Positioning MARPS in Uganda And Sustainably Anchoring LGBTIQ+ Living With HIV To Care-2019

Background And Road Trip Report

Through 'MARPS in Uganda', we have directly been supporting 722 LGBTIQQ in form of:
1. Providing regular counselling and guidance
2. Those who were diagnosed HIV+ve have been linked to ARV care (37 of these are now in Kenya and 217 are in Uganda)
3. Housing support to 39 ( the 37 refugee/asylee seekers were provided with housing while I was in Kenya and made sure they have food, are linked to ARV care, have been provided with two projects for income generation and airtime to keep them connected. The other two are: a beneficiary in Kasese and one in Munyonyo. These houses have two extra rooms and can be used as shelters in case of an eviction emergency
4. Supplies and Logistics: We have provided high nutrition tinned foods, multivitamin packet/nutrition supplements to 55 beneficiaries and these have been distributed fully
5. We provided money to 12 beneficiaries to enable them attend clinics in the next 4 ARV-refill events between July- November 2019
6. The Southern and Western Region of Uganda is unique in that, it is where we noted higher numbers of LGBTIQQ living with HIV and some living as bisexuals. There are 77 beneficiaries living with HIV with Kasese arm having 17; Mbarara region (30); Kyegegwa (08); F'Portal-Hoima corridor (22)
7. Greater Masaka Region has 32 LGBTIQQ living with HIV and they have been linked to ARV support (ARV clinics, stable housing, livelihood projects and all of them have attained viral suppression). Their breakdown is as follows: Kasensero (08); Nnyendo-Kyabakuza-Kitengeesa-Kalangala Corridor (18); Bukomansimbi (02) and Kalungu (04)
8. The Malaba-Mbale-Busia-Kamuli Corridor has 47 LGBTIQQ  living with HIV and they have been linked to ARV support (ARV clinics, stable housing, livelihood projects and all of them have attained viral suppression). Their breakdown is as follows: Malaba-Mbale-Pallisa-Tororo Corridor (30); and Kamuli-Iganga Corridor (27)
9. The Jjinja-Kakira-Lugazi-Mukono Corridor has 28 LGBTIQQ living with HIV and all of them are provided for. They have been linked to ARV support (ARV clinics, stable housing, livelihood projects (quick foods, pastries and fresh foods market stalls|) and all of them attained viral suppression). Their breakdown is as follows: Jjinja (12); Kakira area (07); Lugazi (06); and Mukono (03)
10. Central Region (Makindye, Kawempe, Lubaga and Nakawa) has 33 LGBTIQQ living with HIV.  All of them are provided for. They have been linked to ARV support (ARV clinics, stable housing, livelihood projects (Artist/Music recording Kiosk, Restaurant, Fresh fish stall, quick foods, pastries and fresh foods market stalls|) and all of them attained viral suppression). Their breakdown is as follows: Kiruddu are (13); Kawempe area (07); Lubaga area (9 (with 2 Congolese and 1 Somali)); and Nakawa area (03).

The Clinics we have attached beneficiaries:
Kenya:
Kenyatta Hospital, Kisumu, Medical Centre, Nakuru General Care, Naivasha Hospital and LVCT Clinics in Nairobi.

Uganda:
Kawaala HC
Kawempe Referral Hospital
Kiruddu Referral Hospital
Kitenga HC III
Kasese Hospital
Kakoba HC III
Rwekubo HC IV 
Bushenyi HC IV
Kihihi HC IV
Mityana General Hospital
Kiruhura HC
F' Portal Hospital
Namasagali HC III
Bugulumbya HC III
Bulopa HC III
Buwaiswa HC III
Kigandalo HC III
Bukomero HC IV
Kambugu HC III
Jjinja Hospital
Kawolo Hospital
Nkozi Hospital
Villa-Maria Hospital
Masaka Hospital
Rakai/Kalisizo Hospital
Ssese Islands Africa AIDS Centre
Butenga HC IV
Kitanda HC III 
Mbarara Referral Hospital
MARPI-Skin/STD Clinic


The organizations at the Grassroots:

1. For Greater Masaka Region,we had groomed Masaka KP HIV Prevention Services Organization (MAHIPSO). They seem to be doing well so far but yet to be trained in handling identities of the persons living with HIV. We supported this organization since 2016.
2. For Greater Mbarara-Hoima Region, we had groomed Southern And Western KP AIDS Awareness and Prevention (SWKPAAP) Association. This is a model organization too. We took them up since 2017.
3. MARPS in Uganda is still looking for organizations to work with in other areas.

Accessories, Appliances And Consumables:

1. We have provided a brand new laptop, phone, Cash boost (USD 1,100) and accessories to one Kenyan based organization
2. Given the unique setting of SWKPAAP, we are donating a laptop, phone and Cash boost to be used for opening up two bank accounts, maintain the accounts and general upkeep of officers

Next Steps:
1. Funding: There are challenges we have faced over time including not being funded yet we are the lead HIV Prevention and Care promoter for LGBTIQ+ Ugandans. We hope this will be addressed soon. If we are to end HIV, then those who are at the front-line need all the support.

2. Drug Stock outs: We had established a working relation with 62 Health Facilities and had trained health workers there in handling LGBTIQ+. They were very courteous and we had never had any problems with the staff. However drug stock outs are an issue leading to drastic changes. Right now, we have 30 reliable places where beneficiaries are able to pick up; Cotrimoxazole (960mg), Dapson, ATVIR tablets, AZT/3TC, TDF/3TC/EFEV (500mg),  Fansidar, Paracetamol, Amoxyl, Ibuprufen, do HIV testing and confirmatory tests as well as Viral Load Checks.

3. Purchasing From Private Pharmacies: Drug stock-outs means making purchases from private firms and this is expensive and unsustainable.

We hope, this time around we shall be provided much needed funding. We feel, we shall be able to contribute fully to Epidemic Control.

Conclusion:
This work requires logistics for it to be effective. Hopefully, we shall be provided the necessary support to catalyze and animate eradication of HIV.

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