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 CT come to get tested.

Today the testing takes place at Kinigi, 30km from Ruhengeri in northern Rwanda, for the 63rd Battalion. On arrival, the soldiers gather into groups to receive information about preventing HIV/AIDS. A group of men sits with Eddy Rugamba, the Outreach Coordinator for Population Services International (PSI), the Emergency Plan partner implementing this mobile CT program. He presents a series of paintings that illustrate the issues surrounding HIV. As he moves from one picture to the next, he encourages comments and questions from the soldiers. A picture showing a pretty girl and a soldier elicits laughing, 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 the soldiers see today have been made by other soldiers during ‘Club Anti-SIDA (AIDS)’ activities. The soldiers watch a variety of videos which cover the ABC’s (which stands for Abstinence, Be faithful and appropriate and consistent use of Condoms). Testimonies from soldiers living with HIV, as well as dramatized sketches performed by soldiers during ‘Club Anti-SIDA (AIDS)’ activities 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. Emmanuel Ndoba, Head of High Risk Programs for PSI, summarizes the message for the testing as being “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, and the medical services available for those that test positive.

Each soldier spends around 15 minutes with a counselor who completes a questionnaire regarding the soldiers’ sexual habits. The counselor provides the soldiers with condoms and also tells them where they can buy condoms in the future. After this, the counselor takes a blood sample. The soldier only needs to wait 30 minutes to receive the results from the same counselor.

Innocent Birinda, Staff Sergeant, 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. He, like many of his fellow soldiers, 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 ARV drugs if their blood test results warrant it. The soldiers are reminded there will be no change in their duties or responsibilities, and other than the regular medical visits, life will go on as usual for them. Counselors encourage HIV positive soldiers to use condoms and arrange HIV testing for their wives and children.

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

The US 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. Many of these officers received clinical training at a US military hospital in San Diego. Nathan Dowling, Staff Sergeant in the US Army, notes that the Rwandan military has had very few problems with HIV positive soldiers being stigmatized. He puts this down to the consistent and thorough information about HIV/AIDS available throughout the military.

Sgt Adrien Muhgamrire leaves Kinigi today with the good news that he is HIV negative. Today he participated in the ‘Club Anti-SIDA (AIDS)’ 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.”

Since the mobile Voluntary Counseling and Testing for the military started in August 2005, 1,700 soldiers have received HIV tests. During the last year the US Government has facilitated access to complete HIV counseling and testing for 310,577 people.