This activity (#10307) complements those described in Condoms and Other Prevention (#10049), Basic Health Care and Support (#10055), and CT (#10064).

The EP continues to targeted populations most at risk or vulnerable to HIV acquisition and transmission in order to effect HIV transmission dynamics and provide care to those most in need. In Cote d'Ivoire, with the prolonged political and military crisis, the EP team targeted uniformed services and their sexual partners for special attention. Since Sep 2002, there has been active mobilization and deployment of various uniformed services (national army, gendarmes and police) as well as rebel forces and the potential emergence of militia forces. Increased mobility with separation from spouse(s), economic disparities with the surrounding population, and crisis-related shifts in perceptions (e.g. gender and violence norms, less concern about the long term etc) are likely to contribute to heightened sexual risk behaviors among these populations. Access to information, counseling and HIV testing, and health care is limited overall but particularly so for uniformed services on active deployment. In addition, children have been victims of the conflict. A national disarmament, demobilization and reinsertion program has been planned for both child and adult soldiers and rebel forces.

As such, in Sep 2005, PSI and its partners (AIMAS, CARITAS, ESPOIR FANCI and JHPIEGO) applied successfully to implement the EP project to expand HIV prevention, counseling and HIV testing and care interventions targeting the uniformed services, ex-combatants and their partners in Cote d'Ivoire .

As part of an adapted sexual prevention strategy for these populations the project seeks to address negative gender and sexual violence norms, promote sexual risk reduction especially emphasizing partner reduction, condom use and promoting uptake of HIV testing and STI and HIV care and treatment services including secondary prevention for HIV positive persons and within HIV discordant couples. Prevention interventions targeting child soldiers will be adapted to their age, sexual experience and context working in collaboration with UNICEF.

In Côte d'Ivoire, young girls often begin their sexual life precociously and engage in sexual relationships with men much older than themselves. In the armed forces, knowledge of sexual risk reduction and prevention measures and how they are implemented is not marked. A PSI-conducted survey in 2004, showed that only 2.9% of respondent members of the National Armed Forces of Côte d'Ivoire, referred to faithfulness as an AIDS-prevention measure and only 26.9% mentioned abstinence. The same survey showed that 80.6% of respondents reported having had had more than one sexual partner during the 12 preceding months.

With EP funds to date, PSI and its' partners have coordinated with the Ministry of Defence, rebel forces and other partners (UNFPA and UNICEF) and the national disarmament, demobilization and reinsertion program (NCDDR) to conduct a national needs assessment. With these data they have identified 40 intervention sites (20 in the Northern zone controlled by the Force Nouvelle, and 20 others in the Southern Government controlled zone) as well as 15 "Centers for Transit and Orientation" (CTO) for child soldiers (as part of the larger national programs).

PSI sub-partner CARITAS has been given the lead in "AB" interventions as part of the project and works closely with the Ministry Fighting AIDS (MLS) as well as national and international technical partners (JHU/CCP, UNICEF, UNFPA, ONUCI and (NCDDR). With EP funds to date, they have developed curricula and behavioral communication change (BCC) tools for the child soldiers and children otherwise associated with the military, completed CTO site selection and trained 920 peer educators. The environment in which the child lives will be considered and targeted as well as children themselves.

With FY06 funds, by end March 2007, the training program for adults and child peer educators and supervisors will have been completed. A sustained BCC communication program will be initiated which is designed to reach 140,171 individuals among uniformed services, ex combatants and sexual partners and reduce sexual risk behaviors including abstinence and promotion of sexual health (for children) and partner reduction (for adults) with gender and stigma and CT promotion also integrated as major themes. Interpersonal communication based on participatory approaches will occur through peer

education and reinforced by mass communication at military sites from the mobile video unit. The focal point of each army (both Northern and Southern) will also visit targeted PSI-military projects to exchange evolving best practices with colleagues in other countries.

