Congo: Military Program's Success Spurs Expansion

WASHINGTON, DC, October 26, 2004 — PSI's peer education interventions with the military in the Democratic Republic of Congo (DRC) have resulted in increased condom use and decreased sexual partners. As a result, the Armed Forces of the DRC (FARDC) have signed an unprecedented national protocol expanding PSI military activities and condom social marketing.

PSI and its DRC affiliate, Association de Santé Familiale (ASF), implemented a behavior change communication project with the military at Camp Kokolo in Kinshasha from 2001-2002 with the goals of reducing HIV transmission, increasing knowledge of HIV transmission and prevention, reinforcing HIV/AIDS risk perception, reducing high-risk sexual behavior and increasing condom use. The project was funded by the U.S. Agency for International Development.

In May 2004, the FARDC signed a national protocol expanding PSI's military peer education interventions and the social marketing of Prudence condoms from Kinshasa province to Katanga and South Kivu provinces.

In the first three quarters of 2004, PSI estimates that ASF prevented more than 13,000 HIV infections in the DRC through sales of its products.

In addition, PSI's interventions with the police are also being scaled up. Having trained over 3,500 police peer educators in Katanga and South Kivu, PSI signed a protocol with the Congolese National Police in June 2004 to expand that training to Kinshasa as well. PSI is the only organization to ever partner nationally with the Congolese National Police in the fight against HIV/AIDS.

During the 17-month military intervention period, carefully selected and PSI-trained military personnel at the Kokolo military camp hosted small group activities, conducting over 10,000 household visits to military personnel and implemented 138 behavior change communication activities which directly reached over 8,000 members of the military.

Analysis of a knowledge, attitudes and practices (KAP) survey administered by the University of Kinshasa School of Public Health in 2000 and an October 2002 follow-up survey revealed increases in HIV prevention and transmission knowledge and, more importantly, an increase in healthier sexual behaviors during the PSI intervention period.

For example, the research found that, from 2000 to 2002:

• High-risk behavior such as multiple partnerships and partnerships with casual or paid partners decreased;

• The number of married or domestic partners with a sexual partner outside of their main relationship dropped from 32.8% to 24.5%;

• Condom use with extramarital partners increased 10%;

• Respondents reporting paid partners fell from 62.8% to 37.9%;

• Condom use with occasional partners increased from 41% to 56% and with paid partners from 37% to 57%;

• Condom use by married partners with non-regular partners increased from 27.7% to 37.7%;

• Respondents who knew where to purchase a condom within a ten-minute walk increased from 54% to 85%;

• The frequency of use remains irregular, with only 40% of respondents with paid partners reporting that they always use condoms with such partners.

The most common reasons cited for non-use of condoms include trust in one's partner, a dislike of condoms, belief that they decrease sexual pleasure and the non-availability of condoms at the time of sexual intercourse. PSI has faced these issues with other high-risk groups and the general population in the DRC and other countries, and continues to address them through its targeted behavior change framework that aims to overcome obstacles to use whether they are based on an individual's motivation, capacity or opportunity to adopt a specific behavior.

— Karrie Carnes, PSI/Washington

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Members of the DRC's military have been trained by PSI as peer educators and were able to increase healthy behaviors such as partner reduction and increased condom use within the military.