Awarded in FY11, the PROACTIVO project aims to promote normative change and adoption of safer sexual behaviors, with the aim of reducing new HIV infections among MARPs. The project supports USG contributions under the second goal of the Partnership Framework, reduce the growth of the HIV/AIDS epidemic. PROACTIVOs overall goal is to reduce HIV incidence by preventing HIV transmission between MARPs and their sexual partners in five target provinces along the transportation corridor from Cunene in the south to Luanda. Strategic objectives are to strengthen protective behaviors of MARPs and their partners to prevent HIV, and strengthen the environment at national and lower levels for civil-society led advocacy, networking and collaboration with GRA and stakeholders.

The project provides HIV prevention materials and free condoms through a variety of channels. As an integral part of project design, PROACTIVO has established sub-grants with 2 local non-governmental organizations that work with the target populations. With COP12 funding, the project will continue working closely with sub-grantees to strengthen their capacity to maintain and manage outreach activities and referral networks for HIV prevention, counseling and testing, and care. PROACTIVO will also continue collaboration with a broader group of NGOs to strengthen civil society capacity for advocacy and networking to improve access to services and reduce stigma and discrimination impacting MARPs. The results of a prevention program assessment in July 2011 are factored into PROACTIVO work plans. The Performance Monitoring Plan is in place and includes end-of-project targets. An independent, final evaluation will be supported with other COP12 funds.

In Angola, civil society has been characterized as evolving, but still weak with limited capacity (USAID Assessment, 2010). There is a great need, therefore, for increased institutional and technical capacity strengthening among civil society organizations. PROACTIVO builds the capacity of five civil society organizations (i.e. ASCAM, SCARJOV, ADESPOV, ASD and OHI) to lead and sustain HIV prevention interventions and advocacy in collaboration with the Government of Angola and other stakeholders. Through CSOs, PSI targets key populations in Benguela, Cunene, Huambo, Huila and Luanda to expand outreach for community mobilization in risk reduction and behavior change, consistent and correct condom use, reduction of stigma, discrimination and gender based violence, uptake of HTC and partner reduction.

PROACTIVO builds the capacity of these five local organizations to implement sound HIV prevention interventions and steward USG funds. They provide technical assistance and training in grant writing, management, supervision, leadership, budgeting, monitoring and evaluation to expand high impact structural, behavioral and biomedical strategies. PROACTIVO also helps create and strengthen networks to diffuse information and ignite greater resource mobilization. Specific opportunities include: (1) strengthening MSM networks and the network of people living with HIV/AIDS; (2) training to develop organizational and individual advocacy plans to advance health as a human right to reduce stigma and discrimination; (3) leveraging other HIV platforms to link key populations to global networks; (4) supporting the uptake of quality services; and, (5) working through existing forums to engage government in planning and implementation with civil society organizations. Using the model of multiple sub-agreements under an umbrella project that strengthens the technical and managerial capacity of the local NGOs, USAID/Angola is preparing CSOs (through prime partners like PROACTIVO's) to assume a prime recipient role.

The expansion of HIV testing and counseling (HTC) is a Government of Angola (GRA)/National Institute for the Fight Against AIDS (INLS) priority and PROACTIVO will support INLS to expand these services among key populations in facility and community-based settings along the transport corridor and other identified high-risk areas. PROACTIVO s key populations include female sex workers, truckers and other clients of sex workers as well as men who have sex with men (MSM). PROACTIVO activities will include mobilization to support HTC, activities linking HTC-users to appropriate follow-on services, special campaigns, training and capacity building for HTC. New for fiscal year 2014, INLS has agreed to facilitate training for PROACTIVO outreach workers to conduct testing in high-risk zones; thus, PROACTIVO will do direct testing to help the GRA reach its HTC goals. In addition, PROACTIVO is investigating the use of private facilities for key populations if such subsidized services increase uptake and options for those who prefer and can afford to pay. PROACTIVO will leverage GRA resources, where possible, and their own to monitor quality of testing and counseling as well as leveraging support from other USG funded partners.

Plans for FY12 include a continuation of existing MARP-focused activities focused on the following:

Commercial sex workers (CSW): Activities will reach approximately 6900 CSWs and will target key risk behaviors including low-level of condom use with all partners, challenges of negotiating condoms use especially with clients, low risk perception, gender-based violence faced by partners and/or the police, and alcohol abuse. Outreach activities will increase the HIV prevention knowledge of CSW and their patrons, and will be complemented by small group discussions and trainings in condom negotiation and other topics, led by activists and CSW peer educators. Each intervention will include promotion and distribution of generic condoms, both male and female.

Clients of sex workers: This heterogeneous population is not easily identified, but generally belongs to the general population where they bridge the epidemic through their relationships with wives and girlfriends. PROACTIVO will target approximately 8000 current and potential male clients of CSWs in interventions addressing key risk behaviors including multiple and concurrent partnerships, condom use, low risk perception around HIV/AIDS, and alcohol abuse.

Truckers: Mobile populations are frequent clients of CSWs, often engage in multiple sexual partnerships, and also are believed to be a bridging population of the epidemic in Angola. PROACTIVO will work with 2300 men who drive trucks in-country and across borders. Outreach and peer-education interventions will target key risk behaviors including low level of condom use with both steady and casual partners, low risk perception and knowledge, and alcohol abuse.

Men who have Sex with Men (MSM): Widespread stigma, discrimination, prejudice and misconceptions of MSM in Angola contribute to the challenge of identifying and reaching them with HIV prevention messages and products. The project will pilot activities among 700 young MSM in Luanda. Interventions will address key risky behaviors including low condom use, multiple partners, and low risk perception. Activities will be implemented through social networks where peer educators are able to share HIV prevention messages and provide discrete distribution channels for condoms and sexual lubricants. Peer education and outreach activities are complemented by social activities, such as monthly movie nights or parties, to further promote HIV prevention messages and products.

Activities targeting all populations include: conducting a mapping exercise, capacity building of local organizations, interpersonal communication, target group messaging, promotion of correct and consistent condom use, promotion of MARP-friendly services, support GRA to establish a National MARP Working Group, MARP voices in the media, and advocacy. In Luanda and Huambo, PROACTIVO activities also help foster referral networks for MARP clients to access quality HCT and PMTCT services supported under USAIDs Strengthening Angolan Systems for Health (SASH) project. While the project distributes free condoms as part of its outreach activities, messages also create linkages with the Integrated Social Marketing Program which promotes branded condoms for sale nation-wide.