With FY07 funds, the project will build on foundational work and rapidly expand service delivery and prevention interventions. Following further needs assessments, 10 new additional military camps will be selected in collaboration with the military authorities. The BCC campaign initiated in 2006 will be updated on the basis of ongoing evaluations to make sure that the major risk behavior determinants have been targeted successfully.

With FY 07 funds, key project activities include: For child soldiers - aged 8-14: -Behavior change communication via peers and influential elders will include promotion of abstinence and sexual risk reduction as well as the promotion of positive gender roles and reinsertion into regular society including schools and educational programs at the CTOs; - Adapt the abstinence promotion campaign with results from the initial evaluation; - Produce and disseminate a 5-minute film on abstinence promotion and integrate in site activities;

For older and sexually experienced child soldiers, adult military, ex-combatants and their partners: - other sexual prevention measures will also be promoted, including the importance of partner reduction, mutual fidelity, knowledge of one's serostatus, and positive sexual health. - Training will be conducted to deliver effective BCC messages in sexual prevention to the target population, including 20 adult military personnel trainers, 480 adult peer educators, 10 new adult supervisors, as well as refresher training for 40 adult supervisors; - Trained peer educators will lead participatory educational programs for the armed forces, the ex-combatants and their partners at the 50 adult sites and 10 CTOs; - Produce and disseminate a 5-minute film on sexual risk reduction and integrate in site activities;

In addition PSI will : - Continue regular internal and quarterly external supervisions; - Peform a TRaC survey to monitor prevention activities.

Peer educators trained with harmonized tools by national trainers will deliver interpersonal sessions to their peers in small-sized groups in a workplace. Female peer educators, as uniformed services partners, will also sensitize in military camps and families their peers on HIV prevention, including gender issues. Child soldiers are divided roughly into two groups : 8-14 years and 15-17 years. In each group, peer educators have been trained, under supervision of local NGOs working with UNICEF. They will continue sensitizing children of the same age group.

The project will promote sustainability through the creation of a pool of trainers, peer educators and military supervisors who will keep on carrying out their activities well after the completion of the project and helping the Ministry of Defense to involve, strengthen and reproduce local and regional focal points fighting HIV/AIDS. The project will ensure monitoring of the execution of the Ministry of Defense consolidated HIV plan as well as the sustainability plan worked out in 2006, specifically for all the aspects in relation with HIV prevention.

This activity relates to activities in AB (#10307), Basic Health Care and Support (#10055), and CT (#10064).

The EP targets populations most at risk of HIV transmission in order to affect HIV transmission dynamics and provide care to those in greatest need. In Cote d'Ivoire, which is undergoing a prolonged political and military crisis, the EP team has targeted uniformed services and their sexual partners for special attention. Since September 2002, the country has seen active mobilization and deployment of various uniformed services (national army, gendarmes, and police) as well as rebel forces, along with the potential emergence of militia forces. Increased mobility with separation from spouses, economic disparities with the surrounding population, and crisis-related shifts in perceptions (e.g. gender and violence norms, less concern about the long term, etc. are likely to contribute to heightened sexual risk behaviors among these populations. Access to information, counseling and HIV testing, and health care is limited in general, but particularly so for uniformed services on active deployment. In addition, children have been victims of the conflict. A national disarmament, demobilization, and reinsertion program has been planned for both child and adult soldiers and rebel forces.

In September 2005, PSI and its partners (AIMAS, CARITAS, Espoir FANCI, and JHPIEGO) applied successfully to implement an EP project to expand HIV prevention, uptake of counseling and HIV testing, and care interventions targeting the uniformed services and ex-combatants (including child soldiers) and their partners in Cote d'Ivoire. Increased access to and uptake of combined prevention, sexually transmitted infection (STI) diagnosis and treatment, and CT interventions in these populations is intended to lead to safer sexual behaviors, including abstinence, fidelity, and, for populations engaged in high-risk behaviors, correct and consistent condom use, as well as increased use of HIV care, treatment, and support through a strong referral network to complementary services. The project also seeks to promote behavior change and the uptake of CT and care services.

