Let Us Talk About PrEP And Being Transgender in Uganda: Implications For HIV Prevention

MARPS in Uganda and Masaka KP HIV Awareness & Prevention Support Organisation ( MAHIPSO) have collaborated to provide Information, Education, Communication (IEC) on Transgender Persons’ quality health best practices. 

We have heard of Transgender who are living with HIV. But, beyond that what else do we hear? Have you ever wondered where such a conversation would lead?

An analysis by the Centers for Diseases Control and Prevention (CDC) of PrEP prescriptions between suggests PrEP is being disproportionately prescribed to Transgender persons being the most affected by HIV across all key populations (KP). This scenario can be transferred to Uganda as well.

When analysed for across KP types, Transgender are the most under represented as far as reporting on ARV uptake in Uganda, despite their being the most vulnerable to HIV. 

Most Transgender who are out are between 17-35 years. Generally, there are less PrEP users aged between 18 and 44, suggesting younger people from key populations are not accessing PrEP. Yet young people (aged 13-24) account for a bigger percentage of new HIV infections in Uganda.

It is not known among the Transgender using antiretrovirals for treatment rather than prevention purposes, in addition to those defined as post-exposure prophylaxis users. 

LGBTIQ+ related data need to be made available to analyze PrEP users, address low proportion of Transgender persons being offered PrEP. 

The overall gap between those in need of PrEP and those to whom it is being prescribed, suggests significant barriers to PrEP access exist. 

These barriers need to be better understood and addressed for PrEP to become truly effective as a tool for preventing HIV.

Source: Avert

Stigma-Free Health Services In Greater Masaka Area

As far as HIV Prevention, stigma has its repercussions:

1. Beginning with deterring full participation in health seeking by those who fear being stigmatized

2. Demotivates health providers in providing quality, full unconditional and confidential services to clients

3. Increases vulnerability to stigma itself and other forms of abuse

4. Fuels further denial of services 

5. May lead to below optimum ARV adherence and no suppression of virus

MAHIPSO In Position To Make HIV Testing Popular in Greater Masaka

We want to benefit from the UNAIDS 95:95:95 Goal. We want to contribute to the number of people living with HIV who are aware of their status; diagnosed people on sustained treatment; and those on treatment to attain viral suppression. 

We target Key Populations as a demography with higher HIV burden that general population. According to recent studies categories of KPs accounted for 18% of new HIV infections in Uganda in a 2015/16 Survey.  In another study, another KP demography had 36% reporting regularly having unprotected anal sex, 38% selling sex, 54% having multiple steady partners, 64% having multiple casual partners, and 32% using some of intoxication and drugs. 

These are the social and economical factors around which HIV interventions must revolve for our beneficiaries to shift from being a sink from which HIV draws into the general population. With support from funders and other Districts, we shall be able to create enduring infrastructure which will translate as stigma and discrimination busters. We identified bias, stigma and discrimination against the Key Populations we serve as a major barrier to HIV Services access. 

We propose a unique approach with entails intimate immersion on one hand and driving demand for HIV Testing Services on the other in areas we serve. GMA is known for hotspots and we identified roadside towns with low cost housing, destination stops such as islands and urban centres and education institutions. We have what we call the first 12 in 12 weeks, where we go out to 12 venues conduct HIV Testing Services for 12 weeks and then use that as a model to roll out for the next 40 weeks. The first 12 venues: Masaka, Nnyendo, Bukomansimbi, Kalungu, Lyantonde, Kyazanga, Kalangala, Lukaya, Mukoko, Ssembabule, Kalisizo and  Kyabakuza. 

At the leadership level, we shall be involved with cultural, technical and political leaders. We shall ensure: leadership buy-in; safe space to conduct services for our beneficiaries; identify and train local focal persons in peer education and resilience on how to sustain rapport with leaders so that there is no interruption of HIV services including: Testing; PrEP, PEP, ARV-Adherence and care continuum, U=U best practices; IEC informing decisions for staying negative or for PrEP, PEP and ARV uptake; prophylactics for protection to break transmission cycle; nutrition support; housing and livelihood support. In this project, it is planned that much effort will be focused on increasing HIV testing and case identification among key population, promoting linkage to treatment for those with positive diagnosis and other package of interventions.

