Mobile and Military VCT Prevents HIV in Rwanda

PSI is pleased to present this USAID/Rwanda Success Story on PSI/Rwanda's PEPFAR-funded Military Mobile VCT program.

KININGI, Rwanda, December 14, 2005 — As the mist rises up the volcano, Rwandan soldiers descend from the surrounding hills, their boots caked with mud. They belong to mobile units that patrol Rwanda's borders. They walk for an hour to reach a mobile voluntary counseling and testing (VCT) unit.

Mobile VCT responds to the needs of those who cannot access a fixed VCT center. The Public Health Department of the Rwandan military reports that the military are more comfortable being tested in a military setting and, as a result, 80% of those offered VCT come to get tested. Since the mobile VCT for the military started in August 2005, 1,869 soldiers have received HIV tests (preventing 145 HIV infections, according to PSI's new system for measuring cases of AIDS averted).

"I have wanted to do this for a long time," notes Sgt. Adrien Muhgamrire. "For many years we have been hearing how important it is to get tested for HIV, but we never have the time to get tested. My unit is more than a day's walk to the nearest health center."

On arrival, the soldiers of the 63rd battalion gather into groups to receive information about preventing HIV/AIDS. One group sits with Outreach Coordinator Eddy Rugamba as he presents a series of paintings that illustrate issues surrounding HIV. He encourages comments and questions from the soldiers.

Others gather to discuss a mobile video unit screening which explores the themes of fidelity, partner reduction and condom use. Some videos the soldiers see today have been made by other soldiers during Club Anti-SIDA (Anti-AIDS Club) activities. Testimonies from soldiers living with HIV are featured; as well as sketches performed by soldiers during Club Anti-SIDA.

Club Anti-SIDA meetings take place two or three times a month and provide a welcome diversion for the soldiers. Activities are designed for the whole military community regardless of their HIV status. Soldiers write songs, poems and plays that reinforce the message of HIV prevention. Competitions with other battalions and performances for local communities increase the club's appeal.

In a group counseling session, Emmanuel Ndoba, head of High Risk Programs, summarizes the message: "If you test positive, you learn to live positively and safely, but if you test negative, you must maintain your positive behavior to remain safe from HIV." A 2001 survey conducted by PSI revealed that people who suspected they were HIV-positive were reluctant to get tested. As a result, programs such as this focus on the benefits of getting tested, including the medical services available for those who test positive.

Each soldier spends 15 minutes with a counselor who completes a questionnaire regarding the soldier's sexual habits. The counselor provides the soldiers with condoms and tells them where they can buy condoms in the future, and then takes a blood sample. The soldier waits only 30 minutes for the results.

Staff Sgt. Innocent Birinda is pleased to be getting tested today, since he is ready to look for a wife, and many suspect soldiers of being HIV-positive. Like many fellow soldiers, he is well informed about HIV and though another soldier in his company tested positive, he stressed that they all "live together, sleep together, with no problem, no difference."

Those who test positive are reminded there will be no change in their duties or responsibilities: other than the regular medical visits, life will go on as usual for them. HIV-positive soldiers are advised to use condoms and arrange testing for their families.

Sgt. Adrien Muhgamrire leaves Kinigi with the good news that he is HIV-negative. Today he participated in the Club Anti-SIDA activities and he plans to return for the next meeting. Before heading into the hills, the club practices their new song, which a soldier translates, "We fight against AIDS, then we stay strong, we serve our country, we protect our families and we are careful and loyal."

— Sybella Moumtzis, USAID

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Members of the 63rd battalion at a VCT counseling session