Interventions include referral of those testing HIV-positive to sources of ongoing psychosocial support, comprehensive antiretroviral therapy, and palliative care. In the program area of Condoms and Other Prevention, FY06 activities include a BCC campaign developed in FY05 in collaboration with the ministries of Defense, Health and AIDS as well as local NGOs designed to increase correct and consistent condom use among those engaged in high-risk behaviors as part of a comprehensive ABC prevention strategy; to reduce high-risk behavior and stigma; and to improve perception of personal risk, including the negative effects of alcohol consumption on HIV-infection risk and ART adherence. Activities include training of child-soldier and adult male and female peer educators to promote HIV prevention, counseling during CT, and condom sales in high-risk areas.

PSI collaborates with and provides support to the National Security and Defense Forces, Ministry of Health, and other government agencies, including helping to develop and implement training and communications materials and improving M&E activities to assure high-quality peer education. AIMAS is responsible for creating condom sales points in high-risk areas and ensuring condom promotion and accessibility to high-risk target groups. Espoir FANCI works to reduce stigma through PLWHA testimonials and peer education. PSI and its partners work to link activities with other HIV prevention, care and treatment, and social services in the area.

Project activities complement and build on other EP-funded efforts, including Ministry of Health and FHI development of a palliative-care policy and guidelines for clinic- and home-based care as part of a continuum of care, as well as prevention, care, and treatment activities by other ministries (AIDS, Education, Social Affairs), ANADER (in rural areas), CARE International (in underserved northern and western areas), Alliance CI, and EGPAF. Activities are coordinated with the Ministry of Defense.

Project activities are informed by the National HIV/AIDS Strategic Plan (2006-2010) and draw on the USAID initiative PSAMAO/PSAMAC, a best-practice intervention in high-mobility border regions designed to encourage the adoption of safe and responsible sexual behaviors by truckers, sex workers and "migrant" populations, including implementation of BCC activities, social marketing of condoms, treatment of STIs, and

promotion of HIV counseling and testing and referrals. Overlapping target audiences will allow the EP-funded project's mobile video unit to contribute to mass awareness campaigns on PSAMAO sites, while its mobile CT units will deliver counseling and testing services to truck drivers and sex workers on PSAMAO sites. People tested HIV-positive will be referred to the nearest adequate care structure.

In FY07, the project will continue and strengthen FY05 and FY06 activities at seven sites and will expand community-based educators' intervention areas to eight zones. Activities will encourage partner reduction, promote correct and consistent use of male and female condoms, provide education about STI prevention and treatment, promote HIV counseling and testing, and raise awareness about gender-based violence and HIV-related stigma. Target group members will be provided with condoms at sale outlets set up by AIMAS on or near the intervention sites. On each site outside Abidjan, a referral health center will be identified, and two service providers at each center will be trained in STI syndromic management. The centers will be provided with STI kits. Community-based educators will ensure referrals to the centers with referral sheets that will allow patient monitoring.

Working mainly in the emphasis areas of development of network/linkages/referral systems and training, and on the key legislative issue of stigma/discrimination, FY07-funded activities will reach 249,443 people (including 184,839 members of the uniformed services and 14,029 current or former child soldiers) with appropriate HIV-prevention messages and will train 480 people to promote HIV prevention through methods other than abstinence and fidelity. The project will support 1,680 condom outlets.

The project will promote sustainability through capacity building among local participants (community workers, supervisors, and health service providers), who will continue their activities after project funding ends, and by helping the Ministry of Defense to involve, strengthen, and reproduce local and regional focal points for the fight against HIV/AIDS. The project will monitor execution of the Ministry of Defense's consolidated HIV plan as well as the sustainability plan developed in 2006.

PSI will continue to implement an M&E plan based on national and USG requirements and tools and will contribute to implementation of an integrated M&E system in collaboration with national and international stakeholders.

This activity relates to activities targeting uniformed services and their sex partners described in sections AB (#10307), Basic Health Care and Support (#10055), CT (#10064), and Other Prevention (#10049).

