Ninsiima knows everything about the Rubaare Trading Center in Ntungamo district. She has been a sex worker here for more than 10 years. Ninsiima is a bright energetic lady, praised for her honesty and care for other female sex workers.

She has had a steady partner for eight years who is currently working in Kenya. They are a discordant couple. Ninsiima is living with HIV. She is a walking encyclopedia of information related to HIV. “I speak in specifics and I know the reality,” says Ninsiima as she opens her purse to point out the condoms and lubricator she shares with other girls. 

You see if someone gives you 10,000 shillings how will you say no? That money can help you. But it means that you may not use a condom,” says Ninsiima.

Empowering peer leaders like Ninsiima is critical because they live and work among key populations.  These peer leaders are leveraging their position to raise awareness about HIV/AIDS prevention, care and treatment. In addition, they play an important role in the supply chain by making sure that their peers are equipped with PrEP, condoms, and lubricants, and support them to adhere to the prescribed treatment.

“Everyone knows me. I go bar-to-bar to see that the girls have the supplies they need. I check that they are getting their medicine. And I escort those who are afraid to come to the Knowledge Room. For me I speak the truth. I tell them to come to the Knowledge Room to get help, use condoms, but also to start Pre-Exposure prophylaxis (PrEP) and protect themselves.”

The Knowledge Room is a refurbished shipping container in the center of Rubaare that serves at-risk members of the community, including female sex workers. It is one of several Drop In Centers established under the District Health System to provide safe and conducive HIV and AIDS prevention and treatment services for marginalized and at-risk groups. This Knowledge Room, part of the Rubaare Health Center IV, is supported by the Elizabeth Glaser Pediatric AIDS Foundation through the USAID Regional Health Integration To Enhance Services in South West Uganda (USAID RHITES-SW) project. The room is equipped with a pool table and a television, making it an ideal hang-out spot. It is staffed by health workers and social workers who provide HIV services. The center also provides free condoms, lubricant, and oral pre-exposure prophylaxis.

Ninsiima’s dream is for all the girls on the street to learn occupational skills and make another living. Her reality is different, but her honesty and concern for the health and wellbeing of her peers and clients is creating a better world around her. 

USAID RHITES-SW works to build the capacity of Rubaare Health Center IV—including the Knowledge Room—to increase the availability, accessibility, and quality of integrated health services including HIV prevention, care, and treatment, TB, maternal, neonatal and child health, family planning, and other primary care services.

(Names have been changed to respect the privacy of participants.)