Best of G3P

The AIDS Support Organization (TASO) with support from CDC implemented a home-based ART, prevention counseling and VCT program in Tororo district. Lay staff provided weekly home delivery of ART and patient monitoring, as well as referral to clinic for medical care and psychosocial support. Participants received group prevention counseling as well as individual support, including development of sexual behavior plans aimed at supporting risk reduction. VCT was offered to all household members.

Biruh Tesfa addresses vulnerabilities of migrant adolescent girls who have relocated to urban areas and are at risk of coerced sex, transactional sex and exploitative labor. The program seeks to protect these girls by reducing their social isolation and providing them with health information, including HIV prevention, and services to address sexual exploitation and abuse. Through the program, female community leaders mentor out-of-school girls ages 10-19, addressing issues such as reproductive health and violence. Program services ensure that girls have access to health care; rape victims can obtain support services; and a shelter is available for evicted domestic workers (many of whom are migrant girls). Girls also can get identification cards along with vocational training and job placement.

In support of the National Strategic Framework for HIV/AIDS in Uganda, the AIDS/HIV Integrated Model District Program (AIM) was designed to assist with increasing the provision of quality integrated HIV/AIDS services at the district and sub-district level. The mission of the AIM program was to establish effective, replicable models that would successfully contribute to the decrease of HIV prevalence and incidences in Ugandan adults and children. Key program objectives: 1) To strengthen and support the capacity of government, NGOs, CBOs, FBOs and the private sector to plan, implement, manage and provide quality services at the national, district and sub-district level 2) To increase integration and quality of comprehensive HIV/AIDS prevention, care and support services in selected districts 3) To increase access to and utilization of quality HIV prevention services and quality HIV/AIDS clinical, community and home-based care in selected districts and sub districts 4) To increase access to and utilization of quality social support services for people infected and affected by HIV/AIDS including orphans, vulnerable children and adolescents

Between July 2004 and July 2005 our research team discussed with girls and women individually and in focus groups the ‘wayo’ system (the role of the paternal aunt) and the importance of the role of the grandmother’s hut. We also interviewed women and girls regarding their thoughts about their vulnerability to HIV and AIDS, the impact of the war, abductions and fatalism. We examine the potential of the Wayo institution in protecting young girls and women against sex abuse, HIV/AIDS and STDs in war torn northern Uganda. This is a prospective study to define the intervention and then implementation of the 'wayo' model intervention for the prevention of HIV/AIDS and STIs, in an acceptable way in displacement camp circumstances.

EGPAF’s strategy in Uganda has been to complement Uganda Ministry of Health and private partners to cover human resource, infrastructure and commodity gaps in health districts. EGPAF Uganda helps with the design, development, management, monitoring and technical support of the Uganda Ministry of Health PMTCT program.

m2m is based on the concept that peer support is an optimal model for effective education and social empowerment, and that mothers themselves are the best vehicle to provide support to other mothers. Through education and community-based outreach activities, the program helps women learn to advocate for their own health and the health of their families; it also works to destigmatize HIV/AIDS within communities. Finally, the program provides employment and professional development for local women living with HIV who serve as mentors and educators on HIV/AIDS-related issues.

AMITIE enhances the ability of communities and the government to respond to the needs of OVC and PLWH through home and facility based services. The project works in three cities to support Community Care Coalitions, reduce stigma through training, support youths as caregivers, train men as home-based care providers and implement house-hold income generating activities. The Project has adopted a client-centered approach to service delivery, supporting local networks to provide care and support.

Refentse uses an integrated, nurse-driven delivery model of post-rape care that includes the following services: • post-exposure prophylaxis (PEP) • pregnancy testing • emergency contraception • sexually transmitted infection (STI) treatment • voluntary counseling and testing (VCT) Refentse integrates clinicians, social workers, police officers, and representatives from the local prosecutor’s office to strengthen relationships between the health and criminal justice sectors, and provide comprehensive post-rape care that goes beyond simply providing PEP. Referrals may be initiated at the health facility level to assist patients with police reports if desired. In addition, social workers are made available at the police station to counsel and refer patients to the hospital. The local prosecutor’s office provides advice on legal matters. A study using a combination of qualitative and quantitative methods was conducted from March 2003 to September 2007 to test the effectiveness of this post-rape care model, in Bohlabela District, rural Mpumalanga province, South Africa. It was based at Tintswalo Hospital, Acornhoek, a 450-bed district hospital that functions as a referral site for post-rape care.

AMPATH is amongst the largest and most comprehensive HIV/AIDS-control systems in sub-Saharan Africa, providing a complete system of care that has been described as a model of sustainable development. Delivery of services occurs in the public sector through hospitals and health centers run by Kenya’s Ministry of Health. AMPATH’S model of care includes: • community engagement • education • promotion of safe-sex practices • experience-sharing by persons living with HIV/AIDS • counseling and testing • prevention activities AMPATH touches the lives of millions in a wide geographic area.

The Drug Resources Enhancement Against AIDS and Malnutrition (DREAM) project aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS. The main objective will be achieved through: • the establishment of services providing diagnosis and comprehensive treatment • the prevention of HIV transmission in the general population and of mother-to-child transmission through Community Care and Home Care services (CCHC) and Mother and Child Prevention and Care (MCPC), respectively DREAM provides HAART while also treating for other health ailments and emphasizing education.

The Down Referral Model is a partnership between Broadreach Health Care and Klerksdorp/Tshepong Hospital complex, a public sector hospital in South Africa. The hospital refers patients that are stable on treatment into a program to utilize BroadReach-affiliated community-based general practitioners for ongoing care.

