{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:53:21Z","timestamp":1788472401479,"version":"build-2803163510"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Female Sex workers (FSW) and their clients accounted for 18% of the new HIV infections in 2015\/2016. Special community-based HIV testing service delivery models (static facilities, outreaches, and peer to peer mechanism) were designed in 2012 under the Most At Risk Populations Frame work and implemented to increase access and utilization of HIV care services for key populations like female sex workers. However, to date there is no study that has been done to access the preference and uptake of different community-based HIV testing service delivery models used to reach FSW. We assessed preference and uptake of the current community-based HIV testing services delivery models that are used to reach FSW and identified challenges faced during the implementation of the models.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a cross-sectional study design using quantitative (interview with the health workers in facilities providing services to female sex workers and interviews with FSWs) and qualitative (interviews with Ministry of Health staff, health workers, district health team members, program staff at different levels involved in delivery of HIV care services, FSWs and political leaders to assess for the enabling environment created to deliver the different community-based HIV testing services to FSWs along the Malaba-Kampala highway. Malaba \u2013 Kampala high way is one of the major high ways with many different hot spots where the actual buying and selling of sex takes place. We defined FSWs as any female, who undertakes sexual activity after consenting with a man for money or other items\/benefits as an occupation or as a primary source of livelihood irrespective of site of operation within the past six months.<\/jats:p>\n                <jats:p>We assessed the preference and uptake of different community based HIV testing services delivery model among FSWs based on two indicators, i.e., the proportion of FSWs who had an HIV Counseling and Testing (HCT) in the last 12\u2009months and the proportion of FSWs who were positive and linked to care.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 86% (390\/456) of the FSWs had taken an HIV test in the last 12\u2009months. Of the 390 FSWs, 72% (279\/390) had used static facilities, 25% (98\/390) had used outreaches, and 3.3% (13\/390) used peer to peer mechanisms to have an HIV test. Overall, 35% (159\/390) of the FSWs who had taken an HIV test were HIV positive. Of the 159, 83% (132\/159) were successfully linked into care. Ninety one percent (120\/132) reported to have been linked into care by static facilities. Challenges experienced included; lack of trust in the results given during outreaches, failure to offer other testing services including hepatitis B and syphilis during outreaches, inconsistent supply of testing kits, condoms, STI drugs, and unfriendly health services due to the infrastructure and non-trained health workers delivering KP HIV testing services.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Most of the FSWs had HCT services and were linked to care through static facilities. Community-based HIV testing service delivery models are challenged with inconsistent supply of HIV testing commodities and unfriendly services.. We recommended strengthening of all HIV testing community-based HIV testing service deliverymodels by ensuring constant supply of HIV testing\/AIDS care commoditiesoffering FSW friendly services, and provision of comprehensive HIV\/AIDS health care package.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-019-4610-3","type":"journal-article","created":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T17:03:46Z","timestamp":1572973426000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Preference and uptake of different community-based HIV testing service delivery models among female sex workers along Malaba-Kampala highway, Uganda, 2017"],"prefix":"10.1186","volume":"19","author":[{"given":"Gerald","family":"Pande","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Bulage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Kabwama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Nsubuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kyambadde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaban","family":"Mugerwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Musinguzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Riolexus","family":"Ario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,5]]},"reference":[{"key":"4610_CR1","unstructured":"AVert.org\n                    \n                  . Global HIV and AIDS Statistics 2017 [cited 2018 19th\/Febuary\/2018]. Available from: \n                    https:\/\/www.avert.org\/global-hiv-and-aids-statistics\n                    \n                  . Accessed 19 Feb 2019."},{"key":"4610_CR2","unstructured":"UNAIDS. Global HIV and AIDs Statistics, 2016. 2017."},{"key":"4610_CR3","unstructured":"UNAIDS. \u2018Ending Aids-Progress towards the 9\u201390-90 targets\u2019. 2017."},{"key":"4610_CR4","unstructured":"UNAIDS. \u2018AIDSinfo\u2019 2017."},{"key":"4610_CR5","unstructured":"Health WUMo. \u2018The Uganda population-based HIV impact assessment 2016\u201317\u2019 [pdf]. 2017."},{"key":"4610_CR6","volume-title":"\u2018The Uganda HIV and AIDS country Progress report July 2015\u2013June 2016\u2019 [pdf]","author":"Commission UA","year":"2016","unstructured":"Commission UA. \u2018The Uganda HIV and AIDS country Progress report July 2015\u2013June 2016\u2019 [pdf]. 2016."},{"issue":"6","key":"4610_CR7","doi-asserted-by":"publisher","first-page":"e1001808","DOI":"10.1371\/journal.pmed.1001808","volume":"12","author":"David Wilson","year":"2015","unstructured":"Wilson D. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs. PLoS Medicine. 2015;12(6).","journal-title":"PLOS Medicine"},{"key":"4610_CR8","unstructured":"Ministry of Health U. National HIV and AIDS priority Action Plan MoH, STI\/HIV. 2015;2015\/2016\u20132017\/18."},{"key":"4610_CR9","doi-asserted-by":"publisher","DOI":"10.1596\/978-0-8213-9774-9","volume-title":"The Global HIV Epidemics among Sex Workers","author":"Deanna Kerrigan","year":"2012","unstructured":"Kerrigan D, Wirtz A, Baral S, N\u2019Jie ND, Stanciole JA, Butler J. The global HIV epidemics among sex workers. Washington DC: World Bank; 2012."},{"key":"4610_CR10","volume-title":"The shifting Global Health landscape:implications for HIV\/AIDS and vulnerable populations","author":"FA Research","year":"2010","unstructured":"Research FA. The shifting Global Health landscape:implications for HIV\/AIDS and vulnerable populations; 2010."},{"key":"4610_CR11","unstructured":"UAC. NATIONAL HIV AND AIDS MONITORING AND EVALUATION PLAN 2015\/2016\u20132019\/2020. 2015."},{"key":"4610_CR12","volume-title":"The crane survey report: high risk group surveys conducted in 2008\/9 Kampala, Uganda","author":"MH Uganda","year":"2010","unstructured":"Uganda MH. The crane survey report: high risk group surveys conducted in 2008\/9 Kampala, Uganda; 2010."},{"key":"4610_CR13","unstructured":"Uganda M. Consolidated guidlines for prevention and treatment of HIV in Uganda 2016."}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-019-4610-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12913-019-4610-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-019-4610-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T00:07:34Z","timestamp":1604448454000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-019-4610-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,5]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["4610"],"URL":"https:\/\/doi.org\/10.1186\/s12913-019-4610-3","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,5]]},"assertion":[{"value":"12 February 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"We obtained ethical approval or consent from the Makerere University School of Public Health Higher Degrees Research and Ethics Committee (MakSPH-HDREC) and the Uganda National Council of Science and Technology (UNCST). We obtained administrative clearance from the district authorities where the study was conducted. We obtained writen (for FGDs and KIIs) informed consent from the study participants before enrollment into the study. We paid $4 to each of the FSWs as an incentive to participate in the study and also compensate for losses while interacting with the RAs. During the KIIs or FGDs, respondents were free to respond to questions they wanted to respond to and were not coerced to answer any questions. Anonymity was guaranteed by not writing participants\u2019 names and confidentiality maintained by only researchers having access to information provided by the respondents and not disclosing to anyone outside the research team.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The participants gave consent for direct quotes from their interviews to be published in the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"799"}}