As the mist slowly rises up the volcano in the background, Rwandan soldiers descend from the surrounding hills, their boots caked with mud. They belong to units that patrol Rwanda’s borders with the Democratic Republic of Congo and Uganda. Today they walked for around an hour to this PEPFAR-supported mobile counseling and testing center at Kinigi to be educated about HIV prevention and learn their status. “I have wanted to do this for a long time. 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,” notes Sgt. Adrien Muhgamrire.
On arrival, the soldiers gather into groups to receive information about preventing HIV/AIDS. A counselor presents a series of paintings that illustrate the issues surrounding HIV, encouraging questions from the soldiers. A picture showing a pretty girl and a soldier elicits laughter, followed by questions and comments.
Another group of men gather to see and discuss a mobile video unit screening which explores the themes of fidelity, partner reduction and condom use. Some of the videos have been made by other soldiers during ‘Club Anti-SIDA (AIDS)’ activities, designed for the whole military community regardless of their HIV status. The soldiers watch a variety of videos covering the ABCs of HIV prevention (Abstinence, Being faithful, and correct and consistent use of Condoms). Testimonies from soldiers living with HIV, as well as dramatized sketches performed by soldiers are also featured.
Next, the soldiers participate in a group counseling session to prepare them for what will happen during the individual counseling and testing session. A 2001 survey revealed that people who suspected they were HIV-positive were reluctant to get tested. As a result, programs focus on the benefits of getting tested, and the medical services available for those who test positive. Each soldier spends around 15 minutes with a counselor who completes a questionnaire regarding the soldier’s sexual habits. The counselor provides the soldier with condoms and also tells him where he can buy condoms in the future. After this, the counselor takes a blood sample, and the soldier only needs to wait 30 minutes to receive the results from the same counselor.
Staff Sgt. Innocent Birinda is pleased to be getting tested today, since he says he is ready to look for a wife, and many families suspect soldiers of being HIV-positive. Like many of his fellow soldiers, he is very well informed about HIV. Another soldier in his company tested HIV-positive, and he stresses that they all “live together, sleep together, with no problem, no difference”.
For the men that receive the news that they are HIV-positive, the counselor recommends that they meet with their medical officer to arrange for a transfer to the Kanombe Military Hospital in Kigali, where they will receive additional blood tests. The soldiers will have access to antiretroviral treatment if their blood test results warrant it. The soldiers are assured that their lives will continue, with no change in their duties or responsibilities. Counselors also focus on ‘prevention for positives,’ encouraging HIV-positive soldiers to use condoms and arrange HIV testing for their wives and children.
Mobile counseling and testing responds to the needs of people who cannot access a fixed health facility. Marcel Sebagabo, Head of the Public Health Department for the Rwandan military, reports that the military are more comfortable being tested in a military setting, and as a result 80% of those offered counseling and testing come to get tested. The U.S. Department of Defense plays an important role in training and supporting the personnel working both at the Kanombe Military Hospital in Kigali and the field support staff such as the Battalion Medical Officers.
Sgt. Adrien Muhgamrire leaves Kinigi today with the good news that he is HIV-negative. Today he participated in the ‘Club Anti-SIDA’ activities and he plans to return in a couple of weeks 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.”
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