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A little moonlight goes a long way

…Bringing HIV services closer to the hard-to-reach populations in Namibia

By Selma Shiwaya

The KP-STAR project team set up along a hotspot area where female sex workers frequent.

“Good evening, where are your friends?” “Where can we find them?” “Can you call them?” These are the three questions one could hear as the Key Populations - Strengthening Technical Assistance and Response for Sustainable HIV Prevention and Treatment (KP-STAR) project team engages clusters of Female Sex Workers along different avenues of Windhoek on a Friday night.

IntraHealth Namibia’s KP-STAR project is a United States Agency for International Development (USAID) funded project, that aims at increasing access to HIV services for Key Populations (KPs)—Men who have Sex with Men (MSM), Female Sex Workers (FSW) and Transgender (TG) individuals. Occasionally the KP-STAR project team sets up a mobile van at night to provide HIV testing and counselling, STI screening, treatment, and prevention services, including risk reduction messaging to KPs.

A nurse offering health services to a client in the mobile clinic during a moonlight outreach in Windhoek.

“We do not do moonlighting often in the same places, because we do not want to keep testing the same Sex Workers. So, we would occasionally visit different hotspots to mobilize the Sex Workers about a particular day that we will be having the moonlight. We also ask Sex Workers that we find at hotspots to share the message with their peers who we cannot reach. On the night of the moonlight, we fetch the Sex Workers from the hotspots in groups of three to four people and bring them to our mobile van for sexual and reproductive health services they might need. Bringing Sex Workers in smaller groups is preferred as it avoids congestion. It also ensures that those who already know each other are brought to the mobile services site at the same time. After that, we transport the Sex Workers back to their hotspots,” explains Zieglinde Trooiitha Jod, IntraHealth Namibia’s Khomas Regional Coordinator for the KP-STAR project.

“To ensure continuous provision of services to Female Sex Workers we make weekly rounds at hotspots, to distribute condoms and lubricants. This has led to good working relationships with the Sex Workers. So, whenever Sex Workers see our car approaching, they freely come to us for condoms,” adds Kenneth Kamwi, a Senior Project Coordinator for the Wellness Services at Walvis Bay Corridor Group (WBCG), which is a clinical partner on the KP-STAR project.

It is past 9pm, and the place is gradually getting busy. I approach a lady, seated adjacent to the van as she waits to be assisted. She chooses to remain anonymous. “Thank you very much for bringing these services to us here. Some people are ashamed to come to your clinic during daytime, this is helpful,” she states. As the conversation continues, she narrates how health education offered by the KP-STAR team has helped her to be virally suppressed. “I have been HIV positive for 12 years now and I am happy that my viral load is finally down, and I wish to keep it down” she gushed.

A KP-STAR Case Manager engaging a sex worker during a moonlight outreach in Windhoek.

Meanwhile, another lady, who prefers to be called Marvellous, sits next to her peer and she joins the conversation. “We really like how the KP-STAR team assists us here. You constantly supply us with enough condoms. This is the third time I am accessing your services ever since I came to Namibia. There are people who usually come here to give us condoms and self-test kits,” she says. She adds that because sex work puts them at high risk of HIV infection, Sex Workers appreciate the condoms being supplied by KP-STAR to protect themselves against HIV.

“As for me I am already HIV positive. Therefore, I need to protect my clients from HIV by using condoms every time I have sexual intercourse. I also need to keep taking my medication so that I can be virally suppressed. We really need your services,” says Marvellous.

The KP-STAR project is being implemented by a consortium of partners under the leadership of IntraHealth Namibia, the Prime Recipient. Consortium partners are Walvis Bay Corridor Group, and KP-led Civil Society Organisations namely Rights not Rescue Trust (RnRT), Wings to Transcend Trust of Namibia (WTTN), Voice of Hope Trust (VHT), MPower Community Trust (MPower), Harmony for All Movement (HAM) and Society for Women Empowerment (SWET). The KP-STAR project is being implemented in 10 Priority Geographic Areas (PGAs) namely Gobabis, Swakopmund, Walvis Bay, Windhoek, Oshakati, Rundu, Katima Mulilo, Oshikango, Keetmanshoop and Otjiwarongo.

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