Stakeholders' Consult on HIV/AIDS Sustainability Index Dashboard And Agree On What Works

The LGBTIQ+ in Uganda can ably and effectively contribute to eradicating HIV. They have within them people who have worked so tirelessly to mobilize communities for testing and other attendant activities driving uptake and roll-out of response. 

Strategic Litigation And Human Rights Advocacy: 

From 2000-2019 funding has been provided for Strategic Litigation and Human Rights Mobilization and Advocacy. Almost all activities were: paying for office rent, Litigation, Workshops, salaries for officers and activities geared at raising consciousness toward rights.  Whereas funding was available none of it was provided for caring for the LGBTIQ+ Living with HIV. Rights advocacy work is necessary and commendable but it made it very hard for the Gay medical doctors to provide input or say. Health issues remained to be the work of these selfless medical doctors who decided to use their own funds to care for over 800+ LGBTIQ+ Living With HIV.

Strategic HIV/AIDS Prevention And Public Health Advocacy:

This provides a platform for activities geared at HIV/AIDS Prevention-related work: mobilization, clinical, immunological and virological activities. With PEPFAR Funding this will be possible. PEPFAR released funding support to go toward HIV Eradication, and this has a multiplier effect. The Gay medical doctors will bring on board past experience from working within various primary health areas as well as see to it that prevention and care is strategic. They will at the same time support the process of SID 2019 effectively and positively. They will leverage their knowledge, be able to identify and manage various non-presumptive and presumptive/definitive stages. For instance wasting syndrome, CNS Toxoplasmosis, extrapulmonary TB, Pneumocystis pneumonia (PCP) to name but a few. They will use their expertise to ensure early sustainable interventions. They are the Subject Matter Experts (SMEs) and perhaps that is why they give way to those experts in legal, litigation and Human Rights advocacy work. Separation of tasks is an effective way of addressing needs, because it engenders specialization and quality work outputs.  Because, they are well positioned to attend to cases, they will make early timely referrals because they have been available, built trust and have goodwill with the LGBTIQ+ Living With HIV. They can support the process of adherence and viral suppression at social and facility levels. Asymptomatic stage of HIV is very deceptive, but for those who are experienced it can be a very crucial opportunity to link a client to Prevention and Care Continuum. With PEPFAR funding made available, it will be possible to facilitate mechanisms for HIV eradication led by the LGBTIQ+ Community.

 History of HIV Prevention Targeting LGBTIQ+ Living With HIV

Strategic HIV Prevention targeting LGBTIQ+ began in mid 1990s with Kucus Living With HIV (KULHAS) led by Dr. Paul Ssemugoma and The Good Samaritan Uganda ( GSU) which became MARPS in Uganda. This work has culminated into services alleviating needs for over 800 LGBTIQ+ Living With HIV.

LGBTIQ+ And SID 2019:

The SID 2019, is  the Sustainability Index Dashboard (SID). It is a tool comprised of a series of question/indicators under four domains and seventeen elements. Scores are generated for each of the 17 elements and are represented by four colours. The overall score for each element is auto-generated by summing the scores for the separate responses to questions under that element, with possible maximum of 10 points.

The questions inform on whether more investment of time, logistics and personnel is required for an area to score numbers toward 10 points.

This dashboard is country specific and PEPFAR has given/specific objectives it looks forward to achieve.

And so, between 27th August-28th August 2019, diverse stakeholders were invited  to complete the SID 2019. This was under the auspices of UNAIDS and PEPFAR.

People who were knowledgeable in given areas were allowed to breakaway and form four Domain fora representing the four SID Domains. The breakaways were opportunities for discussing the elements at length. Sources were referenced and these were captured as well.

The domains were scored as follows:

Dark Green (Score 8.50-10.00);

Sustainable and requires no additional investment at this time

Light Green Score (7.00-8.49);

Approaching sustainability and requires little or no investment

Yellow Score (3.50-6.99) 

Emerging sustainability and needs some investment

Red Score (< 3.50pts)

Unsustainable and requires significant investment

The Domains:

Domain A: Governance, Leadership and Accountability

Domain B: National Health System and Service Delivery

Domain C: Strategic Financing and Market Openness

Domain D: Strategic Information

SID 2019 And PEPFAR Goals:

What PEPFAR anticipates is a Uganda, where institutions ( inclusive of government, NGOs, Civil Society, and Private Sector), the domestic workforce, local health systems and other service points constitute the primary vehicles through which HIV/AIDS programmes and services are managed and delivered. To gain optimal coverage, national, sub-national and local governments have achieved high and appropriate coverage of a range of quality, life-saving prevention, treatment and care services and interventions.

Conclusion:

The LGBTIQ+ must and shall contribute to the demand for HIV/AIDS services, which are user-friendly, accessible and affordable. We hope to consolidate our effort and enable over 800+ LGBTIQ+ Living With HIV/AIDS to remain in care and optimally achieve viral suppression. For LGBTIQ+, Sexual partner reduction, a full range for preventive prophylactics, cultural sensitivity addressing other gender diversities, unconditional positive regard reports, linkage to livelihood and entrepreneurship, substance use/anti-suicide support and other issues unique to sexual/gender minorities who are vulnerable/susceptible to HIV are crucial interventions.