Baylor College of Medicine
Children’s Foundation - Uganda

Reducing the Risk for HIV Transmission Through PrEP

Nakato Norah*(not real name) is a 19-year-old sex worker from the Ndaiga landing site in Kakumiro district. She had seen and briefly heard health workers talking about a medication that prevents sex workers from contracting HIV, but thought it was a hoax. When one of her clients sexually assaulted her, Norah turned to the only option she had heard of: the pre-exposure prophylaxis (PrEP) service available at Ndaiga Health Centre III.

Norah had shunned this information because she thought it was too expensive for her, a single mother struggling to fend for her three children. At the landing site, most young girls have gotten pregnant and opted to engage in transactional sex because they consider it to be one of the quickest and easiest ways to make money. “I found it better than washing people’s clothes or running errands. All I must do is block out any emotions. On a bad day, I get clients who pay between $5 and $10 for each sexual encounter,” Norah intimates.

When she arrived at the health facility and explained her dilemma to the health worker, the health worker explained that PrEP is a daily medication that reduces the risk of contracting HIV, dispelling her misconceptions surrounding the drug. She further reassured her that it was free at government health facilities. To address self-stigma, she explained to Norah that PrEP is not only for sex workers but for everyone who is at high risk of contracting HIV. With that information, Norah felt relieved. “I now have a better and bigger reason to start taking PrEP. I do not want to get HIV. I also do not want to be the reason any other child I get catches it,” beamed Norah, who still has dreams of getting married one day.

As long as Norah stays on PrEP, she—and other sex workers using this comprehensive HIV prevention—can stay HIV-negative with a chance to pursue their life goals. After starting the PrEP medication, Norah realized the importance of protecting herself from HIV and other sexually transmitted infections by taking PrEP. She now actively encourages her fellow sex workers to also consider taking PrEP to stay HIV-negative. Her experience has further helped health educators address the myths and misconceptions about PrEP through targeted messaging.

Before starting PrEP, I relied on condoms for protection during sexual encounters. Now, I have a sense of liberation during intimate moments. The fear that used to accompany sexual encounters became a thing of the past.” Norah narrated.

Baylor Foundation Uganda, with funding from the U.S. Centers for Disease Control and Prevention, continues to seek out people living in densely populated, underserved areas such as the Ndaiga landing site who are at high risk of contracting HIV. It provides them with the means to safeguard themselves and lead safe and healthy lives. Through targeted messaging aimed at addressing myths and misconceptions about PrEP, there has been an increase in the uptake of PrEP services among key and priority populations from 1,551 clients in December 2023 to 2,070 clients in March 2024.

Story compiled & edited  by Honorata Twebaze & Louisa Kiggwe (Communications team at Baylor Foundation Uganda)

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