The fishing communities of Lake Victoria are scattered across thousands of island and shore locations in Kenya, Tanzania and Uganda with population numbers difficult to estimate due to their wide distribution in small, often remote and informal settlements.

These settlements are often formed by people who have migrated to the lake out of economic necessity, attracted to the opportunities provided by the harvesting and processing of fish. This financial opportunity subsequently attracts a range of other people who provide services or otherwise are dependent on the fishing economy; these include housewives, farmers, shop keepers, restaurant and bar workers, sex workers and tradespeople.

Across the three countries it has been understood for many years that fishing communities are vulnerable to HIV- but due to their difficult to reach locations and patterns of mobility, the magnitude of the HIV epidemic in fishing communities was not clearly documented until recently. In 2008, the Uganda Virus Research Institute (UVRI) initiated a study which demonstrated that this population has HIV rates that are amongst the highest in the region. Even more alarming was the finding that people living in fishing communities experience extreme conditions of poverty: low income, poor housing, lack of clean water and sanitation, inadequate health care, limited access to education and information and social exclusion. It is estimated that less than 25% of fishing communities have access to even the most basic health care in a setting where there are high rates of malaria, diarrhea diseases, respiratory infections, parasitic infection and infant/maternal mortality. The research teams also note with concern that there are large numbers of children in this population who have unmet needs with regard to health care, nutrition and education.