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Countering HIV/Aids using those most at risk

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Kigali: A truck stop in Gikondo-MAGERWA, suburb of Kigali, was transformed into a discussion forum on HIV/AIDS this week. Truck drivers, sex workers, and members from the community exchanged ideas with HIV/AIDS representatives from across the great lakes region.  

Rwanda hosted visitors from Burundi, DR Congo, Kenya, Tanzania and Uganda during the sixth and final session of a two year process to establish a new control measure for the region’s neighbours. The process is known as the AIDS competence.

“An HIV/AIDS competent community is a community that first acknowledges the issue,” said Jean-Louis Lamboray, chair of the Constellation for AIDS Competence, an organization seeking to stimulate and connect local responses to HIV/AIDS around the world. “Basically it is managing the issue of AIDS itself and it is making it one amoung many problems in life.”

The Great Lakes Initiative on Aids (GLIA) adopted the AIDS competence approach to strengthen capacity between networks and people living with HIV/AIDS.

“The approach has been adopted to see how we can stimulate the communities, appreciate their strengths, learn what they’re able to do, and transfer their capacity amoung and within the networks of GLIA,” said Zacharie Nzeyimana, the HIV/AIDS network program coordinator of GLIA.  It’s a community approach meant to empower people to use their own strengths and learn from one another.

The approach targets vulnerable populations, like truck drivers, who might not have the support they need from health facilities and can be stigmatized, said Nzeyimana. He said the visit to the truck stop was the “ultimate way of working” because the community can assess the capacity they have and attendees from the various countries can see what services are available in one place.

The AIDS competence approach will be integrated into other programs existing at the truck stop, said Murenzi Theodore, secretary general of the Association des Chauffeurs des poids Lourds au Rwanda, the union that represents truck drivers in Rwanda and facilitates activities to help fight HIV/AIDS.

Currently, the truck stop is a centre that provides testing for sexual transmitted infections and HIV/AIDS, education on the subject, condoms, and shower facilities. It also provides recreational activities, such as a pool table and movies. Over a hundred people use the centre daily, roughly 40 being truck divers.

A similar stop exists in Rusizi (by the DRC border) and funds are being gathered to open a centre in Gatuna (by the Tanzanian border) by June 2010. The creation of three other sites bordering countries in the Great Lakes area is being planned.   

“The centres are very important because of their location,” said Theodore. Since truck drivers are always on the road, the stop sites include services drivers might not access elsewhere. “Coming to my centre,” Theodore said speaking of the GLIA group, “will give them a good image of how centres like this are being managed and how services in the centre are provided.”

Tremendous progress has been made since representative from the six countries came together two years ago, said Lamboray. “Here is a bunch of people discussing totally openly what their experience is and looking for what is common in their experience while their background is different,” said Lamboray. “Congo is not Rwanda, is not Tanzania, and yet they came to identify common principles.”

GLIA still faces multiple challenges. For example, how the context of a region affects the implementation of an idea.  “Sometimes we intend to copy the studies done in other countries, but the context, the local context, can be a challenge,” said Nzeyimana.  “GLIA is a bridge organization.”

In one group discussion at the truck stop, a sex worker who is HIV positive said she tells her costumers that she is positive, but some still will not wear a condom. She said she doesn’t refuse them business because she needs the money. Another participant gave the example of a women’s cooperative in India that created an emergency fund so sex workers would feel they have the ability to refuse clients. Due to the fund, workers refused sex without a condom, and condoms became more common place.  

At the close of the two year project, 18 facilities, three in each country, are to use the AIDS competence approach. But it’s not going to stop there. GLIA wants to continue to empower other communities to address HIV/AIDS, starting with fisherman.

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