Founded and started operating in 1990 as a referral Centre for HIV counseling and testing, AIDS Information Centre-Uganda (AIC) is a national non-governmental Organization (NGO) that provides Comprehensive HIV Prevention, Care, Treatment and Support services including capacity development to health workers in the health facilities and communities. AIC is a fully registered NGO with the Uganda National NGO Board in 1992 under Cap. 113, Registration No. is 133 (S.4914/291). AIC was the first of its kind in Sub-Saharan Africa outside the health infrastructure to provide integrated HIV Testing Services (HTS).
AIC covers the entire country through her nine (9) stand-alone regional centers including: Kampala Regional Centre for central region; Arua Regional Centre for West Nile region; Lira Regional Centre for Northern Region; Soroti Regional Centre for North East Region; Mbale Regional Centre for Eastern Region; Jinja Regional Centre for East Central Region; Mbarara Regional for Western Region, Kabale Regional for South Western Region and Moroto Regional Centre for Karamoja Region.
AIC employs a number of Service Delivery Models. We map out hotspots where Key and Priority Populations (KPPs) operate including sex workers, Transgender Community, Men Who Have Sex with Men (MSM), Fisher Folks among others using District HIV/AIDS focal persons, Sex Workers’ Organizations, Transgender Organizations, Leaders of KPPs, Community leaders, Traditional Health Practitioners and Cultural Institutions. The hot spots include bars, lodges and hotels, discotheques, brothels, transport hubs and places of residences. AIC has successfully reached and provided targeted services to KPPs through the following models which may be Facility or Community based:
- Accredited Standalone ART Clinics/Sites: Accredited in 2012, AIC has continued to offer Antiretroviral Treatment (ART) to the general public in its nine (9) standalone ART Clinics/Sites. All clients who test HIV+ either in the facility or community are linked to our ART clinic services.
- Peer/Leader-Led Service Delivery Model: AIC has existing trained sex workers, MSM, Transgender, Drug Users, Fisher Folks and Truck Drivers well equipped with appropriate information and skills to educate their peers. Peer educators are trained to conduct basic counselling, health education, mobilization, referral, community dialogues, condom promotion, and linkage to care. These peer educators ensure provision of services in a friendly environment such as privacy, confidentiality, attitude of service providers and accessibility of services. This is achievable by working in partnership with District Local Governments, related NGO/CBOs and other implementing partners. We work with the “Madams” (heads of brothels) and “Misters” to ensure their buy-in and engage them in planning and mobilization of the sex workers, Transgender women/men, Chairpersons of MSM, Truck Drivers, Fisher Folks and those of Drug Users to utilize the friendly integrated HTS in their catchment areas. During planning phases, it is made clear to the Madams when services will be provided (evening or night or sunrise) depending on their schedules, by whom and for how long.
- Moonlight Service Delivery Model: AIC spear headed the KPPs hotspot mapping and size estimation study being used to prioritize the location of service delivery to KPPs including SWs. AIC uses a moon light service delivery approach to reach sex workers in these hotspots. AIC interacts persuasively with sex workers at their site of work preferably at night. The mobilization of moonlight is done through trained KPPs peer mobilizers, VHTs, District HIV Focal Persons, Male Champions, KPPs Servicers Providers and networks. AIC seeks permission from sex workers’, MSM’s and Transgenders’ leadership prior to providing services and KPs conveniently at their work place. AIC has continued to use its experienced staff in handling key populations to provide needed services. Before provision of HTS, AIC engages KPPs with prevention messages while providing IEC materials on topical issues on HIV prevention.
- Targeted HIV Testing Service Outreaches: These outreaches have been predominately for sexual partners of index HIV positive clients and their children (through Home Based Testing Approach) as well as outreaches to Men at their places of work or recreation particularly those considered to be priority populations like the truck drivers and Boda-boda riders. These HTS are provided in the community and any newly tested HIV positive client referred to health facility of their choice to continue in care. Linkage to care is confirmed through follow up of these clients. Outreach services are provided to the general population. However, testing is provided mainly to those who when screened are considered to be at risk of HIV infection. AIC adapted theTest and Treat (T&T) approach for Key and Priority Populations. Since initiation of the T&T approach at AIC in July 2012, 1,910 individuals have been enrolled into care of which 6.3% are SWs.
- Protect the Goal/Kick the Ball Campaigns: AIC uses football and netball tournaments to as power mobilization strategies to provide HTS to general public, key and priority populations. Through 94 kick the ball and netball tournament campaigns, 27,489 Males and 10,537 Females were counselled and tested for HIV and all received their results, of which 72.3% and 27.7 % service deliverance to Males and Females respectively. A total of 327 (139 Males and 188 Females) HIV positive clients were identified with a sero positivity rate of 0.86% compared to 1.35% of last FY 2014/2015.
- Integrated HIV/AIDS Community Dialogues: AIC has continued to hold dialogue sessions with among key and priority populations with the theme of attracting community members to seek medical services from health facilities. Community members have been challenged to highlight the pros and cons of seeking health services from health units. Dialogues have been conducted among politicians, health workers, VHTs, men, women and the youth. Village Health Teams (VHTs) have been tasked with the responsibility of mobilizing both community and duty bearers for dialogue sessions.
- Assisted Partner Notification (APN): AIC uses APN model which is proactively offering HTS to sexual partners of index clients (i.e. the newly identified HIV positive, the virally unsuppressed, those on ART with STI’s or new partners and clients not yet on ART) so that they can learn their HIV status. Those who test HIV positive are linked to care and those HIV negative receive HIV prevention and support services. This network system has increased HIV awareness because it traces the previous and current sexual contacts of index clients. APN activities are carried out both in the health facilities and in the community.
- Differentiated HIV Service Delivery Model: AIC works with Groups of PLHIV and functional Treatment Adherence groups were formed, leadership committee members were selected amongst themselves to monitor PLHIV on treatment and to know who needed to collect their medicines from HFs. These stable PLHIV receive multi months’ bundled antiretroviral medications from health facilities of their residence and distribute them within their groups, and advocate for resources. The model is effective because it reduces on transport costs of group members to distance facilities. In this model clients stable on ART according to pre-defined characteristics may receive ART refills through community client led ART distribution or Community Drug Distribution Points. Unstable clients only receive facility-based ART refills. All clients receive clinical and laboratory monitoring particularly with scheduled viral load tests.
- Boat-to-Boat and Sunrise Service Delivery Models: Fisher Folks are a unique population; AIC works with both the coxswains and the fishermen to organize boat to boat HTS outreaches. The coxswains have been trained on correctly and consistent condom use, we have provided them with boxes of condoms for distribution from boat to boat or from Island to Island. AIC HTS and Health Workers from a nearby Public Health Facility are equipped with Testing Kits, condoms and IEC materials and a Key and Priority Population Register which is kept at public facility we partner with.
- Workplace Service Delivery Model: We have also worked with both the formal sector (banks, NSSF, Insurance companies and Hotels) and the informal sector (markets, industries, factories, garages, artisans and large plantation workers) to organize HTS outreaches.
- DREAMS Initiative: AIC has continued to empower Adolescents, Young Girls and Women (15-24 years old) in safe sexual reproductive health services where those who test HIV negative form groups and empowered to remain negative, by equipping them with life skills, building their capacity in income generating activities and empowering them to form saving groups. 28 Groups have been formed in Isingiro District in Western Uganda.