Background: In 2014, there was an estimated 54,549 Female Sex Workers (FSW) in Uganda with HIV prevalence of 34.1% (UAC 2014).The combination of a restrictive legal environment and mobile nature of FSW are among the barriers that influence access of HIV/AIDS services, leading to poor retention in the continuum of care. TASO Entebbe, a model center of excellence, piloted the Community Client Led ART Delivery (CCLAD) Differentiated Services Delivery Model (DSDM) among 90 HIV positive FSWs in care to increase access to HIV/AIDS services and improve retention rates among FSWs in care.
Description: Following complaints from some FSWs, of long waiting time with loss of clients in lodges, inconvenient time drug refills time, and stigma & discrimination from the general population due to their dress code and appearance at the drug pick-up points, TASO Entebbe introduced the Community Client Led ART Delivery (CCLAD) model for stable FSWs living in the same community. This involved grouping FSWs according to a criteria of; being HIV positive, registered with TASO, having disclosed to peers, consented to join CCLAD and having suppressed VL. The group selected a leader whose roles included; taking members'' parameters like weight and MUAC, distribution of condoms and lubricants, delivery of pre-packed ARVs to members and submission of the filled tools to the TASO technical staff.
Lessons learned: A total of 14 FSWs aged 20-29 years (3) and 30-35 years (11), were identified and 2 CCLAD of 7 members each were formed. All FSWs in each CCLAD group maintained a suppressed VL.100% retention rates in each group was achieved. ART adherence improved from 75% to 95%. The ripple effects of CCLAD caused other FSW in the same hotspots to request to join the CCLAD groups.
Conclusions/Next steps: Innovative ART delivery models like CCLAD among FSWs stimulates demand for HIV/AIDS services, mitigate effects of stigma and enhance treatment adherence and retention.

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