Country studies on HIV&AIDS indicate that Uganda seems to be losing the battle in the fight against HIV/AIDS. The Uganda AIDS Indicator Survey (2011) reveals an increase in HIV prevalence from 6.4% since 2002 to 7.3% in 2011.Similarly, the number of new infections is increasing at an annual rate of 11.4% from 11,775 in 2007/08 to 128,980 in 2010 with women carrying a high proportion of new infection at 7.7% as compared to men at 5.6%.
PICOT with funding from Infectious Disease Institute (IDI) is implement a project on Strategies to Combat HIV/AIDS Project (SOCAH). The overall objective of this project is to ”Contribute to improved access to comprehensive HIV/AIDS prevention and care through increased awareness, referrals and linkages, access and utilization of services in Maracha and Arua (Rhino Camp Settlement) District. The specific objectives of the project include;
1. Increase access to and utilization of comprehensive HIV/AIDS prevention services in Maracha District by the end of Dec 2020
2. To increase access and utilization of HIV/AIDS care, treatment and support services to children, adolescents and adults living with HIV/AIDS in targeted communities by Dec 2020.
3. To strengthen referrals systems, linkages and follow-ups for improved HIV/AIDS care, treatment and support services in 6 sub counties by Dec 2020
It in the medium term 1, the project expects, 5470 Individuals in key population accessing & utilizing comprehensive HIV prevention services through conducting community outreaches, distribution of condoms, and mobilization of key people for HCT services. Medium term2: Increased access, retention, and utilization of comprehensive HIV care, treatment and support services by PLHIVs through support of PLHIVs. TB patients to access HCT, and TB screening, ART services, Linkages for other livelihood support services with government. Integration of structural interventions that hinder HIV prevention. Ensure effective and Efficient referral systems operational in all the 6 focus sub counties of Maracha district through strengthening referrals and linkages as well as Strengthening partnerships with existing structures
In West Nile region the HIV prevalence rate is on rise from 2.3% to 4.9% , and Maracha and Arua District inclusive posing a big threat in the region. These District through its strategic direction is committed and is making efforts to contribute to UNAIDs 2030 Goal of ending AIDs epidemic 90:90:90; where 90% of all people living with HIV know their status, 90% of all people with diagnosed HIV infection will receive sustained ART, and 90% of all people receiving ART will have viral load suppression. These efforts include; to reduce HIV positivity rate from 1.2% to 0.8%, to increase the proportion of the eligible population tested from 50.1% to 80%, focusing on Couple counseling and testing, to increase the proportion of pregnant mothers tested for HIV from 90.1% to 100%, to increase the proportion of HIV +ve mothers enrolled on ART from 92% to 100%, and finally to increase the proportion of eligible men circumcised from 25.5% to at least 33%. However despite these efforts, access to quality and comprehensive HIV/AIDs prevention care and treatment services by adolescents, youth and adults in Maracha District has remained big challenge. This is being attributed to weak referral systems, follow up and linkages with communities to HIV/AIDs services including TB; the lack of community based outreach programs. Very low retention of adolescents for ART due to often perceived unfriendly services by adolescents and high stigma due to poor counseling skills and inadequate counselling by some health workers.
Through this project, PICOT will make use of its experience of ‘’four ten model ’ to ensure prevention and care services are well linked through expert clients who are community resources persons (Corps), VHTs and trained counselors and home care givers. PICOT will work closely with local governments and health structures that includes; VHTs, home based care, Health centers, Local Council 1s, Sub County and district leadership to ensure holistic approach to address HIV challenges in the district. Additionally, expert clients, VHTs, and home based care givers to provide psychosocial counseling and follow up on clients to improve adherence to treatment. Community level dialogues will be targeted to address socio cultural drivers, reduce stigma and increase male involvement in antenatal services. The Leadership of the district Local Council V, Chief Administrative Officer and District Health Officer, and others Maracha will be engaged to ensure access to clients across borders. PLHIV will be supported and linked to ongoing government programs such as youth livelihood program through the office of community development officer for sustainability.