Breaking Down Barriers: Empowering Young people Living with HIV in Uganda

"Link Up’s experience in Uganda demonstrates the success empowered young people living with HIV can have in achieving greater access to SRHR and HIV services for their peers. Building a strong team of peer educators who were visible and proud of their work proved the foundation for service provision in the project.”

This is a key outcome outlined in this 16-page case study discussing the experience of the Link Up Project in Uganda, which was designed to increase access to integrated and quality sexual and reproductive health and rights and HIV information, as well as commodities and services, for young people living with and most affected by HIV. Between October 2013 and March 2015 the Link Up Project used peer educators, along with improving youth-friendly health services, to address barriers facing young people in accessing reproductive health services, such as lack of knowledge, skills, and youth-friendly services.

The case study first explains the context of the programme and then goes on to describe the main component of the programme - the use of peer educators. As stated in the document, "649 peer educators were trained through a three-day course where issues relating to growing up, body changes, relationships, sex, sexuality, pregnancy, sexually transmitted infections (STIs), HIV and sexual and gender-based violence were explored. Peer educators also learnt strategies for talking to their peers on SRHR and what to do if they could not answer a question." To reach young people who do not want to go to health facilities, implementing partners collaborated with existing HIV support groups, clubs, HIV related events, and local organisations to identify young people, make them aware of the services on offer, and give them confidence that those involved had been trained on important issues such as confidentiality and informed consent.

The peer educators also came up with their own ideas of how to interact with peers, including youth camps that offered young people living with HIV a weekend of fun activities. To ensure youth-friendly services, the project also included training health providers on the specific needs and experiences of young people living with HIV, how to communicate effectively with this group, such as the importance of listening and giving non-judgemental responses. The programme was also complemented by radio and print media, community dialogues with gatekeepers such as police workers and brothel owners, and a beauty pageant to address HIV stigma.

According to the case study, through the project young people who are normally hard-to-reach were brought closer to SRHR and HIV services, and many were referred for antiretroviral therapy enrolment. Between 2013 and 2015 the project:

• "Reached 5980 young people living with HIV with SRHR information, counselling and services in their own communities.
• Reached 3794 young people living with HIV with SRHR information, counselling and services in health facilities and through clinical outreach.
• Made 224 completed referrals of young people living with HIV to health facilities."

Based on the experiences of this project, the following recommendations are offered for consideration when implementing similar projects:

• ensure peer educators know what they do not know, and know when to refer to others;
• when designing campaigns, it important to include positive and innovative messaging (using songs and bright and colourful print materials), and include youth people in the design of materials;
• include activities which build a sense of community within young people’s clubs;
• provide ongoing mentorship for health providers and find opportunities for joint activities between them and young people living with HIV;
• budget for the cost of peers accompanying young people living with HIV to health services;
• involve young people living with HIV in service provision; and
• Develop meaningful collaborations with youth organisations and networks.

“It is important to promote strategies that meaningfully engage young people living with HIV in all their diversity, including young people living with HIV who sell sex, young people who identify as lesbian, gay, bisexual, transgender or intersex and sell sex or use drugs as they may be the best placed to reach others living similar lives with the tailored information and services they need to access their sexual and reproductive health and rights.”

Click here to download the summary case study in PDF format.