Publications by authors named "Grace Nalukwago"

Article Synopsis
  • * Successful referrals for support services were positively associated with provider awareness and client engagement, but barriers like financial constraints and socio-cultural norms hindered full implementation.
  • * The study underscores the importance of GBV screening in HIV care, suggesting that increasing awareness and addressing socio-cultural barriers could enhance outcomes for clients facing violence.
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Article Synopsis
  • * The Partners PrEP Program in Uganda integrated PrEP with ART services, revealing important implementation processes through qualitative interviews with couples and healthcare providers.
  • * Key factors for successful integration included high-quality training, supportive teamwork, and effective communication from providers, although barriers like lack of disclosure and retention issues also arose.
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Article Synopsis
  • In Uganda, people who inject drugs (PWID) face significant barriers to healthcare and have a high risk of HIV, highlighting the need for integrated pre-exposure prophylaxis (PrEP) and harm reduction services to better meet their needs.* -
  • The study involved semi-structured interviews with 41 PWID in Kampala from May 2021 to March 2023, focusing on their experiences with harm reduction services and motivations for using them, employing purposive and snowball sampling methods.* -
  • Findings showed that while participants were aware of their HIV risk and knew about harm reduction services like sterile needle distribution, many struggled with treatment adherence, and awareness of PrEP was limited; however, they supported its integration into existing services
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Introduction: Peer delivery is a client-centred approach that could maximize the coverage and impact of HIV services for transgender women (TGW). We conducted qualitative interviews to examine how peer-delivered HIV self-testing (HIVST), sexually transmitted infection self-sampling (STISS) and oral pre-exposure prophylaxis (PrEP) influenced prevention choices among TGW and their intimate partners in Uganda.

Methods: Within a cluster randomized trial of peer-delivered HIVST, STISS and PrEP among HIV-negative TGW (NCT04328025), we conducted 55 qualitative interviews with 30 TGW, 15 intimate partners and 10 TGW peers (August 2021-February 2022).

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Article Synopsis
  • People living with HIV in Uganda face a higher risk of gender-based violence (GBV), which negatively affects their treatment outcomes, prompting guidelines for GBV screening in HIV care settings.
  • A study was conducted with 30 healthcare providers from 12 ART clinics to identify factors that help or hinder the implementation of GBV screening and referral services.
  • Key facilitators included access to training and resources, while barriers consisted of poor referral service quality, lack of financial support, and cultural attitudes affecting client willingness to accept help.
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We used qualitative data from the Partners PrEP Program (PPP) to address the question: How did Central Ugandan HIV clinics adapt to COVID-19 lockdown restrictions to promote continuous access to HIV care? PPP was a stepped-wedge cluster randomized trial of integrated PrEP and ART delivery for HIV serodifferent couples at Central Ugandan HIV clinics (NCT03586128). Individual interviews with purposefully selected PPP couples (N = 42) and clinicians, coordinators, and counselors providing HIV care (N = 36) were carried out. Sixty-four interviews were completed after lockdown and included questions about accessing and providing ART/PrEP refills during lockdown restrictions.

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Introduction: Increased HIV testing by men in sub-Saharan Africa is key to meeting UNAIDS 2025 testing targets. Secondary distribution of HIV self-testing (HIVST) kits by pregnant women attending antenatal care to male partners has been shown to increase testing among African men. A detailed understanding of how women and male partners manage the distribution and use of HIVST and subsequent linkage to clinic-based follow-up can inform implementation and scale-up efforts.

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Article Synopsis
  • The study examined the effects of standardized training on healthcare workers’ (HCWs) knowledge and attitudes toward HIV pre-exposure prophylaxis (PrEP) service delivery in Uganda, finding that awareness and support for PrEP increased after training.
  • Despite improvements in knowledge and preparedness among HCWs, significant gaps remained, and knowledge tended to wane over time, highlighting the need for ongoing education.
  • Results also showed that while HCWs recognized PrEP as an effective HIV prevention method, they expressed concerns about patient adherence, infrastructure issues, and the clinic's capacity to deliver PrEP services effectively.
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Introduction: In Kampala Uganda, female sex workers (FSWs) have high HIV prevalence (33%). Oral PrEP is a novel HIV prevention intervention that offers hope to decrease HIV incidence in key populations especially among FSWs. Studies have shown that with poor adherence, oral PrEP has no efficacy, and therefore adherence to PrEP is critical among FSWs to maximize HIV prevention.

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Introduction: HIV self-testing (HIVST) and oral pre-exposure prophylaxis (PrEP) are complementary, evidence-based, self-controlled HIV prevention tools that may be particularly appealing to sex workers. Understanding how HIVST and PrEP are perceived and used by sex workers and their intimate partners could inform prevention delivery for this population. We conducted qualitative interviews to examine ways in which HIVST and PrEP use influence prevention choices among sex workers in Uganda.

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