HIV Prevention Among Student and Faculty at Pre-Service Institutions in the Republic of Mozambique
"Since I was told by a friend that condoms are infected with HIV, I stopped wearing it in all my sexual relations and stopped believing that is an effective way of protection. But from today, as I heard explanations around the importance of condom use, I will use it again and persistently. Beyond that, I will mobilize and share this good news to my fellow inmates." -Feliciano Rangeiro Nachengua, 26-year-old inmate and peer educator
In 2009, Pathfinder International launched the HIV Prevention among Students and Faculty at Pre-Service Institutions program. With support from the Centers for Disease Control and Prevention and PEPFAR, and in partnership with the Ministry of Justice, the program brought HIV prevention outreach and behavior change promotion to two target populations:
- Students, faculty, and staff at public health and educational training institutes in 11 provinces
- Inmates in the prison systems of five provinces
Funded by CDC/PEPFAR, this project promoted HIV prevention in two distinct communities—the students, staff, and faculty of training institutes and inmates of the Mozambican prison system—by providing counseling and testing and promoting behavior change. In partnership with the Ministry of Health, the project initiated the development of a behavioral and epidemiological surveillance system of key populations. A gender-based violence component was also integrated into the project.
Pathfinder's HIV prevention work with training institutes extended to 11 provinces. The involvement, guidance, and leadership of the institute directorates was crucial to the success of the project. The project was implemented in 23 pre-service institutes, where each class had two peer educators who work with colleagues to raise awareness on the importance of HIV prevention, counseling, and testing. In the past six months, more than 600 students, teachers, and non-teaching staff were trained to promote HIV prevention behaviors. As a result of communication activities, more than 760 students underwent counseling and testing, and subsequently learned their serostatus.
In 2009, the government of Mozambique, recognizing the magnitude of the HIV epidemic in its prison population, prioritized prison inmates as a high-risk group in need of immediate intervention (National Strategic HIV and AIDS Response Plan 2010–2014). For four years, Pathfinder International supported the government’s response by implementing HIV Prevention in Prisons—the country’s first project to contribute to an increase in access to HIV prevention and care for prisoners.
Today there are 15,415 inmates in the Mozambican prison system, 98 percent of them men. Though evidence of the impact of HIV in prisons is limited, a preliminary report from Mozambique’s Ministry of Justice, released in 2013, reveals that HIV prevalence among inmates may reach 24 percent—nearly three times the rate of the general adult male population.
The study also reveals the significant barriers inmates face, including a lack of services and commodities for HIV prevention and care, as well as widespread misconceptions about how HIV is transmitted. Thirty-five percent of respondents said they believe HIV can be transmitted through mosquito bites, and 19 percent, through a shared drinking glass. Twenty-four percent do not recognize that HIV can be transmitted through unprotected anal sex. In order to provide a comprehensive response to the HIV epidemic in Mozambique’s prisons, these and other factors—including the interruption of HIV treatment—must be addressed.
Outreach catered to inmates takes place in five provinces (Cabo Delgado, Nampula, Zambezia, Gaza, and Inhambane). Pathfinder has also made significant progress in developing a comprehensive HIV and sexually transmitted infection intervention package for inmates, including training courses for peer educators. Since the project began 225 prisoners and 45 prison staff have been trained as peer educators across nine prisons. The project is also supporting the renovation of one prison health facility and providing technical support to Ministry of Justice to improve the health programming targeting inmates.
Pathfinder aims is to evaluate the strategies of the Geracao BIZ project, as well as transform the knowledge, attitudes and practices of primary school, high school, secondary education and technical education students in sexual reproductive health.
This paper offers a critical overview of social science research presented at the 2014 International AIDS Conference in Melbourne, Australia.
Estrella Alcalde, Gender Advisor for Pathfinder Mozambique, is featured in the Universal Access to Female Condoms (UAFC) Joint Programme's 2014 Annual Report discussing the power of female condoms alongside two other UAFC partners.