This activity forms a continuum with activities in Condoms and Other Prevention (#9944), Basic Health Care and Support (#9930), CT (#9933), OVC (# 9934), and ARV Services (#9927).

This activity is part of a broad four-year project launched in FY05 to build a local response to HIV/AIDS in underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and education services, accompanying expansion of these services as national programs scale up. The implementing consortium brings together and applies the expertise of: ? The National Agency for Support to Rural Development (ANADER) for rural community mobilization and HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees ? The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC, including local outreach and radio, training, and use of its lexicon to communicate about HIV/AIDS in 16 local languages ? PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for palliative care ? ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care provision and referral to ARV treatment

MSD Interpharma and the HIV/AIDS Alliance are providing technical assistance.

In the program area of AB, FY07 funds will be used to continue and strengthen FY06 activities in four regions (Lagunes, Bas-Sassandra, Moyen Comoé, and Zanzan) and to extend these activities into two new regions (Fromager and Haut-Sassandra). These activities, implemented through village HIV/AIDS action committees in 24 village sites per region, draw on ANADER's risk-mapping approach. Local HIV/AIDS action committees and community counselors will be supported, with the help of JHU/CCP, in applying culturally appropriate BCC strategies, curricula, and educational materials with abstinence, faithfulness, partner-reduction, stigma-reduction, positive-prevention, and gender-based violence-prevention messages targeting youth, women, girls, illiterate populations, discordant couples, and other particularly vulnerable groups.

Activities will include coordinated BCC campaigns mediated by influential figures and peers and designed to decrease sexual risk by a) delaying sexual debut among youth, b) decreasing the number of sexual partners, and c) promoting mutual fidelity with knowledge of one's own and one's partners' serostatus. Use of methods of proximity (debates, sketches, videos, peer education, traditional events, etc.) in the community, schools, sporting fields, mosques, and churches will be reinforced by radio in local languages. Traditional and religious leaders will be empowered through tools such as the HIV/AIDS lexicon, targeted BCC materials, and use of participatory approaches to lead communities to address HIV/AIDS in their socio-cultural context, including addressing the key legislative issues of negative gender attitudes and HIV-related stigma and discrimination. ANADER will work with teachers to reach youth in primary and secondary schools, drawing on Ministry of Education (MEN) life-skills materials and approaches.

Project activities complement and build on other initiatives, including EP-funded efforts, such as Ministry of AIDS and JHU-CCP activities to develop effective BCC approaches and mobilize faith-based communities and opinion leaders; MEN and Ministry of Family and Social Affairs activities in support of youth and OVC; Care International and HIV/AIDS Alliance support for CBO/FBOs and PLWHA; and MOH and EGPAF/ACONDA support for expanded PMTCT, CT, and treatment. Activities are coordinated through relevant village, district, regional, and national forums.

In 2006, activities conducted with FY05 and FY06 funds include: -- Identification of 96 village sites (each with multiple surrounding villages) for intervention -- Baseline needs assessments in the four regions -- Training of 130 ANADER staff in AB-targeted prevention -- Training of 20 ANADER workers/facilitators (five per region) in use of the local-language HIV/AIDS lexicon and AB-targeted prevention -- Training of 96 community counselors (one per site) in AB prevention -- Broadcasting of spots on local radio (240 spots on abstinence, 240 on fidelity)

-- Broadcasting of 24 AB-oriented educational programs on local radio (six per region) -- Video/film projection with AB prevention messages in 96 sites

In FY07, AB activities will be informed by quantitative and qualitative assessments in FY06 and the 2005 national AIDS Indicator Survey. To increase collaboration with MEN, ANADER will add training for schoolteachers in all six regions. With the technical assistance of CCP, ANADER will also develop the Sports for Life approach with youth organizations in rural areas in all six regions. Involvement of schoolteachers and of youth associations will contribute to sustaining the AB approach. The project will work to build REPMASCI's sustainable organizational capacity and ability to identify and creatively meet the needs of rural families, particularly women and youth without access to mass media, for HIV and other health-related information.

Working mainly in the emphasis areas of IEC, community mobilization/participation, and training, and on the key legislative issues of gender, stigma/discrimination, and wraparounds, specific activities supported by FY 2007 funding will reach 158,000 (including 90,000 youth (60%) with A-only messages) through community outreach that promotes AB-oriented prevention and will train 176 people to promote AB-oriented prevention.

