1. THE AIDS SUPPORT ORGANIZATION
TASO
TASO Uganda (Ltd). P.O Box 10443, Kampala Tel: +256 414 532580/1, Fax +256 414 541288
Email: mail@tasouganda.org. Website: www.tasouganda.org
Oroma Alan Denis,Nono Denis,Odong Kenneth, Grace Akello, PhD
UAC Scientific Conference, June, 2015
Innovative approaches toward zero HIV virus transmission: Assessing the efficacy
of TASO’s interventions at moonlight clinics in Gulu Municipality

2. Outline
i. Background: TASO Activities
ii. Methods: Mixed Methods study
iii. Findings: Responses in epidemic control
iv. Discussion: Efficiency vs. effectiveness
v. Conclusion: To what extent are approaches
effective?

3. Background :TASO Activities
Uganda country HIV and AIDS progress report (2013:18) indicates that HIV prevalence
among MARPS by category stands at 35.7% for sex workers, 16% among drug
injection users, 9.3% for fisher folks, 9.1% for MSM, 6.6 % for truckers and 1.9% for
uniformed services.
MARPs remain at higher risk of HIV infection and transmission and continue to be
underserved by current HIV intervention.
TASO through moonlight clinics targeted MARPs by providing access to a package of
combination prevention services which include, behavioral, structural and biomedical
interventions (TASO Annual Report, 2013).

4. Objective
To assess efficacy and challenges in scaling up services offered in TASO's moonlight clinics

5. Methods: Mixed Methods Study
Qualitative methods were used in data collection including key informant interviews, participant
observation, and focus group discussions.
Data collection tools consisted of Ministry of Health HCT client Card, HIV prevention
behavior communication register (BCC) , clinical laboratory request questionnaire ,MOH HCT
register and MOH client referral slip, interview guides, FGD guides.
Community dialogues with a total of 25 participants were carried out around hotspots to demystify
the socio cultural drivers of HIV and AIDS among the MARPS.
TASO set up moonlight clinics at night in hot spots providing services including HIV Testing and
Counseling, treating STIs.
Health education, life skills and entrepreneurial, leadership and governance skills training for
commercial sex workers (CSW), condom distribution including instituting of condom dispensers
was done to interest this target population.

6. Findings: Responses in epidemic control
• A total of 771 Commercial Sex workers (CSWs) were tested for HIV, of
these 104 turned HIV positive and 667 were HIV negative .
• A total of 1007 CSW partners tested for HIV, 104 were HIV positive
and 903 were HIV negative.(CSW partners are those brought by the CSWs
as their partners)
• A total of 333 truckers tested for HIV, 19 turned HIV positive and 313
were HIV negative.
• Economic insecurity and peer pressure are the major factors for CSW.
• CSWs struggle to adjust to abandon the trade which they see as lucrative
but risky.
• When CSWs abandon the business and adopt positive and healthier life
styles they begin to feel happy and their self-esteem and communal
respect is earned as shown by one former commercial sex worker.

7. Findings: Responses in epidemic control
“It’s not easy to abandon what brings you big money and go for that which brings small
amounts. But this ‘awaro’ (small vendor business) has lesser associated risks. You don’t
have fear of someone bumping on you and start a fight for either claiming that you stole
his (customer) money or you’re messing around with her husband.” Lamunu, 25 years
“She respects me, we no longer receive strange phone calls from men because she has
changed. She plans to open her personal account and diversify her business. This has
helped me think positively about my life and less risky behaviours”. Husband to
former CSW
• Working under the cover of darkness can be risky.
• Tracing some clients like long distance truck drivers is difficult.
“Your services are very good, the nature of our work cannot allow us to seek
services. Please continue coming to us because if you leave us we shall die because
we have no time to get medical care.” Truck driver

8. Findings: Responses in epidemic control
“I’m not a married man, I have four sexual partners that I spend my time with at night
after a hard days work”. 26 year old partner to CSWs who turned HIV positive, linked to
biomedical care.

9. Discussion: Efficiency Vs. Effectiveness
• On spot registration and linkage to biomedical care
• On spot diagnosis and treatment of sexually transmitted infections (STIs)
• Livelihood interventions targeting CSW s are key in encouraging health seeking
behaviours
• Moonlight reaches out to key populations that shy away getting services from public
health facilities
• Increased demand for condoms at the moonlight clinics

10. TASO
Although TASO is contributing to the provision of HIV prevention services among
MARPS, with very encouraging results, we believe finding ways to get down to zero
and to enforce prevention of the virus, more effort is needed in scaling up access,
informing, educating and communicating to these key populations so as to reduce the
impact of the virus in the community. The central question still is to what extent such
interventions targeting MARPS are contributing towards zero transmission.
Conclusion