PSI will expand sexual-prevention interventions targeting mobile and other high-risk populations along major trucking routes, including frontier towns, building on the successful regional PSAMAO project funded through USAID and complementing the World Bank-funded coastal Corridor project.

Cote d'Ivoire remains the major hub of the West African region, characterized by high mobility of people, due mostly to economic integration and opened borders but also to political, military, and economic instability. To mitigate the spread of HIV associated with this mobility, cross-border interventions targeting core and bridge groups and populations along the main migratory routes have been identified as national and regional priorities.

"Prevention du SIDA sur les Axes Migratoires de l'Afrique de l'Ouest et du Centre" (PSAMAO) was started under the previous USAID regional Family Health and AIDS project, which covered four countries (Burkina Faso, Cameroon, Côte d'Ivoire, and Togo) and was subsequently expanded into 17 countries. The expansion was initially associated with decreased per-country funding, and the number of sites and population coverage were reduced in Cote d'Ivoire. With country EP funding, PSI seeks to again expand these interventions along the North-South routes.

PSAMAO is a best-practice program designed to encourage the adoption of safe and responsible sexual behaviors among truckers, sex workers, customs and uniformed officials, and other high-risk and mobile populations. The program includes behavior change communication (BCC) activities, social marketing of condoms, treatment for sexually transmitted infections (STI), and voluntary counseling and testing (VCT) promotion and referrals.

Studies have indicated that condom use is inconsistent among truck drivers and sex workers in the region, suggesting a need for consistent program intervention. Cote d'Ivoire's 2006-2010 National Strategic Plan identified prostitution, non-systematic use of condoms, migration, and mobility of people as determinants of the HIV epidemic in Côte d'Ivoire.

PSI received USAID funding through the SFPS and WARP projects from October 2003 to September 2006 to implement the PSAMAO regional project in Côte d'Ivoire. Two local NGOs, Croix Rouge de Cote d'Ivoire (targeting truck drivers) and SidAlerte Cote d'Ivoire (targeting sex workers), benefited from capacity building to carry out activities at eight sites identified by the project: two in Abidjan and one each in Bouaké, Korhogo, Ouangolodougou, Pogo, Man, and Danané. Within these organizations, two focal points, 14 ground supervisors, and 28 community-based educators were trained in behavioral change communication based on a participatory approach. On average over the past two years, 5,000 truck drivers and sex workers a month were educated about partner reduction and correct and consistent use of condoms and given access to CT, STI, and family-planning services. Two health centers in Abidjan participated in a training program on STI syndrome management and were provided with STI syndromic treatment kits.

With FY07 EP funds, PSI will build on the PSAMAO activities and extend these interventions to new sites on the border and in the interior, for a total of 22 intervention sites. Target populations will be truckers, sex workers, customs and uniformed officials, and "migrant" populations. BCC activities by community-based educators will be expanded to customs and other officials (formal and informal) at 14 border crossing zones. BCC interventions will include promoting partner reduction, correct and systematic use of male condoms, STI prevention and treatment, and HIV counseling and testing. Gender-based training will focus on sexual violence, alcohol, vulnerability, and condom negotiation.

The project will use a mobile video unit from PSI's HIV prevention and care project targeting the uniformed services for mass awareness campaigns at PSAMAO sites. Target group members will be provided with condoms at 84 or more sales outlets established by the Ivorian Social Marketing Agency and by community-based educators and supervisors. A referral health center will be identified at each site outside Abidjan, increasing the

number of referral centers from two to 14, and two service providers (center personnel) will be trained in STI syndrome management at each site. The centers will be provided with STI kits. Community-based educators will ensure that referrals are made to the centers, using standard referral forms to monitor referred clients.

After education about CT, clients will be referred to the nearest CT centers in coordination with local health authorities and EP partners. If services are not already available with support from EP or other partners, PSI will support integration of CT services into 14 existing health facilities, with training of health personnel using an integrated HIV/STI approach. Additional staff may be provided on a contractual basis, given the dire human-resource shortages in the North and West. HIV tests will be carried out using a whole-blood rapid test algorithm with finger pricks in 2007, when national guidelines are expected to be revised to allow this method. Clients tested HIV-positive will be referred to the nearest adequate care structure. BCC materials, including posters and flyers, will be developed in coordination with JHU/CCP and the national BCC technical committee. PSI will ensure their distribution and correct use at the sites. Monitoring and assessment will be integrated into project activities transversely.

