Stigma Among People Living With HIV Hindering Differentiated Service Delivery.

By Naboth Isaac Niwagaba.

Stigma among people living with HIV is hindering Government’s efforts to fight AIDS by improving adherence to HIV drugs through the Differentiated Service Delivery program in which beneficiaries have access to medicine without necessarily having to travel to the health centers.

Differentiated service delivery (DSD) is a person-centered approach to HIV management launched by the government in 2017.  DSD tailors HIV services to diverse groups of people living with HIV according to the challenges faced while trying to access treatment and care from health facilities.

In Kabale district, the program has been hampered by stigma which creates a gap between clients and health service providers.

This was revealed on Tuesday by the acting Kabale District Health Officer Alfred Besigensi during a media engagement organized by the Uganda Aids Commission in partnership with the Global Fund, at Bunyonyi Safaris Resort in Kabale District.

Mr. Besigensi explained that Kabale Regional Hospital has faced a lot of challenges caused by stigma whereby people living with HIV do not want to get in contact with anyone attached to the hospital with fear that it would attract suspicion from the public about their status.

Besigensi said that they had tried enrolling many clients on the Differentiated HIV Care and Treatment where people were organized in groups of six at the parish level and a contact person, usually a hospital staff member, assigned to collect  Anti Retroviral Drugs -ARVs on their behalf. However, he said that they received reports of cases where clients had started to dodge hospital staff in charge of delivering the drugs.

As another alternative, Besigensi said they had signed a memorandum of understanding with selected pharmacies in Kabale Municipality to avail drugs to some clients who found it uncomfortable receiving the drugs from the hospital or the outreach service providers. He said the pharmacies were providing ARVs to clients with medical cards issued by the hospital, and in turn, the Government was paying for the drugs.

Willy Tukamushaba, the Chief Coordinator of the association that brings together people living with HIV in Kabale District said that the stigma is usually caused by internal fear and ignorance. He said unlike in the past where the community contributed much of the stigma, today, people living with HIV have self-judgment which makes them feel discriminated against even when they are not.

Joanita Kemigisha an official from Uganda Aids Commission explained that Stigma and discrimination usually result in violations of Human rights. She gave an example of orphaned children whose guardians refuse to take them to school because they were born HIV positive.

Kemigisha asked the media to the champion condemnation of such human rights violations.

Statistics from the Kabale District Health Office records indicate that by September 2021, about 8964 people were leaving with HIV, and enrolled on Anti Retroviral Therapy – ART..

According to the Uganda AIDS Commission, by 2020, about 1.5 million Ugandans are living with HIV with an estimation of only 1.3 million enrolled on ART.