Greater Masaka Regional Parent and Community Leaders’ Development Public Dialogues (PACOD) 2019-2021

Greater Masaka Regional Parent and Community Leaders’ Development Public Dialogues

 (PACOD) 2019-2021

MASAKA KP HIV Prevention & Support Organization (MAHIPSO) 

Background and History

We started our work as a mobilization entity. We have worked together with Kampala City-based organizations as the mobilizers for different interventions ranging from circumcision;  voter education; immunization; and other services. In 2015, we mobilized young persons to access HIV testing and engage in World AIDS Day; we mobilized 50 young males to attend Safe Male Medical  Circumcision sessions; 100 girls to attend to hepatitis immunization. In 2016, we were part of the South Uganda region wide mobilization of communities to engage in immunization drives; with time we have identified vulnerable transgender persons with whom we have been involved more than any other category. We have experienced a lack of prevention commodities in Greater Masaka Region; a lack of Information, education and communication materials on Life Planning Skills, young persons specific HIV Care and Prevention information or services. We are now writing this proposal to enable us establish a young persons friendly Resource Center and engage community leaders in dialogue sessions to accept their Transgender children. This followed a spate of home evictions, disowning, abandonment, assault, imprisonment and brutality.

Vision:

Using secular, spiritual and  religious freedom to mobilize, promote expression and quality life for young persons. 

Mission:

Establish Greater Masaka Regional young persons friendly Resource Center to address a paucity of Sex-young persons-related services in Greater Masaka Region which serves South Uganda.

Theme: Parent and Community Leaders’ Development Public Dialogues (PACOD)

Increased social inclusion: Uganda has increased tightening the Public Order Management Act (POMA). So, all forms of social meetings must be registered, notified and given permission. We use music, dance, drama and gardening to meet our members.  We hope to increase reach out social events to provide meeting or get together opportunities for young persons in Greater Masaka Area three times a month.

Cascading into Core focus: Provide support for groups to meet frequently under the different music, dance, drama and gardening themes. We shall document and influence rates of acceptance; build collective voices to advocate for inclusion; and build and coordinate long-term strategies to strengthen inclusion for transgender and sex workers. The following are our strategies:

Advocacy: Increase coverage using social media platforms by writing, talking or showcasing information,  education and communication around life preserving practices, announce health events in the region, mobilize communities for development, build resilient viable groups and network with leaders to address discrimination and violence

Documentation: Engage in generating, disaggregating, and analyzing data on public opinion and themes directly affecting life of young persons in rural conservative Uganda districts (rates, what messaging generates change, understanding of lived realities of young persons—particularly the most marginalized); and tracking and analyzing media representation.

Training: Organize, plan and conduct outcome-based training, including for media coverage of all parents/leaders, with whom we can advocate for specific changes as well as catalyze social inclusion plans

Objective 1 Activity: Pay Rent

Activity: Rent

Activity: Manage a resource center

Activity: Provide drop-in services/space

Objective 2 Activity: Recruit and maintain support staff 

Activity: Front Office Manager and Drop-in staff

Activity: Provide Services at a friendly space

Objective 3 Activity: Office Administration 

Activity: Deal with documentation, filing and record keeping

Activity: Movement building

Activity: Engage in other administrative activities

Objective 4 Activity: Music, Dance, Drama and Gardening Practices

Activity: Rent space

Activity: Conduct practices

Activity: Gardening

Objective 5 Activity: Social Outreaches

Activity: Conduct outreaches

Activity: Transportation and logistics

Objective 6 Activity: Social Media

Activity: Documentation & Update

Activity: Internet connectivity

Activity: Conferences

Source: Google

Masaka KP HIV Prevention And Support Organization HCT Activity In Nnyendo Town

MAHIPSO has conducted an HCT focusing on sex workers (Female, Male and Trans Sex workers) in Nyendo and neighboring areas. Registered and registering new sex workers to be worked upon went on well.

The attendees were youths, various population groups including sex workers.

We carried out one on one counseling sessions. These involved meeting a trained health personnel, distributed Information, Education and Communication (IEC) materials to them as well as Prevention Prophylactics such as condoms and lubricants.

HIV testing was carried out by professional health workers from MARPI Mulago and Masaka Referral Hospital.

As the #thinkPositive Campaign goes on, we always encourage all population groups especially sex workers to regularly  test themselves for HIV and use protection.

At MAHIPSO our goal is to:

   1. Reach to all sex workers(Female,Male amd Trans sex workers)  in rural areas.

   2. Fight against stigma and discrimination amongst sex workers and other sexual minorities.

   3. Carry out HIV/AIDS awareness.

   4. Fight against Gender Based Violence against women and sex workers in general.

   5. To advocate for sex workers rights' & sexual minorities' rights and health goes on.

#Gender#MAHIPSO#SayNoToStigma#ThinkPositive#Inclusion4All

We are grateful for the support of Most At Risk Populations' Society in Uganda (MARPS in Uganda) under which we are members. For those who would like to read more about MARPS in Uganda you can follow this link as well. 

Addressing Violence Faced By Sex Workers

1.    Female, Male and Transgender sex workers face high levels of violence, stigma,discrimination and other human rights violations. Violation against sex workers is associated with inconsistent condom use or lack of condom use, and with increased risk of STI & HIV infection. Violence also prevents sex workers from accessing HIV information and services.
Male, female and transgender sex workers may face violence because of stigma associated with sex work, which in most settings is criminalized, or due to other factors. Most violence against sex workers is a manifestation of gender inequality and discrimination directed at women, or at men & transgender individuals who do not because of their feminine appearance or the way they express their sexuality.