In collaboration with community leaders, World Vision Rwanda identified 990 youth-headed households living in southwestern Rwanda in 2001 and began to provide these households with a basic needs program that included assistance with housing, education, health, and food.

In this program, Thai companies agreeing to implement at least three HIV and AIDS workplace policies would receive a reduction of 5 to 10 percent off their group life insurance premiums from implementing partner AIA (American International Assurance), Thailand's largest insurance provider, if they were AIA clients. As the initiative evolved, implementing partner TBCA (the Thailand Business Coalition on AIDS) introduced the additional incentive of a certificate endorsed by the government and awarded at a high-profile public ceremony. For each company agreeing to participate, TBCA offered assistance to enhance their activities, including providing educational leaflets, videos, and a mobile exhibition, as well as condoms, peer education training, counseling and referrals to support groups for HIV-positive employees, and assistance with writing company HIV and AIDS policies.

Population Media Center-Ethiopia developed the Youth-Focused Media Communication Project to promote social response to HIV/AIDS, ARH, and positive youth development. The project was aimed to enable young people to acquire knowledge, values, skills and experiences through dialogue and capacity building and to address social issues including HIVAIDS. The project included the following activities: Menta Menged radio serial drama, Print media (namely Alegnta special Booklet, “Alegnta” Radio phone-in panel discussion programs (weekly 30 minutes telephone discussion), and Media Capacity Building Workshop. The overall objective of the project was to contribute to the national effort to prevent and reduce HIV/AIDS epidemic through implementing the planned intervention with the ultimate goal of behavior change among the target audiences. Specifically, the project intended to: bring about behavior change among the youth on HIV/AIDS and Family Planning issues through effective communication; and; enhance the creativity and communication skills of the youth to enable them to effectively address RH and HIV/AIDS issues.

Families and communities throughout the world hope for healthy babies. Mother-to-child transmission (MTCT) of HIV has become a major area of concern and action in Kenya, where at least 50,000- 60,000 infants become HIV-infected each year due to mother-to-child or vertical transmission. In response to the devastating human and development effects of HIV/AIDS, Pathfinder International is working with communities and health facilities to prevent mother-to-child transmission and support women and their babies to lead healthy, productive lives. Pathfinder’s Expansion of Mother-to-Child HIV/AIDS Prevention Project, funded by the Centers for Disease Control and Prevention (CDC) operates in Nairobi, North Rift, and Eastern Provinces. Phase one of the project (2002-2005) ended, and the CDC granted Pathfinder funds to continue and expand its prevention of mother-to-child transmission (PMTCT) work in a second phase of the project from 2005-2010.

Soul City: IHDC was initiated in 1992 in order to harness the power of the mass media for health and development. It has, in the last 10 years done this successfully by using a concept known as “edutainment,” entertaining while educating. This enables Soul City: IHDC, through radio and TV dramas, to access audiences at prime time and thus enables us to reach the maximum possible audience. High quality color booklets complement these dramas. 5-year strategic goals to: • Prevent 204 380 new HIV infections (which equate to 7% of new infections, given an incidence rate of 2.4% among 15-49 year olds). • Increase access to treatment by 5% and adherence to treatment by 20%, by people who need it. • Reduce violent behaviour by men aged 15-35 by 10%. • Build capacity in southern Africa to do effective health promotion and communication. • Respond to emerging and other priority health issues.

The New Start Counseling and Testing centers aim to increase the number of adult South Africans who know their HIV status. New Start targets young adults, men and couples who are least likely to visit government clinics for testing. Each New Start center provides high quality, anonymous HIV counseling and testing (CT) for a subsidized fee of R25. In addition to the static sites, each center operates a mobile CT program that brings services to communities, partner organizations and workplaces. Mobile teams that go into the communities provide free service.

LoveLife is a comprehensive national-scale HIV prevention program focused specifically on 12-17 year olds. Launched in late 1999 as a joint initiative of leading South African non-government organizations and the South African government, in partnership with several private foundations and with substantial South African private sector support. LoveLife’s comprehensive strategy was designed to address the specifics of the epidemic in South Africa, its resources and infrastructure and the socio-cultural context. The program seeks to achieve sustained engagement with the first generation of young people growing up in post-apartheid South Africa (the so-called “born frees”) who are exposed to greater benefits and opportunities than their parents, but still face many of the socio-economic legacies of apartheid such as poverty, unemployment and a lack of social and economic advancement opportunities.

Program H stimulates young men to question traditional “norms"" associated with masculinity and promotes both discussion and reflection about the ""costs"" of traditional masculinity as well as the advantages of gender equitable behaviors, such as better care for their own health. Program H, replicated in several parts of Brazil and throughout the world, uses educational workshops, lifestyle campaigns, innovative approaches to attracting young men to health facilities, and a culturally sensitive impact evaluation methodology.

In this HIV prevention trial sponsored by the National Institute of Mental Health (NIMH), 34 communities in Africa (in South Africa, Tanzania, and Zimbabwe) and 14 communities in Thailand will be randomized to receive either a community-based voluntary counseling and testing (CBVCT) intervention in addition to standard clinic-based VCT (SVCT) services, or SVCT services alone. The CBVCT intervention has three major strategies: 1. To make VCT more available in community settings 2. To engage the community through outreach 3. To provide post-test support These strategies are designed to change community norms and reduce risk for HIV infection among all community members, irrespective of whether they participated directly in the intervention.