Ugandan healthcare workers seek to integrate HIV prevention with drug services
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Healthcare workers in Kampala, Uganda, expressed strong support for combining HIV pre-exposure prophylaxis (PrEP) with services for people who use drugs.
Researchers from the University of Washington, the Infectious Diseases Institute at Makerere University, Uganda’s Ministry of Health, and the Most-At-Risk Populations Initiative interviewed twenty-eight social workers, nurses, psychologists, and clinical officers.
These professionals believe offering PrEP alongside medication for opioid use disorder and needle exchange programs would improve care for their clients, who face a fourteen times greater risk of HIV infection than the general population. The healthcare workers described this combined approach as providing a “full course meal” of care, addressing multiple needs at once. They noted that current systems require clients to travel to separate HIV clinics, which are often unwelcoming to people who use drugs.
Integrating PrEP into existing programs would create a safer, more convenient experience, reducing barriers to care. However, the workers also raised concerns about feasibility, citing potential disruptions to workflows, limited funding, and shortages of trained staff and medication. They recommended decentralizing services by delivering them through outreach programs and peer support, as well as continuous training for healthcare professionals.
They also urged policy changes to allow drop-in centers to initiate PrEP and advocated for access to longer-acting PrEP formulations to improve adherence and reduce stigma.