2.    BUT the violence against sex workers can be addressed in different ways such as;
   
      * Promote the full protection of sex workers' human rights.
      * Reject interventions based on the motion of rescue & rehabilitation.
      * Promote gender inequality.
      * Respect the right of sex workers to make informed choices about their lives, which may involve not reporting or seeking redress for violence, not seeking violence-related services, or continuing in an abusive relationship.

3.    BUILDING THW CAPACITY OF SEX WORKERS.

Several kinds of activities build sex workers' knowledge of their rights in relation to sex work and violence, & their confidence to claim these rights. These include;
    * Training & sensitizing sex workers about sex-work related laws & their human rights. ( Building the capacity of sex workers.)
    * Community empowerment.
    * Advocating for reforms.
    * Fostering police accountability.( working with the police has been a key element to efforts to reduce violence against sex workers.)
    * Promoting the safety & security of sex workers.
    * Providing health services to sex workers who experience violence.

#Inclusion4All
#UDon'tNeedToBePositiveToThinkPositive.

Follow us on our Facebook platform;  https://www.facebook.com/mahipso.

We Are Proud of Masaka City and Masaka Regional Referral Hospital, says the MAHIPSO Executive

We at MAHIPSO, bring you a glimpse of Masaka. We hope you will enjoy this marvelous place.

Greater Masaka Region is comprised of Masaka, Kalungu, Lwengo, Kyotera, Rakai, Lyantonde, Bukomansimbi, Kalangala and Ssembabule districts. It is served by a main town called Masaka. Masaka Municipality sits on 58 square kilometres and has 11 streets and three divisions including Katwe-Butego, Kimanya-Kyabakuza and Nyendo-Ssenyange divisions. It has 54 zones. It is located in southern Uganda, situated about 80 miles (130 km) southwest of Kampala at an elevation of 4,300 feet (1,310 metres). Roads connect it with Kalungu, Kyotera, Rakai, Lyantonde, Bukomansimbi, Kalangala and Ssembabule and Mbarara districts. It is an important cultural, educational, residential and commercial centre in a rich coffee-growing and farming area. Its industries produce processed meat and fish, beverages, footwear, furniture, bakery products, glass, clay products, and milled grain. The town was the site of Fort Masaka. About 24 miles (39 km) to the east is the small Lake Victoria port of Bukakata. Pop. (2008 est.) 71,700. For more: See Masaka website

According to a Uganda Daily, Masaka Town is about to gain City Status. Authorities in Masaka Municipality want the administrative boundaries of the town expanded in pursuit of a city status. According to Mr Godfrey Kayemba, the municipality mayor, the proposed expansion is one of the priorities lined up in his new term of office. Speaking to Daily Monitor on Monday, Mr Kayemba said the expansion will involve annexing four more parishes of Kitengeesa in Buwunga Sub-county, Kirimya in Kabonera Sub-county, Ssamariya in Buwunga Sub-county and Kalagala in Mukungwe Sub-county into the municipality. For more: See story: Masaka-town-expands-to-get-city-status.

We are so happy that the recent Masaka District Local Government Womens’ day celebration on 20th April 2018 at Masaka Liberation square was under the theme "Empowerment of rural women and girls: Opportunities and Challenges.” This is in line with our own Partner Violence Awareness drives.

Masaka Regional Referral Hospital works is in line with different international, national and regional objectives including: Masaka District Health Sector's Goal; ”To provide good quality services to the people of Masaka District to make them attain a good standard of health so that they can live a healthy and productive life.”

The Objective; “To reduce the morbidity and mortality from the major causes of ill health and premature deaths and disparities therein”. The Section is Headed by the District Health Officer, Dr. Stuart Musisi. Sub-sections include Health Promotion and Education under Dinah Kakande-Senior Health Educator, Health Inspectorate and Environmental Health under Kewaza Dauda-Principal Health Inspector, Drug Inspectorate under Okot Peter-District Assistant Drug Inspector, Health Management Information System headed by Martine Sseruyange-Biostatistician, Maternal and Child health under Batenga B. Kiyingi-Ass. DHO/MCH, Medical Supplies and Logistics headed by Nambalire Feiruz-Ass. Inventory Mgt. Officer and TB/Leprosy supervised by Niyonzima J. F-DTLS.

We hope you will visit us and enjoy the hospitality. When you do also come and we take you around our extremely beautiful region. Visit this site for map of Masaka Area.

Mayor of Masaka

Masaka Green parks

Masaka Pupils

Masaka Frams

Masaka grazing land

Clinics

Tropic inn

Brovad Hotel

Brovad Hotel

Banda Lodges

Brovad Hotel Room

Masaka on the map