In the Democratic Republic of Congo (DRC), extreme poverty and weak infrastructure pose daunting challenges to those working to stem the spread of HIV. Less than 20 percent of the population knows their serological status, and less than 20 percent of the health providers have integrated HIV prevention and testing into their services.
The Integrated HIV/AIDS Program (ProVIC) project—a partnership among PATH, USAID, and Chemonics—is working with local organization Progrès Santé Sans Prix (PSSP) to reach out to the most at-risk populations in the country, primarily commercial sex workers, men who have sex with men, miners, truckers, and fishermen. Because these groups have poor access to HIV counseling and testing (HCT) services, PSSP reaches out to them where they live and work through mobile “moonlight” clinics that operate from 6 p.m. to as late as 1 a.m.
Working in Kinshasa and other urban areas, the project has provided HCT services to nearly 300,000 people through the “moonlight” HIV testing initiative.
ProVIC Prevention Specialist Voulu Makwelebi says the evening hours have contributed to the program’s success. “People prefer to come at night. For people who work nine to five, they cannot come during the day. Also at night, people can come in secret. They feel more comfortable because people can’t see them.”
Word has spread quickly about the mobile clinics. In particular, the men who have sex with men peer educator program relies heavily on participants’ social networks to encourage the use of mobile clinic services. “MSM [men who have sex with men] involve their friends,” said Voulu. “More men agree to get tested and there has been an increase in male participation. The MSM community is the one that is the most involved.”
ProVIC’s mobile moonlight testing for commercial sex workers and men who have sex with men is being presented at the XIX International AIDS Conference in Washington, D.C.
ProVIC is based on the “champion community” approach pioneered in Madagascar, where Chemonics implemented the SanteNet project, and adapted to the unique and com¬plex context of the DRC. Through champion communities, individuals, families, and communities actively participate in the progressive, deliberate practice of collectively defining and resolving their problems by accessing ProVIC’s integrated HIV/ AIDS services. Hilaire Mbwolie, a project director at PSSP, recalls the challenges of convincing the government to support targeting most-at-risk communities through mobile HCT.
“We had to explain our goals to them many times. They finally understood that our approach was innovative and that we were reaching out to a large number of people,” said Hilaire.
Having recently declared moonlight HCT a model program for the country’s HIV/AIDS activities, the DRC government has begun working with ProVIC to expand the program in other areas.