July 21, 2014 |

Bike messenger: unlocking new voices to stop HIV/AIDS in Uganda

PATH's Arise program gives vulnerable communities in Africa and India the tools to reduce their risk of HIV. For an Arise community case worker in Uganda, that meant regaining the most powerful tool of all.
Mary Achaido standing next to her bicycle on a dusty road.
Mary Achaido, a case worker with PATH’s Arise program in Uganda, educates women and men in her community about family planning and HIV services. Photo: Pathfinder International.

If you see Mary Achaido sailing by on her bicycle, or hear her talking confidently with members of her Ugandan community, it’s hard to believe that just three years ago, she wasn’t sure her voice could matter.

For Mary, who struggled under the stigma of HIV, the change came during a community meeting. There, she heard that PATH’s Arise program needed case managers to help improve women’s access to family planning and prevent new HIV infections in their communities. The program particularly wanted women and men living with HIV. Mary joined immediately. “I wanted to relieve myself from the stigma of being HIV-positive,” she says.

Closing the gap in family planning

In Uganda, where many communities have only recently emerged from decades of conflict, it can be difficult for women to obtain family planning tools and information. Only 30 percent of married women use contraception; many more would like access but are restricted by a lack of supplies, education, and services. Women with HIV, who also have to navigate stigma, antiretroviral treatment, and HIV prevention, face even greater barriers.

Arise is closing that gap by building a confident cadre of community and clinic-based outreach workers to engage women living with HIV and their husbands and communities. Because many of these workers are themselves HIV-positive, they have the perspective to build trust and spark meaningful conversation. It’s a simple, powerful approach that is breaking longstanding barriers.

The role also supports the workers’ own health, explains Betty Inyakoit, a program supervisor. “When the project started, many [workers] were weak and stigmatized. Now, all of them are strong. . . able to ride bicycles, able to talk to their husbands, and all [have begun to use] family planning.”

A long way home

During her case management training, Mary learned about HIV counseling, family planning, and integrated care. Today, she uses that expertise (and a trusty bicycle) to raise awareness of HIV and AIDS through discussions, meetings, and home visits with other women living with HIV.

Of course, the work isn’t easy. For Mary, a long bicycle ride to a client’s home in blistering heat is just another day on the job. Sometimes, she has to stand up to strong resistance to family planning, particularly from men. Still, she loves her work and says she’ll continue to serve her community even after the Arise program has ended.

A healthier community

Since 2010, Arise has trained more than 85 community health workers and given thousands of Ugandan women and men access to family planning, empowering them to care for their health, prevent new infections, and plan when and whether to begin a family. The results are powerful. With every mile Mary pedals—and every discussion, meeting, and educational event she and her cadre make possible—Uganda moves closer to a future free of HIV.

Arise—Enhancing HIV Prevention Programs for At-Risk Populations—is made possible through financial support provided by the Canadian Government through the Department of Foreign Affairs, Trade and Development Canada, and via financial and technical support provided by PATH. Our work in northern and eastern Uganda is conducted in partnership with Pathfinder International and the National Community of Women Living with HIV/AIDS.

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