Mozambique

Supporting In-service Communication and Counseling and Demand Creation for VMMC

In the Manica and Tete provinces, USAID-supported voluntary medical male circumcision (VMMC) services have been offered since 2014, yet site capacity analysis done in September 2015 revealed that these VMMC sites were underutilized. HC3 was contracted in December 2015 to increase demand for VMMC services, particularly among males ages 15 to 29, and improve the quality of counseling communication in these provinces. The approaches used to generate demand for services included:

• Partnerships with community radio and national radio to broadcast radio spots, panel discussions, call-in programs and testimonials from satisfied clients
• Promotion of the service at workplaces, formal and informal markets and soccer games, where 15- to 29 year-olds tend to congregate (through personalized invitation, mobilization and billboards at those places)
• Targeting school dormitories of those ages 15 and up, and secondary and tertiary schools
• Involving the local community leadership in the mobilization
• Improving data collection at the site level to better inform demand creation efforts

Results: 13,015 Men Sought Service from late December 2015 to late March 2016
In just the first three months of HC3 support, the combined activities above has already attracted 13,015 men to VMMC service providers in Manica and Tete, of which 11,170 benefited from the service.

“Costa (a community mobilizer) said that circumcision makes the penis clean and reduces the risk of contracting HIV, in addition to what I also saw on TV, so I went to do it.”

Tauanda, a satisfied client

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Community-Level Stigma Reduction

HC3 reduced community-level stigma towards people living with HIV (PLHIV) in Sofala Province. Building on work done by PACTO, the program aimed at influencing HIV outcomes among men throughout the treatment continuum:

• Community Dialogues: Carried out by NGO facilitators, these group sessions reduced stigma among community members while educating them on HIV and gender issues. In addition, referrals for HIV testing and counseling, treatment initiation and other HIV-related services were disseminated and tracked with a tablet-based SMS referral system.
• Men’s Positive Prevention: This participatory education program allowed men who have tested positive for HIV to challenge gender norms. Content was focused on addressing internalized stigma, self-stigma, disclosure empowerment, treatment literacy and treatment adherence.
• Champion Testimonials: Using community radio to broaden and reinforce stigma reduction messages, HC3 and RENSIDA, a Mozambique network of PLHIV, highlighted champion testimonials that encouraged HIV service-seeking behaviors among men.
• Linkage to Care: By collaborating with the Co-Management Health Committees, stigma reduction was integrated into health care provider and community meetings. This reduced stigmatizing behavior within health facilities and strengthens the community-facility linkage.