The project will promote sustainability by working through CBOs and other local public and private organizations as well as building capacity of local participants at various levels (community workers, supervisors, and health-service providers). PSI will also seek to participate in relevant coordination forums at local, regional, and national levels, complementing activities of EP and other partners.

Commodities (condoms, STI kits) will be procured through existing distribution channels, in coordination with SCMS and national authorities.

This activity (#10307) relates to activities in AB (#10307), Condoms and Other Prevention (#10049), and CT (#10064).

The EP continues to target populations most at risk of HIV acquisition and transmission in order to affect HIV transmission dynamics and provide care to those in greatest need. In Cote d'Ivoire, with the prolonged political and military crisis, the EP team has targeted uniformed services and their sexual partners for special attention. Since September 2002, there has been active mobilization and deployment of various uniformed services (national army, gendarmes, and police) as well as rebel forces and the potential emergence of militia forces. Increased mobility with separation from spouses, economic disparities with the surrounding population, and crisis-related shifts in perceptions (e.g. gender and violence norms, less concern about the long term, etc.) are likely to contribute to heightened sexual risk behaviors among these populations. Access to information, counseling and HIV testing, and health care is limited in general, but particularly so for uniformed services on active deployment. In addition, children have been victims of the conflict. A national disarmament, demobilization, and reinsertion program has been planned for both child and adult soldiers and rebel forces.

In September 2005, PSI and its partners (AIMAS, CARITAS, Espoir FANCI, and JHPIEGO) applied successfully to implement an EP project to expand HIV prevention, counseling and HIV testing, and care interventions targeting the uniformed services, ex-combatants, and their partners in Cote d'Ivoire. In the program area of palliative care, the project aims to provide comprehensive care, including health care, psychosocial and spiritual support, and appropriate referrals to people living with HIV/AIDS (PLWHA). Linkages with HIV prevention, CT, and treatment services will be emphasized. Activities are informed by the new national palliative-care policy and guidelines and the 2006-2010 National HIV/AIDS Strategic Plan and Palliative Care Strategic Plan. FY06-funded project activities include needs assessments and selection of intervention sites: 40 military camps for adult solders (20 in the North, under New Armed Forces control, and 20 in the South, under the National Armed and Security Forces) and 15 transit and orientation centers (CTO) for child soldiers. In October 2006, resource trainers from RIP+ (network of PLWHA) will begin training trainers in psychosocial support based on peer counseling among members of Espoir FANCI, an NGO of military members living with HIV. This will be followed at each site by a series of training programs for counselors selected from among solders living with HIV or newly identified as HIV-positive by the PSI project's CT component. These counselors and peer educators (four per site) will work with the project's mobile CT units, organize and supervise support groups, speak about their own HIV status, and ensure home visits to assist PLWHA and their families, whom they will encourage to get tested. Espoir FANCI will provide psychosocial support to people who test HIV-positive on southern project sites. Since Espoir FANCI does not have access to northern sites, two local northern NGOs of PLWHA will be identified to provide palliative care in the New Armed Forces zone. Site counselors will deliver support to PLWHA through home and workplace visits, encourage treatment literacy and observance, organize support groups with military authorities, conduct sensitization to reduce stigma and discrimination, and strengthen networking with other PLWHA organizations. In addition to psychosocial support, the project will provide PLWHA with "positive-living" kits containing insecticide-treated nets, a safe-water system, oral rehydration salt, condoms, cotrimoxazole, and a positive-living guide. Counselors will promote prevention for PLWHA through use of the kit, e.g. teaching correct and consistent use of condoms. For each kit distributed, the project expects to provide social support for at least three people (the PLWHA, a partner, and a child).