Specific activities with FY07 funds will include: 1. Identify at least 48 central village sites (each with multiple surrounding villages) in the two new regions and activate or reinforce village HIV/AIDS action committees in each 2. Conduct needs assessments in the two new regions 3. Train 10 ANADER facilitators (five per new region) and 144 community counselors (three per village site in the two new regions) in use of the local-language HIV/AIDS lexicon and in AB-targeted prevention 4. Train 144 schoolteachers (one per village site in all six regions) in AB-oriented prevention 5. Train four local radio announcers (two per new region) in AB prevention. REPMASCI will provide the training, drawing on IRIN/JHU-CCP materials. 6. With CCP support and in coordination with Care International and Alliance CI, develop and implement plans for distribution, use, and evaluation of new and appropriate BCC materials for particularly vulnerable groups. 7. Deliver at least 48 video campaigns (one per new village) and at least 96 prevention campaigns (two per new village) on local radio 8. Create linkages among village action committees and cooperatives (agricultural, fresh-food traders) by involving one or two members of cooperatives in committee activities 9. Broadcast AB prevention spots on local radio (a total of 1,920 emissions in the six regions) 10. Broadcast radio programs with AB prevention messages (a total of 156 emissions in the six regions) 11. Conduct one video campaign in each village per year (a total of 144 video film projections in the six regions)

ANADER 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.

Activities will strive to build capacity among CBOs and village and district action committees to achieve local ownership and sustainability. Training of community counselors and schoolteachers, initiation of income-generating activities, and involvement of agricultural cooperatives are designed to enable communities to carry on HIV prevention activities after EP financing has ceased.

This activity complements ANADER activities in AB (9932), Basic Health Care and Support (#9930), CT (#9933), OVC (# 9934), and ARV Services (#9927).

This activity is part of a broad four-year project launched in FY05 to build a local response to HIV/AIDS in underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and education services, accompanying expansion of these services as national programs scale up. The implementing consortium brings together and applies the expertise of: . The National Agency for Support to Rural Development (ANADER) for community mobilization and HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees . The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC, including training, local radio and community outreach, and use of its lexicon to communicate about HIV/AIDS in 16 local languages . PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for palliative care . ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care provision and referral to ARV treatment

MSD Interpharma and Alliance CI are providing technical assistance.

In Condoms and Other Prevention, FY07 funds will be used to continue and strengthen FY06 activities in four regions (Lagunes, Bas-Sassandra, Moyen Comoé, and Zanzan) and to extend these activities into two new regions (Fromager and Haut-Sassandra). These activities, implemented through village HIV/AIDS action committees in 24 village sites per region, draw on ANADER's risk-mapping approach. Traditional and religious leaders will be empowered through tools such as the HIV/AIDS lexicon in local languages, appropriate BCC materials, and use of participatory approaches to lead their communities to address HIV/AIDS, including addressing intergenerational sex, gender inequity, and HIV-related stigma and discrimination.With the help of JHU/CCP, local HIV/AIDS action committees and community counselors will be supported in applying culturally appropriate BCC strategies and materials, including a new video aimed at rural audiences, with abstinence, faithfulness, partner-reduction, stigma-reduction, positive-prevention, and gender-based violence-prevention messages targeting youth, women, girls, illiterate populations, discordant couples, and other particularly vulnerable groups.

Activities complement and build on other EP-funded initiatives, such as Ministry of the Fight Against AIDS and JHU/CCP activities to develop effective BCC approaches; Ministry of Education and Ministry of Family and Social Affairs activities in support of youth and OVC; CARE International and Alliance CI support for CBO/FBOs and PLWHA; and Ministry of Health and EGPAF/ACONDA support for expanded PMTCT, CT, and treatment. Activities are coordinated through village, district, regional, and national forums.

The project trains action committee members and community counselors to provide information to adults about the correct and consistent use of male and female condoms. The project supports or helps establish condom vending points in sites selected by the village action committees. An initial supply of male condoms is provided free of charge, and a restocking structure ensures that the adult community has a continuous supply of condoms.

