Empowering people living with HIV to serve as ambassadors to advocate for the enlightenment of the masses can also be strategized to increase accessibility and acceptability of community-based HIV testing services thereby reducing stigma levels in the society. Kenya Red Cross Society worked with Mama Margaret Doyo from Rachuonyo North District's Kobiero community.
Background
From the (UNAIDS data) of 2018 one comes to several new findings such as: Over 1.3 Million Ugandans are currently infected with HIV. 23,000 of the population has died from AIDS-related illnesses. Among adults (15-49) years of age 5.7% of them are infected. The most affected gender seems to be women whose percentage (8.8%) is more than that of men (4.3%). Furthermore, the statistics indicate that Children (33%) have no access to medical care as compared to the adults (27%). The most affected groups seem to be sex workers, homosexuals, drug addicts, the transient fishing community and the young girls.
In the wake the widespread Covid-19 outbreak the situation could be more dire and infection levels could ultimately rise due to the increased difficulty in accessing health care services, increased poverty levels due to loss of jobs would also mean that priorities would shift and, more focus be drawn to providing food that seeking medication or counselling services and the stigma and prejudice from correlating the corona virus and the HIV would factor in. Currently the government in collaboration with Uganda AIDS Commission has taken steps to re-invigorate the National HIV and AIDS response efforts. This has been through renewed engagement of the political leadership at all levels and strengthening the multi-sectoral efforts to curb the impact of the epidemic.
The government on the implementations of SDG number 3 that focuses on good health and well-being has projected that 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression as of 2020 but due to the pandemic the actualization of this goal might have to be postponed. Other intervention practices would be looked into below as follows;
1) Advocacy Efforts Spearheaded by the People Living With HIV
Empowering people living with HIV to serve as ambassadors to advocate for the enlightenment of the masses can also be strategized to increase accessibility and acceptability of community based HIV testing services there by reducing stigma levels 1n the society. Kenya Red Cross Society worked with Mama Margaret Doyo from Rachuonyo North District's Kobiero community. Her message was, "AIDS is not a disease but a condition that when managed well, one can live their fullest length of life". She was the first person in her community to disclose her HIV-positive status. Meaningful involvement of people living with HIV is very effective in HIV prevention and management and the same strategy can be used in Uganda. The impact of these success stories and also the way they have managed to get help and leave a purpose life with the infection to motivate more people to test. (AIDs.gov, 2016)
2) Health Workers Taking a More Empathic Approach
Recognizing that the community health workforce, including volunteers, play an essential role in accelerating universal access to HIV testing and treatment, the Kenya Red Cross Society trained over 2,700 community health workers. The community health workforce was successful in encouraging community members to visit outreach clinics to seek HIV information and voluntary counseling and testing in hard to reach areas, thus improving access to these services. However with an increase in the rise of infections the workforce has become understaffed and as such the use of community volunteer counsellors could be an additional resource to the inadequate staff Their selection, however, should be done with great care to avoid negative outcomes and ensure that they are accepted in their communities. In their study, Kipp et al. found that some study participants recommended that counsellors be non-residents of the area, as non-residents were considered more credible and would offer greater confidentiality than residents.
3) Government-Based Policies and Intervention Strategies
The Uganda National Policy Guidelines 2005, voluntary counselling and testing (VCT) is HIV testing provided to individuals who seek the service out of their own will without any coercion. These persons may be referred by a provider, a sexual partner or a friend, or they may have learned of the service from hearsay or public media. They receive pre-test counselling, HIV given the HIV test results. Thereafter testing and post-test counseling during which they are given the HIV they are usually referred for follow-up care and support. This type of HIV testing is aimed at integrating HIV Counselling and testing (HCT) services with existing day to day clinical services. This model testing for HIV is carried out routinely in health units/facilities.
This increase in access to HIV testing and early care where needed. It also helps to reduce stigma and discrimination. However, the counselling process is modified from that of the traditional VCT. It must be done by skilled personnel as it can scare off communities from seeking health care services from the facilities.
Meanwhile in Kenya, The Kenyan Ministry of Health has launched the Be Self-Sure campaign to encourage people to get tested for HIV. As part of the campaign, the government is making HIV self-test kits available through public and private health facilities and selected pharmacies at a low price which was negotiated in a partnership between the government of Kenya and the private sector. The campaign website includes an interactive map to let people know where to get the testing kits from and plays videos demonstrating how to use the kits and tells people what to do if they are HIV-positive or if they are HIV-negative. A helpline, open for 12 hours a day, is also available. For people testing negative for HIV, the site urges people to talk to their health providers about HIV prevention options, including PrEP, a medicine that people at higher risk of HIV infection can take to prevent becoming infected with the virus. PrEP 1S being rolled out as part of the campaign, with the Government of Kenya offering it free of charge in selected public health facilities as part of a combination HIV prevention programme for people most at risk of HIV infection, including young people, serodiscordant couples, people who inject drugs and sex workers.
