With the increased availability of antiretroviral therapy (ART) there are now many more people living with HIV in Uganda. As a result, the challenges to dealing with AIDS are now are very different to those we faced when HIV was first discovered 25 years ago.

I have been living with HIV for 20 years, and as the epidemic has evolved, so has the activism and approaches taken in response to the virus. With more people now taking treatment, there are new challenges - especially in the areas of treatment adherence (people taking their ARV medication correctly) and positive prevention, as health services are overstretched and burdened with critical staff shortages.

It is because of this that people living with HIV must themselves become active players in the delivery of HIV and AIDS services. This is a very different role from that taken by activists in the 1990s.

As Country Director for the International HIV/AIDS Alliance Uganda, I have been working on a scheme called the "Networks Project" which covers 40 districts. This project, funded by USAID, capitalises on the advantages that have resulted from expanded treatment programmes which enable people living with HIV to regain their health and strength. This programme trains them to become Network Support Agents (NSAs), and there are now over 1,300 agents who act as a bridge between the formal healthcare setting and local communities.

The Agents become actively involved in various aspects of HIV and AIDS. I call them "the true heroes". This is a new phase in our HIV and AIDS response - one of Positive Leadership - where people living with HIV take the leadership in the management, decision making, and delivery of HIV and AIDS programmes globally.

The work has meant that now over 1.2 million people receive prevention and care services from over 650 health care facilities across Uganda. The International HIV/AIDS Alliance brings together communities, groups of people living with HIV and AIDS, health care workers and government departments to contribute to a shared goal of providing universal access to care, support and prevention services for individuals living with HIV/AIDS and their families.

Mr Gava Musisi from the Mukono District Network of People Living with HIV and AIDS is one of more than 700 groups we're working with. "By supporting groups of people living with HIV and AIDS to deliver some of the services that people living with HIV and AIDS and their families need, we are seeing more people opening up to be the ambassadors of change. We are also able to attract additional support from other partners because our groups are more organised," he says.

Central to this change are the health care workers who have in the past taken on the burden of caring for the sick. Now with people living with HIV being empowered to care for themselves, the health care workers' burden is reduced. Other providers of support services are also finding it relatively easy to provide services to an empowered and better organized community of people living with HIV.

Here is the story of one of the people living with HIV in Namungalwe Village, Iganga District, that the Network Support Agents have been helping:

"Monica (an NSA) met my husband and I in 2007. At that time she would persuade us to go for HIV testing but we did not respond. She would always pass by our home since we live in the same village to encourage us to take an HIV test."

"One day she came home and told us that an outreach for HIV counseling and testing was going to be conducted in Namunkeso village not very far from our village and she urged us to go for the test."

"We decided to go for the test and results unfortunately indicated that we were both HIV positive. It was a very challenging time for us but Monica comforted us. She always reminded us that she was also living with HIV but was surviving."

"She then referred us to the health facility where she worked (Namungalwe HCIII) and linked us to the health workers who were of great help to us. "

"Within a short period of time we were started on ART. Monica has been of great support to me, helping me to adhere to treatment, and I am doing well. She has also supported us to disclose to our relatives who initially thought that it was witchcraft. Disclosing has helped us to get care and support from the family. I do appreciate Monica's support, she is a great help."

The International HIV/AIDS Alliance are running a "Have Your Say" discussion forum on their website, which has comments from HIV experts, people living with AIDS, the general public, and world leaders.

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