Innovating for effective HIV Prevention Outcomes: The TASO Capacity building peer-to-peer model for Key Populations supported by Civil Society Fund

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
Consultation with district Sensitization of key Selection of participants to
health office population group leadership attend Peer Educator’s
training
Linkage to key population As gate-keepers Selection criteria jointly
group contacts To obtain buy-in developed
Target setting for
Initial training conducted
performance measurement
1-day Monthly mentorship
and performance review 3-days focusing on risk-
10 peers per Peer Educator
reduction strategies
per month
Delivery of HIV Prevention
service package to peers
End of Project Evaluation
BCC, RRC, Condom education
& distribution & Referral &
Linkage to Care & Treatment

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
169
109
Male, 1
37
Female,
29 33
203

7. Results (2) - The Cascade
HTC being conducted for the
Armed forces
296,980 pieces of condoms
were distributed
87,010 3,353 (1620
(47,835 males and
males and 1733
39,175 340 Peer females
females) educator tested for
reached s trained HIV
with Risk 4.6%
reduction positive
messages
100% positive linked to care-

8. Results (3)
HIV Prevalence among Key Populations
Incarcer Uniform
Youths
HIV Fisher ated ed men
CSW Truckers out of TOTAL
Results Folk Populati &
school
on Partners
Positive 4 31 13 26 10 70 154
Col % 4.8 4.1 6.9 8.8 4.9 3.8 4.6
Negative 79 724 176 271 194 1755 3199
Col % 95.2 95.9 93.1 91.2 95.1 96.2 95.4
TOTAL 83 755 189 297 204 1825 3353
Col % 100.0 100.0 100.0 100.0 100.0 100.0 100.0

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

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