Structural frameworks necessary for men-who-have-sex-with-men (MSM) and other MARPs to access services in Uganda: lessons for meeting the MDGs by 2015
T.A.R. Mukasa-Muyunga1,2, S. Baral3, MARPs in Uganda
1Mulago-Mbarara Teaching Hospitals’ Joint AIDS Program, STD/SKIN Unit, Kampala, Uganda, 2MARPs NETWORK, MoH, Kampala, Uganda, 3Johns Hopkins University, Department of Public Health, Baltimore, United States
Issues: Most at risk populations’ Initiative (MARPI) extends SRH/HIV/STI intervention services to high risk populations (Young people in tertiary education institutes, Couples, CSW, and MSM).Over 50.000 MARPs were targeted to access services between 2008 and 2010. Between March 2008 and June 2009, 18,981 had so far been reached; 591 Local leaders, 300 MSM, 120 WSW, 400 CSWs, 391 couples, 4219 Students from tertiary institutes and 12,960 from community and entertainment centers.
Description: MSM-friendly services included training 23 staffs in Unconditional Positive Regard (UPR), a needs assessment with 30 selected MSM group leaders and identified 120 safe spaces (friendly venues) for outreach services. Other activities; training 100 peer leaders to encourage health seeking behaviour, established a hotline,100 health education sessions, quality male and female condoms through 40 condom outlets, 100.000 2ml lubricant sachets, STI treatment to 100 MSM, 300 HCT and STI screening sessions, creating 20 health action groups among the MSM and WSW and generating activity plans for regular meetings up to December 2009. 50 MSM made calls through the hotline to access SRH/HIV/STI management at MARPI. 20 MSM who are HIV Positive were given follow up HIV care and all of them are enrolled on Cotrim prophylaxis.
Lessons learned: The PATS model; Participation of MARPs; promotion of Attitude that improves health seeking behaviour to all concerned; Training of peers and staffs and; Sustained documenting and different forms of advocacy have generated a profile of an evidence base. Identified safe spaces, provided opportunity for same sex to access services.
Recommendations: Participation and awareness to MSM in SRH/HIV/STI integrated services and thereby generating evidence based documenting enables Policy-makers, stakeholders, Programme level and community level opinion leaders to use the evidence to enable them advocate and match needs to Policy framework.