4.6. HIV/AIDS awareness

According to the Ministry of Health, between January 1990 and May 1996, a total of 3,318 cases of AIDS were diagnosed in Mozambique.³ The worst-hit provinces were Manica and Tete, followed by Sofala and Zambezia, all of which are in the centre of the country. These are the provinces which are home to the greatest number of refugees returning from high-HIV-infected areas, such as in Malawi and Zimbabwe. Few health units, however, have the technical resources to diagnose the HIV virus and government estimates suggest that as many as 16,000 Mozambicans have AIDS and possibly 1 million (one-sixteenth of the population) have the HIV virus.⁴ The results of the latest governmental HIV/AIDS survey are expected soon.

³ Dr. Avertino Barreto, Head of the Health Ministry's AIDS Programme, quoted by AIM Reports, Issue No. 87 (18 June 1996).

⁴ UNICEF, Mozambique situation update: November 1995-January 1996, p. 4.

The Ministry of Health, together with the Mozambican Red Cross and other non-governmental organizations, has tried to alert the public to the need of using condoms in any casual or extra-marital sexual encounters. UN AIDS was launched in April 1996 in Mozambique. A technical group has been preparing a list of all AIDS-related activities in the country and efforts have begun to encourage an intersectoral approach to HIV prevention.¹

¹ UNICEF, Mozambique situation update, May-July 1996, Maputo, undated.

In addition, an international NGO, Comunica e Marketing Social Para Saude (PSI), has been involved in AIDS and other STD-awareness activities. Their focus has been on high-risk groups, such as soldiers, the police, lorry drivers and sailors. Activities are also carried out with children in groups of not more than 20 both in school (a youth-to-youth school-based programme has begun in Tete province with the Ministry of Education and expansion to other provinces is planned) and out of school (e.g. through theatre, associations and church groups.) The emphasis is on peer education. PSI picks someone from community² and trains him or her to become a trainer.

² The selection process is done through the local health centre. Selection criteria are that the individual must be aged between 18 and 30, must be able to read and write, must know the local language, and must be trusted within the community.

Condoms are provided free by the Government in health centres - this has always been the case. PSI, on the other hand, import Jeito³ from the United States and sell the condoms. The cost of a packet of four, which is heavily subsidized, is 500 meticals (equivalent to approximately 4 US cents). A free condom is supplied in an awareness pamphlet (which is unfortunately only in Portuguese). PSI also run three radio spots. Rap music is used as a method of communication with the youth. The concentration of the messages is mainly in urban and peri-urban areas, but work in some high-risk rural and border areas started in December 1996.

³ The word means “cool” or “style” and is thus clearly youth-oriented.

A number of obstacles have been encountered during the programme. There is some cultural resistance to the use of condoms on the part of men, who say that they reduce their sexual pleasure. “You don't eat a banana with the peel on!” is a message commonly heard. Many women have a fear of negotiating with their partners for the use of contraceptives. At school level, the organization found that it had as many objections from teachers as it did from parents (on the basis that they were teaching about sexuality). There is a need to work on curriculum development to institutionalize HIV/AIDS awareness.

PSI is also working with prostitutes but find that it is difficult to gain their trust. Men are willing to pay more to have sex without a condom. Although some prostitutes insist on the use of contraception, not all do so.

Another initiative aimed at the literate young is the free distribution of the Magazine SIDA by the youth newspaper, Aro. The paper, which is only available in Portuguese, has had a distribution of 21,000. Its publication was supported by Redd Barna (Norwegian Save the Children).

Given the risk posed by the demobilized soldiers, it is rather surprising that no HIV/AIDS awareness seems to have been undertaken in the assembly areas, whether linked or not to the vocational training programmes. The opportunity to inform captive high-risk audiences of the dangers of AIDS should be seized. In addition, even though HIV/AIDS training may not be formally included in vocational training programmes, information and awareness posters can be put up on walls as they are, for instance, in the CFPM training centre described in box 1 above.