What We Do
The Test and Treat Project
CHEDRA provides a multitude of services, including free antiretroviral therapy, regular HIV testing, Linkage to HIV Care. CHEDRA uses rapid HIV testing and group counseling sessions. Free condom and lubricant distribution, as well as the promotion of safer sex through outreach and media campaigns, is conducted.
Despite the significant HIV Prevention, treatment and care services supported by AIDS service organizations within Masaka District, the proportion of OVCs accessing and adhering to comprehensive HIV care services remains low due to limited access to health services, infrastructure limitations and resource constraints. Uganda has an estimated 1.6 million people living with HIV (PLHIV) and HIV prevalence of 6% with higher prevalence rates among key populations (KPs) and priority populations (PP) including sex workers (SW) (35-37%), fisherfolk (22-49%), uniformed services personnel (18.2%), men who have sex with men (MSM) (13.7%), boda-boda riders (7.5%) and long-distance truck drivers (25%).
HIV infections are still high among young people and comprehensive HIV prevention knowledge is still low. There is increased engagement in risky sexual behavior (24.5% increase in multiple concurrent partnerships from 2011 to 2016), low condom use among those engaging in high-risk sex and a decline in age of (early) sexual debut (UPHIA 2016/17). The Masaka District HIV prevalence rate of 10% is higher than the national average of 6%. As a result, OVCs and AGYW account for a disproportionate number of new infections among young people and the number of young people living with HIV. When girls drop out of school, their risk to acquire HIV increases considerably (UNAIDS Gap Report 2014).
In Masaka District the school dropout rate is high, putting OVCs and AGYW at a higher risk of acquiring HIV/AIDS. Adolescents and young people (10-24 years) have lower HIV treatment coverage and viral suppression (68% on treatment and 77% virally suppressed).
Key barriers include poor adherence due to non-disclosure, stigma and discrimination, lack of information, stress, and inadequate support. Retention in HIV care remains a challenge, especially among children and adolescents. Adolescent girls and young women often do not have the final say on matters related to their own health care and have remained at a much higher risk of HIV infection than their male peers.
In Masaka District, OVCs have limited livelihood opportunities with economic dependence on caregivers and a tendency towards labor migration. Moreover, persistent stigma and discrimination prevent those most vulnerable to HIV from accessing HTS and other services. Among HIV service providers in Masaka, there is limited availability of youth and OVC-friendly services. Coverage of priority interventions targeting this age group remains low (<10%) in Uganda and in Masaka as well.