Background: Men in Uganda contribute significantly to new HIV infections annually yet PrEP uptake among them is low and those initiated are likely to discontinue usage. We explored the barriers and facilitators to PrEP uptake among high-risk men employed in private security services with negative HIV results after testing at workplaces in Uganda.Methods: An explorative qualitative study comprising in-depth participant interviews. Data were collected via telephone calls and manually analyzed by inductive content analysis.Results: Fifty-six (56) men participated, 27(48.21%) had heard about PrEP, and 29(51.79%) were willing to initiate it. Four categories emerged for the facilitators of PrEP uptake including the perceived need for HIV prevention, awareness creation, availability, and sexual freedom. Six categories emerged for the barriers to PrEP uptake. These were: Inaccessibility of PrEP services, Misinformation, Knowledge deficit, Medication-related barriers, Potential for increased risky sexual behavior, and Perceptions about PrEP use.Conclusion: The findings suggest the need for healthcare providers to offer information regarding PrEP and HIV prevention services and mass sensitization campaigns to facilitate uptake. Participants recommend mass roll-out of PrEP to lower-level facilities and accessible pick-up points for men such as workplaces. The men also suggested the use of longer-acting PrEP modalities such as an injectable option or an option that is utilized specifically by the female partner. Finally, the stigma surrounding PrEP use could be reduced by the separation of PrEP and ART services at health facilities, or special pick-up days to reduce waiting times.

Background: HIV testing uptake remains low among men in sub-Saharan Africa. HIV self-testing (HIVST) at the workplace is a novel approach to increase the availability of, and access to, testing among men. However, both access and linkage to posttest services remain a challenge. Objective: The aim of this protocol is to describe a cluster randomized trial (CRT)—Workplace-Based HIV Self-testing Among Men (WISe-Men)—to evaluate the effect of HIVST in workplace settings on the uptake of HIV testing services (HTS) and linkage to treatment and prevention services among men employed in private security services in Uganda. Methods: This is a two-arm CRT involving men employed in private security services in two Ugandan districts. The participants in the intervention clusters will undergo workplace-based HIVST using OraQuick test kits. Those in the control clusters will receive routine HTS at their work premises. In addition to HTS, participants in both the intervention and control arms will undergo other tests and assessments, which include blood pressure assessment, blood glucose and BMI measurement, and rapid diagnostic testing for syphilis. The primary outcome is the uptake of HIV testing. The secondary outcomes include HIV status reporting, linkage into HIV care and confirmatory testing following HIVST, initiation of antiretroviral therapy following a confirmatory HIV test, the uptake of voluntary medical male circumcision, consistent condom use, and the uptake of pre-exposure prophylaxis by the most at-risk populations. Results: Participant enrollment commenced in February 2020, and the trial is still recruiting study participants. Follow-up for currently enrolled participants is ongoing. Data collection and analysis is expected to be completed in December 2021. Conclusions: The WISe-Men trial will provide information regarding whether self-testing at worksites increases the uptake of HIV testing as well as the linkage to care and prevention services at male-dominated workplaces in Uganda. Additionally, the findings will help us propose strategies for improving men’s engagement in HTS and ways to improve linkage to further care following a reactive or nonreactive HIVST result. Trial Registration: ClinicalTrials.gov NCT04164433; https://clinicaltrials.gov/ct2/show/NCT04164433 International Registered Report Identifier (IRRID): DERR1-10.2196/25099

