Using Geographic Information Systems to improve condom availability among Female Sex Workers in four HIV high risk districts of Southwestern Uganda

Summary:

Condoms have played a central role in Uganda's HIV prevention strategy, though hampered with challenges of inconsistent availability, which has affected use. Uganda has an estimated population of 195,626 female sex workers (FSW), whose HIV prevalence is estimated at 37%, compared to national prevalence of 6%. Geographic Information System (GIS) data visualization has been used to effectively map FSW hot spots to inform the distribution of condom access points and document, track, and inform condom supply activities. In-depth GIS analysis was carried out using geospatial analysis tools and field GIS data to produce category and intensity maps, which were used to visualize coverage and identify gaps. Two local Civil Society Organizations (CSO) engaged in condom distribution activities were engaged in primary and secondary GIS data collection to map FSW hot spots (205 bars and 211 lodges), to track the number of FSWs hot spots per zone, catalog contact information of peer leaders, and the availability of condom dispensers. This exercise also helped the two CSOs to improve communication with peer champions working in hot spots, who are better able to report stock outs and have built on this relationship to promote HIV testing and prevention services among FSW. Applying GIS technologies to map FSW hot spots has enabled the more efficient distribution of limited condom supplies, allowing programmers to better deploy resources and more quickly anticipate and respond to stock-outs in key hotpot zones.

Background/Objectives:

Condoms have played a central role in Uganda's HIV prevention strategy, though hampered with challenges of inconsistent availability, which has affected use. Uganda has an estimated population of 195,626 female sex workers (FSW), whose HIV prevalence is estimated at 37%, compared to national prevalence of 6%. One barrier to condom use among FSWs is poor access and availability. Geographic Information System (GIS) data visualization has been used to effectively map FSW hotspots to inform the distribution of condom access points and document, track, and inform condom supply activities.

Description of Intervention and/or Methods/Design:

In-depth GIS analysis was carried out using geospatial analysis tools and field GIS data to produce category and intensity maps, which were used to visualize coverage and identify gaps. Two local Civil Society Organizations (CSO) engaged in condom distribution activities were engaged in primary and secondary GIS data collection to map FSW hot spots (205 bars and 211 lodges), to track the number of FSWs hot spots per zone, catalog contact information of peer leaders, and the availability of condom dispensers. At the time of mapping, 56% of the bars and lodges were experiencing condom stock out. These data were used to develop hot spot zone maps and attribute information that could be used by peer champions at hot spots and CSOs to monitor condom availability and inform activities to replenish condom supplies, follow-up with ART-enrolled FSW, and coordinate demand creation activities.

Results/Lessons Learned:

GIS mapping of FSW hot spots improved the monitoring of condom availability by two CSOs responsible for condom distribution activities. The capacity to use data for decision-making was strengthened by two CSOs, improving condom availability while also improving the coordination of demand creation activities. This exercise also helped the two CSOs to improve communication with peer champions working in hot spots, who are better able to report stock outs and have built on this relationship to promote HIV testing and prevention services among FSW. Subsequent follow-up activities revealed that hot spots without condoms had reduced from the initial 56% to only 11%.

Discussion/Implications for the Field:

Applying GIS technologies to map FSW hot spots has enabled the more efficient distribution of limited condom supplies, allowing programmers to better deploy resources and more quickly anticipate and respond to stock-outs in key hot spot zones. GIS should be used to visualize and document interventions aiming to improve access to key health products.

Abstract submitted by:

Felix Manano - FHI360
Edward Kagguma Kakooza - FHI360
Ingrid Nyesigire - FHI360
Musa Kimbowa - FHI360
Brian Asiimwe - FHI360