Experiences of managing Urethral Discharge(UD) in 3 clients attending as MSM at the MARPI/STD/Skin Unit.

 Uganda criminalises Commercial sex work, Drug Use and same sex marriages. The recent Anti-Homosexuality Bill of 2009 seeks to apportion punishment for all acts that have anything to do with same sex relations or tendencies. However, in the interests of human dignity and following the mandate of the Ministry of Health of Uganda there have been efforts to provide health services to AT RISK POPULATIONS. Most at risk populations’ Initiative (MARPI) at the STD/Skin Unit of The National Referral Hospital, adopted a go-slow approach and through a comprehensive SRH/HIV/STI intervention has extended services to high risk populations. In order to effectively provide comprehensive SRH/HIV/STI interventions, a model based on active participation of high risk populations was designed. Peer leaders of the different MARPs categories were trained. Over 50.000 MARPs were targeted to access comprehensive SRH/HIV/STI services between 2008 and 2010. Between March 2008 and June 2009, 18,981 had so far been reached; 591 Local leaders, 300 MSM, 120 WSW, 400 CSWs, 391 couples, 4219 Students from tertiary institutes and 12,960 from community and entertainment centers.

 Comprehensive SRH/HIV/STI interventions to provide MSM/Sexual Minorities’ services included training 23 staffs in Unconditional Positive Regard (UPR). These are friendly to MSM/Sexual minorities. On 20th   March 2010, 3 MSM aged 24, 28 and 36 attended an outreach organised by MARPI nearer to their home 5 Kms outside main City center. They were then diagnosed with a UD and referred to the STD Unit to receive an injection of Ceftriaxone X 1 gm stat (a drug of choice) followed by doxycycline 100 mg twice for seven days beginning 22nd March 2010. The process was simple for them as opposed to what they had feared. They were reassured of non discrimination and they were given medical forms with prescriptions which they got after waiting for only five minutes in the waiting room. During the waiting period they were given health education and adherence plans by counsellors.

Lessons learned:
 At the STD Unit there is no discrimination and stigma after what clients report. This has made it easier for clients to communicate their problems. This makes diagnosis easier and correct. This in turn makes it possible to give right counselling and medication.


  Integrated SRH/STIs/HIV services that are MSM/Sexual minorities friendly provide a quality humane atmosphere and improve on confidence levels of beneficiaries. Treatment can happen in the shortest time possible; it provides early detection opportunities and timely management.
 AIDS 2010 - XVIII International AIDS Conference Track C:  Epidemiology and Prevention Sciences


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