Progress in the fight against HIV in Uganda appears promising, with national infection rates plummeting from 30 percent to 5 percent over three decades. This success is attributed largely to improved education and prevention strategies, including expanded HIV testing and treatment. However, despite these gains, concerns persist, particularly among sex workers, where HIV prevalence remains alarmingly high, affecting over one in three women in the profession.
In the heart of Kampala’s slums, Deborah Nakatudde, a former sex worker herself, is leading the charge to address this pressing issue. Nakatudde’s journey into sex work began at the tender age of 15, following a tumultuous upbringing marked by parental loss and mistreatment by a stepmother. Forced to abandon her education, she found herself in Bwaise, one of Kampala’s largest slums, where sex work is prevalent.
In 2008, Nakatudde was appointed as a peer educator for women in the slum by a sexual and reproductive health organization. When the project concluded, she felt a compelling need to continue the work independently, thus founding Saving Lives Under Marginalisation (SLUM). Through SLUM, Nakatudde orchestrates campaigns against sexually transmitted diseases within Kampala’s sex worker communities, providing vital HIV testing and treatment services in collaboration with public health facilities.
Her organization also conducts outreach programs to educate sex workers on preventive measures such as condom usage and pre-exposure prophylaxis (PrEP) medication, reaching over 350 individuals annually with these vital messages. One beneficiary, Amina, shares her experience of shock upon discovering her HIV-positive status during pregnancy. Thanks to SLUM’s intervention, she received timely testing and commenced HIV treatment alongside antenatal care, safeguarding her health and that of her unborn child.
Efforts to prevent mother-to-child transmission of HIV have seen significant success in Uganda, with a 77 percent reduction observed between 2010 and 2020. The nation aims to eliminate this transmission entirely by 2030. Health worker Innocent Kaitta, part of Nakatudde’s SLUM project, emphasizes the heightened vulnerability of sex workers to sexually transmitted diseases due to their limited agency in negotiating protection. He underscores the economic pressures that often compel sex workers to engage in unprotected sex, despite the associated risks.
Looking ahead, Nakatudde underscores her commitment to ensuring HIV treatment accessibility for at least 95 percent of those diagnosed with the disease, with a particular focus on sex worker communities. By aligning her efforts with broader national objectives, she aspires to replicate the success achieved in the general population, fostering a future where infection rates among sex workers mirror the declining trend observed nationwide.