Project activities complement and build on other EP-funded efforts, including Ministry of Health and FHI development of palliative-care policy and guidelines for clinic- and home-based care as part of a continuum of care, as well as prevention, care, and treatment activities by other ministries (AIDS, Education, Social Affairs), ANADER (in rural areas), CARE International (in underserved northern and western areas), HIV/AIDS Alliance, and EGPAF. Activities are coordinated with the Ministry of Defense. With FY07 funds, PSI will continue its FY05 and FY06 activities at the 40 adult sites and 15 CTOs and will expand them to 10 new sites to be selected in collaboration with military

authorities. PSI will also explore expanding palliative-care operations to other armed and security forces (police, customs, and forest rangers). Ten palliative-care trainers will be trained in FY07, and they in turn will train 60 PLWHA soldiers in provision of palliative care (one additional for the 40 FY06 sites and two for each of 10 new project sites). ESPOIR FANCI and the two local NGOs will train site counselors to refer PLWHA to appropriate health and other services and to update the mapping of palliative-care units, treatment centers and OVC-management units for referral purposes. Working mainly in the emphasis areas of development of network/linkages/referral systems and training, and on the key legislative issue of stigma/discrimination, FY07-funded activities will support 50 palliative-care service outlets, train 60 people to provide PC services, and provide palliative-care services to 5,045 PLWHA. The project will promote sustainability through training of service providers and military trainers, who will continue their activities after project funding ends, and by helping the Ministry of Defense to involve, strengthen, and reproduce local and regional focal points for the fight against HIV/AIDS. The project will monitor execution of the Ministry of Defense's consolidated HIV plan as well as the sustainability plan developed in 2006. PSI will continue to implement an M&E plan based on national and USG requirements and tools and will contribute to implementation of an integrated M&E system in collaboration with national and international stakeholders.

This CT activity (#10064). complements those described in AB (#10307) Condoms and Other Prevention (#10049), and Basic Health Care and Support (#10055)

The EP continues to targeted populations most at risk or vulnerable to HIV acquisition and transmission in order to effect HIV transmission dynamics and provide care to those most in need. In Cote d'Ivoire, with the prolonged political and military crisis, the EP team targeted uniformed services and their sexual partners for special attention. Since Sep 2002, there has been active mobilization and deployment of various uniformed services (national army, gendarmes and police) as well as rebel forces and the potential emergence of militia forces. Increased mobility with separation from spouse(s), economic disparities with the surrounding population, and crisis-related shifts in perceptions (e.g. gender and violence norms, less concern about the long term etc) are likely to contribute to heightened sexual risk behaviors among these populations. Access to information, counseling and HIV testing, and health care is limited overall but particularly so for uniformed services on active deployment. In addition, children have been victims of the conflict. A national disarmament, demobilization and reinsertion program has been planned for both child and adult soldiers and rebel forces.

As such, in Sep 2005, PSI and its partners (AIMAS, CARITAS, ESPOIR FANCI and JHPIEGO) applied successfully to implement the EP project to expand HIV prevention, counseling and HIV testing and care interventions targeting the uniformed services, ex-combatants and their partners in Cote d'Ivoire .

The use of HIV voluntary counselling and testing (VCT) in Cote d'Ivoire remains insufficient, despite the expansion of routine provider initiated counselling and testing at health centres and expanded community based CT centers. Some regions and all rural areas are grossly underserved and VCT uptake remains low. The 2006-2010 HIV/AIDS national strategic plan identifies counseling and testing as a priority area. It aims at increasing voluntary testing from 85 to 460 sites by 2010, and increasing the rate of voluntary testing from 6% to 25% by 2010. Among the armed and security forces, despite significant interest in CT uptake remains low. In a 2004 PSI survey among the Army of Cote d'Ivoire 81.6 % of respondents stated that they had the intention to get HIV tested yet fewer than 30% had done so. The main reason cited for not seeking a test was the lack of medications for treatment of PLWH/A (65.9 %). PSI was granted Emergency Plan (EP) funding in September 2005 and charged with improving access to, and uptake of, quality counseling and voluntary HIV testing services provided to the armed forces, ex-combatants and their sexual partners, in accordance with national standards and approved guidelines. A double strategy has been selected: fixed VCT services integrated at 3 military health structures (existing VCT centre at the Military Hospital of Abidjan, and integration of new VCT services in Daloa and Korhogo), and mobile VCT services through establishment of 2 mobile units.

