After 22 years of conflict, the autonomous region of Southern Sudan is moving toward peaceful self-governance. However, concerns about HIV/AIDS cast a shadow on positive developments. While prevalence of HIV is thought to be low in Southern Sudan, collecting accurate epidemiological data during decades of unrest has been difficult. Furthermore, there are concerns that increased mobility to this region from areas of higher HIV/AIDS prevalence may accelerate Southern Sudan's infection rate.

To keep the levels of HIV/AIDS from rising, the US Centers for Disease Control and Prevention (CDC), has funded the three-year Reduce the Impact of HIV in Southern Sudan Project. This IntraHealth-led project is working with the Sudan People's Liberation Army (SPLA) and other partners to develop HIV/AIDS prevention, care and treatment interventions. The SPLA which began as a rebel force, is now the recognized military of the autonomous region. The SPLA plays a central role in the government, with influence extending through all layers of a highly militarized society.

The government of Southern Sudan has made addressing HIV/AIDS a high priority, and a Presidential decree was issued to facilitate the formation of the Southern Sudan AIDS Commission (SSAC). Following this decree, the SPLA formed the HIV/AIDS Secretariat as one of its directorates to oversee and implement HIV/AIDS prevention, care and support activities within the military. The SPLA HIV Secretariat is led by Acting Director Major John Woja. The Secretariat began the fight against HIV/AIDS in September 2006 by sensitizing senior commanders to increase their knowledge about HIV/AIDS and its potential impact on their personnel and the institution. Making use of the extant chain of command to distribute HIV/AIDS information, senior commanders have tasked mid-level commanders with getting prevention and treatment messages to the troops. To ensure that the messages and training styles are appropriately tailored to their audience, IntraHealth and senior SPLA commanders met with Ugandan and Kenyan military leaders who have promoted similar programs through their countries' military structures.

Capacity Building for the Secretariat

IntraHealth and the Secretariat have trained 27 officers so far to serve as HIV/AIDS educators and liaisons between the HIV/AIDS Secretariat and the Divisions. Eventually the officers will become trainers. With support from Population Services International, the SPLA HIV/AIDS Secretariat has also trained 90 peer educators. The peer educators are in daily contact with the fellow soldiers and use this interaction to provide information about HIV/AIDS.

The project has established voluntary testing and counseling centers in Juba, Lainya and Nimule. IntraHealth assisted the SPLA in renovating an existing building for the Juba center, which opened in February. The Nimule center, housed in a tent, opened in April and the Lainya center, based on the traditional tukul building style of Southern Sudan, opened in May. The project is also in the process of initiating mobile testing and counseling units, to reach people who aren’t near the three centers.

The project produces a bulletin distributed to the SPLA, other government ministries and development partners. This bulletin provides information on the various aspects of HIV/AIDS prevention, treatment, care and support and also covers HIV/AIDS-related events and stories in the SPLA. The bulletin is also raising awareness of the relationship between alcohol abuse and gender-based violence and the spread of HIV/AIDS.

Through subgrants to Medical Emergency Relief International (Merlin), the International Medical Corps (IMC) and the St. Bakhita Health Center, IntraHealth is supporting the launch of HIV/AIDS programs in health settings in four other locations. The programs will provide services that include HIV/AIDS education, counseling and testing, prevention of mother-to-child transmission (PMTCT) and care for people living with HIV/AIDS.

As the project moves forward its goals include building health care capacity for the SPLA medical corps; integrating HIV/AIDS into other SPLA directorates such as training and research; strengthening palliative care for HIV infected people; improving treatment and care for people infected with tuberculosis (a common HIV/AIDS co-infection); and participating in forums organized by SSAC and the Ministry of Health to develop guidelines, policies and protocols and developing HIV/AIDS units for other uniformed forces.