Background: The transgender or trans population is one of the most marginalized social groups globally, frequently experiencing ill-treatment and discrimination. This is disproportionately higher in sub-Saharan Africa where trans people experience stigma even in healthcare settings. There is limited evidence concerning the implementation and outcomes of interventions to mitigate this stigma. Therefore, this scoping review aimed to describe interventions and determine their effectiveness in reducing transgender stigma in sub-Saharan Africa. Methods: Searches (completed November 01, 2021, and re-run May 2022) were conducted in MEDLINE (via PubMed), Cochrane Library including the Cochrane Central Register of Controlled Trials, EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of science, clinicaltrials.gov, and online grey literature sources to identify publications that described interventions to reduce transgender stigma in sub-Saharan Africa. Results: From 877 literature search results, 23 full-text articles were assessed. Data were extracted from the four (4) eligible papers. Only one study explicitly mentioned transgender people. Second, while two studies incorporated conceptual frameworks, they did not show how the frameworks guided the study. The four studies implemented unique interventions at various socio-ecological levels to address individual and interpersonal and structural stigma. Each study utilized a different methodological approach, and the interventions were all evaluated qualitatively. Conclusions: There is a paucity of transgender stigma reduction interventions implemented in Sub-Saharan Africa with limited evidence of interventions delivered to mitigate stigma at interpersonal and structural levels. Future anti-transgender stigma research should consider reporting details about the core components and descriptions of the interventions. Additionally, the use of validated measures of stigma and the evaluation of interventions for implementation outcomes would be helpful.

Background: Basic emergency care is an important component of health system strengthening in resource-limited settings in sub-Saharan Africa. Objectives: This scoping review mapped and synthesised evidence on the implementation, capacity-building approaches, and policy implications of the WHO/ICRC Basic Emergency Care (BEC) course in the region. Methods: Twenty studies from 13 countries were included. Reported facilitators of BEC implementation included perceived relevance to frontline practice, practical and structured course content, contextual adaptation, mentorship, and training-of-trainers or cascade approaches. Reported barriers included time constraints, staffing shortages, limited infrastructure and emergency care resources, and technological challenges affecting digital reinforcement strategies. Across studies, BEC was generally associated with short-term improvements in provider knowledge, confidence, and perceived competence. However, implementation outcomes were reported inconsistently and were largely limited to acceptability, feasibility, and appropriateness, with less evidence on adoption, cost, penetration, and sustainability. Evidence on longer-term retention, practice change, patient outcomes, and broader system-level impact remained limited. Conclusions: Overall, BEC appears to be a potentially useful and context-appropriate approach to strengthening frontline emergency care training, but stronger longitudinal and implementation-focused evaluations are needed.

Sexual and gender minority (SGM) populations in Uganda experience significant mental health challenges, exacerbated by widespread stigma, discrimination, a

Background: Nurses play a pivotal role during infectious disease outbreaks, including Ebola Virus Disease (EVD), often placing themselves at significant personal and professional risk. While nurses are central to Ebola response efforts, their lived experiences, particularly in Uganda, remain underexplored. This study aimed to explore the lived experiences of nurses who provided care to EVD patients during the 2022 outbreak at Mubende Regional Referral Hospital. Methods: An exploratory qualitative design was employed using in-depth interviews with seven nurses who worked in the Ebola Treatment Unit (ETU). Participants were selected through purposive and snowball sampling. Data were analysed thematically using a phenomenological approach to capture the emotional, psychological, and professional dimensions of nurses’ experiences. Results: Findings revealed a complex interplay of positive and negative experiences. Positive experiences included joy from patient recovery, strong teamwork, professional growth, and enhanced training in infection prevention and control (IPC). Nurses reported increased confidence, new skills, and opportunities for career advancement, including recognition from international agencies. Conversely, negative experiences dominated the narratives. These included severe resource constraints, overwhelming workload, physical exhaustion, and psychological distress, particularly from witnessing patient suffering and death. Participants described post-traumatic stress symptoms and constant fear of infection and death, exacerbated by inadequate early-stage preparation. Social isolation and disrupted family life were also common, with some nurses concealing their work to avoid distressing loved ones or experiencing stigma within their communities. Additional challenges included team tensions, absenteeism, and disparities in compensation and recognition between existing staff and external recruits. Conclusion: The study highlights the profound emotional and professional toll on nurses during the 2022 Ebola outbreak in Uganda. While moments of resilience and growth were evident, structural and systemic challenges significantly impacted nurses’ well-being and care delivery. To better support frontline health workers, future outbreak responses must prioritize fair compensation, psychosocial support, consistent training, and improved resource allocation. Insights from this study can inform policies aimed at strengthening workforce readiness and retention during health emergencies.