With EP FY06 funds, intervention sites were selected which will receive visits by the mobile units, that is 40 adult military camps (20 in the Northern zone controlled by the Force Nouvelle, and 20 others in the Southern Government controlled zone) as well as 15 "Centers for Transit and Orientation" (CTO) for child soldiers (as part of the larger national programs). By March 2007, 165 peer counsellors will be trained to deliver individual and couples counseling using adapted modules from CDC. Service delivery will commence at the two new static centers (Daloa and Korhogo) and continue at the Military Hospital of Abidjan (HMA) VCT centre. The activities of mobile units and those of the integrated centres of Daloa (western part, loyal army area) and Korhogo (northern part, rebel-held territory) are designed to deliver counseling and testing to 15,800 people among the target groups by March 2007. For quality control, blood samples will be sent to an approved referral laboratory. A mapping exercise by region is also being completed to define referral which will help PSI supported sites to refer HIV positive people to services related to their specific needs (HIV treatment, PMTCT, psychological management, nutritional management, OEV for examples) in their geographic region. For the 2007 fiscal year, the project proposes to build on these accomplishments. The mobile VCT units will serve 50 military camps (40 old plus 10 added in 07) where the mobile units provide services to the armed and security forces, ex combatants and their partners and families, as well as the 15 CTO. PSI will expand the use of mobile VCT

services to other sites frequented by uniformed services including the police. PSI will also add 5 new static sites and evaluate the feasibility of equipping the two mobile units with a portable CD4 counter in order to add CD4 screening for HIV positive clients on site and better triage referrals of HIV positives individuals in need of ARV treatment. The BCC campaign initiated in 2006 (including individual and couple VCT promotion) will be revised on the basis of initial evaluations to improve impact. Major activities in the VCT service delivery area will include the following: 1. Establish 5 new integrated VCT centres in 5 military health centres chosen with the approval of the Ministry of Defense and the project partners at Bondoukou, Dimbokro, Yamoussoukro, Man and Seguela; 2. Complete a needs assessment of 10 new adults sites (military camps) that could be visited by mobile VCT units; 3. Train 50 people in counselling and testing according to the procedures approved by the Ministry of health, including 8 military supervisors in counselling and 2 military supervisors in testing. 4. Equip two units/centers with equipment to measure CD4 cell counts; 5. Providing counselling and testing services at 8 fixed sites (Abidjan, Daloa, Korhogo, Bondoukou, Dimbokro, Yamoussoukro, Man and Seguela) and 65 sites to be visited by the 2 mobile VCT units (40 former sites chosen in 2005- 2006, 10 new additional adult sites and 15 CTO, of which 5 at Bouaké, 5 at Guiglo, 1 at Logoualé, 1 at Man and 2 at Korhogo); 6. Strengthening the national referral network through the establishment and the regular updating of the repertory of referral community and health centres; 7. Constant internal quarterly external supervisions of VCT activities on project sites; and 8. Monitor and evaluate all the counselling and testing activities. The project will promote sustainability through the creation of a pool of military counsellors, laboratory technicians, and a team of supervisors which will continue their activities well after the project is completed. It will help the Ministry of Defense to involve, strengthen and regional focal points by strengthening the Military Hospital of Abidjan. Seven operational centres will be installed in the Military Hospital along with 2 mobile VCT units that will return under the Ministry of Defense on completion of the project. The integrated centres which will be set up in the north of Cote d'Ivoire (under New Forces New Armed control) will return under the Ministry of Defense once the army is reunified. The project will ensure monitoring of the Ministry of Defense consolidated HIV plan as well as the sustainability plan validated in 2006, specifically for all aspects regarding HIV VCT.