KAMPALA, Uganda – The trash cans that sit in different corners of the Makerere University campus in Kampala, Uganda, are no ordinary bins. Each is crafted from more than 100 empty pill bottles, which used to contain antiretroviral (ARV) drugs taken by HIV-positive people to suppress the virus.

The artist behind the cans is Barbara Kemigisa, and some of the bottles used to belong to her. Others came from her young daughter.

Kemigisa, 31, is open about her HIV status. But she says most people living with the illness often throw their empty drug bottles into pit latrines or burn them for fear of others finding out that they are HIV-positive. So in October 2016, she began her art project as a way of fighting the stigma, while also protecting the environment from the fumes released when people burn the bottles.

“I started collecting and keeping my empty ARV bottles after realizing I could make something out of them and achieve a lasting impact,” she says.

With the empty bottles and some silver string, Kemigisa has crafted everything from trash cans and flowerpots to laundry baskets and chairs.

Because she thinks of her creations as both functional and educational, she sells them to schools and universities. But they are for sale to anyone, and institutions such as UNAIDS have supported Kemigisa by buying her flowerpots. Depending on the size, the pieces sell for between Shs150,000 ($40) and Shs350,000 ($100).

Curious people can come to Kemigisa’s workshop to look at the finished pieces. She uses the opportunity to talk to them about HIV, opening up about the fact that some of the bottles used to hold her own medicine.

“They carry a message about HIV and the importance of taking ARVs consistently,” she says. “My focus is mostly on young people who are living with HIV. I try to encourage them to continue to take their medication.”

Raising Awareness

Uganda, once considered a success story in the fight against the HIV epidemic in East Africa, has seen its prevalence rise among the general population in recent years – from 6.4 percent in 2005 to 7.3 percent by 2011, according to the most recent data.

There are currently an estimated 1.5 million people living with HIV/AIDS in Uganda. They receive free antiretroviral drugs, largely through funding from the U.S. government.

Kemigisa first learned about her status when she was 22 and expecting her first child. She gave birth to an HIV-negative baby, but six months later, hospital tests revealed the child had contracted the infection from her breast milk. With little money and nobody to help her, Kemigisa had been unable to protect her baby from the virus.

“As a single mother, I did not have the support and financial capacity to afford formula milk for my child, so I continued to breastfeed,” the artist says.

Now with strict adherence to her medication, Kemigisa’s viral load has reached undetectable levels. Her daughter’s viral load is also suppressed. Kemigisa says the girl also takes her medicine by herself every day and needs no reminding.

When people with HIV suppress their viral load to undetectable levels with regular ARV use, they significantly reduce the risk of transmitting the virus to others. But Dr. Cordelia Katureebe, coordinator of the pediatric and adolescent HIV program at Uganda’s Ministry of Health, says official statistics show the rate of suppression among children and adolescents is low compared to that of adults, largely because of poor adherence.

“Only 69 percent of children under 5 and 71 percent of adolescents have been virally suppressed, compared to 93 percent of adults,” she says.

Pill Power

Kemigisa knows firsthand how difficult it can be to stick to a treatment regime without support from family or community members.

“Some [people] lack food to eat after taking the medication or transport to the facility to get a refill of their medicine. This has an impact on how they adhere to treatment,” she says.

To help, Kemigisa formed what she calls “Pill Power Units” in her community. These units are composed of young adolescents living with HIV who go out to health centers that provide HIV treatment services to collect the empty ARV bottles that she needs for her artworks. In return, the young people receive a small amount of money, which they can then use to buy food or pay for transport to get a refill on their medication.

Sometimes, Kemigisa will get a call from someone saying they have empty ARV bottles for her to collect. To her, it means her message of shedding the stigma while protecting the planet is getting through.

“Instead of throwing the bottles in pit latrines, people are now giving them to us, which is a good thing,” she says.

“When people see these many bottles, they will know that this is the reality for people living with HIV who are on ARV treatment. For them to look as healthy as I am, they need to take their medicine consistently.”