed 90-90-90 by 2020. The US government and the Centre for Disease Control launched the campaign in March, where it aims to identify at least 90 per cent of people living with HIV/Aids through responsive HIV testing services.

However, Dr Senteza warns that the campaign may hit a dead end if some people, including sex workers, are left out of all efforts to curb the HIV/Aids plague.

He says it is in this regard that Moonlight HIV/Aids Testing was started.

Dr Senteza observes that there is an increase in the number of sex workers in the region due to the socio-economic growth linked with the anticipation of oil and gas production activities.

Other activities that are fuelling the increase in the number of sex workers in the sub-region include construction of oil roads, mushrooming rural trading centres, increase in the number of bars and lodges and the wide income disparities, which leave some people unable to earn a decent living.

"The growth of rural towns like Kakumiro, Igayaza, Mwitanzigye, Kisiita and Kisengwe provide fertile environment for sex workers who can easily spread the virus to other people," Dr Senteza says.

Other services

Besides sex workers and their clients, the Moonlight HIV/Aids Testing campaign has helped health workers reach out to other people with risky lifestyles and occupations such as the fishing community, long distance truck drivers, uniformed men and women, among others.

The IDI HIV/Aids field coordinator, Mr Robert Bossa, says under the campaign, besides testing sex workers and their clients, they also give them a package of other services, including counselling and link them to medication enrolment in health centres.

"We also give them condoms and sex lubricants after sensitisation. Neglecting these people poses a danger to the general population and can ruin all efforts of fighting against HIV/Aids.

Mr Hatib Sayd, an HIV/Aids counsellor attached to Kakumiro Health Centre IV, says in a single day, they test and counsel at least 200 clients at a hotspot.

"We have used this strategy to sensitise people on ground, especially in highly-populated rural areas. We mobilise them through different ways. We use Village Health Teams and local leaders," Mr Sayd notes.

The Impact

High prevalence. According to Dr Robert Senteza, the Kakumiro District health officer, out of every 10 sex workers tested, seven are found HIV/Aids positive and immediately advised to start getting ARVs and other relevant medication forms.

For Kakumiro District only, the HIV/Aids prevalence rate has tremendously reduced from 6 per cent in 2016 to 3.9 per cent in 2017. The national HIV/Aids prevalence rate stands 7.3 per cent and 8.2 per cent for Bunyoro sub-region.

Campaign life span. Mr Robert Bossa, the Infectious Disease Institute HIV/Aids field coordinator, says the campaign will continue as long as the organisation continues to get funds from donors.

Death rates. According to Mr Bossa, annual HIV/Aids-related deaths have reduced from 100,000 people in 2004 to 28,000 in 2016. Every day, approximately 151 people get infected with HIV/Aids in Uganda and nearly 44 per cent of these are young people.

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