Other Prevention linkages with CT services emphasize testing for couples. HIV-positive people are provided counseling and access to support groups of PLWHA, which focus on secondary prevention messages and healthy lifestyles, drawing on RIP+ (network of PLWHA) expertise and materials. Community counselors work with support groups to facilitate PLWHA disclosure of their status to optimize protection of HIV-free partners and encourage psychological support through the family. A campaign will address barriers to CT and disclosure, including stigma. Existing tools such as films on PLWHA testimonials will support communication activities to promote acceptance and minimize stigma.

Discordant couples are a target population that will be supplied with condoms. It is estimated that 80,640 male condoms will be distributed. Awareness sessions will deal with reducing other risk factors for HIV infection, often revealed during risk-mapping sessions,

such as sharing knifes and razors for male circumcision, female genital mutilation, and scarification. When possible, traditional "doctors" and midwives will be trained, based on materials developed by JHU/CCP, to reduce the risk of HIV infection through unsafe practices. The project will work to build REPMASCI's sustainable organizational capacity and ability to identify and creatively meet the HIV-information needs of rural families, particularly women and youth without access to mass media.

In 2006, activities conducted with FY05 and FY06 funds include: - Identification of 96 village sites (each with multiple surrounding villages) for intervention - Baseline needs assessment in the four regions - Training of 130 ANADER staff in ABC-targeted prevention - Training of 20 ANADER workers/facilitators (five per region) in use of the local-language HIV/AIDS and ABC-targeted prevention - Training of 96 community counselors (one per village site) in ABC prevention - Initiation of at least one support group in each village - ABC-oriented spots on local radio - 24 ABC-oriented educational programs on local radio (six per region)

FY07 OP activities will be informed by assessments in FY06 and the 2005 AIDS Indicator Survey. Working in the emphasis areas of IEC, community mobilization, and training, and on the key legislative issues of gender and stigma/discrimination, FY07 activities will reach 52,292 people through community outreach that promotes HIV prevention through methods beyond AB and will train 230 people to promote such prevention.

Activities with FY07 funds will include: 1. Identify 48 central village sites (each with multiple surrounding villages) in the two new regions and activate or reinforce a village HIV/AIDS action committee in each 2. Conduct baseline KAP surveys and evaluations as needed in the two new regions 3. Train 10 ANADER facilitators (five per new region), 48 rural development agents, and 144 community counselors (three per village site) in use of the local-language HIV/AIDS lexicon and in ABC prevention 4. Train four local radio announcers (two per new region) in ABC prevention. REPMASCI will provide the training, drawing on IRIN/JHU-CCP materials 5. With CCP support and in coordination with Care and Alliance CI, develop and implement plans for distribution, use, and evaluation of new and appropriate BCC materials for particularly vulnerable groups. 6. Reach at least 52,292 people with evidence-based ABC-targeted BCC messages via community outreach 7. With CCP support, produce a BCC video designed for rural audiences. 8. Deliver at 48 video campaigns (one per new village) on prevention for high-risk populations and positive living and at least 96 prevention campaigns (two per new village) on local radio 9. Broadcast ABC prevention spots on local radio (a total of 1,920 emissions in the six regions) 10. Broadcast radio programs with ABC prevention messages (a total of 156 emissions in the six regions) 11. Create at least 48 new support groups for PLWHA 12. Distribute 80,640 male condoms 13. Establish at least 48 new condom outlets 14. Initiate linkages between village action committees and cooperatives (agricultural, fresh-food traders), involving one to two members of cooperatives in each committee's activities

ANADER will implement an M&E plan based on national and USG requirements and tools and contribute to an integrated M&E system.

This activity complements ANADER activities in AB (9932), Condoms and Other Prevention (#9944), CT (#9933), OVC (# 9934), and ARV Services (#9927).

This activity is part of a broad four-year project launched in FY05 to build a local response to HIV/AIDS in underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and education services, accompanying expansion of these services as national programs scale up. The implementing consortium brings together and applies the expertise of: - The National Agency for Support to Rural Development (ANADER) for rural community mobilization and HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees - The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC, including training, local radio, and use of its lexicon to communicate about HIV/AIDS in 16 local languages - PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for palliative care - ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care provision and referral to ARV treatment

MSD Interpharma and the HIV/AIDS Alliance are providing technical assistance.

In the program area of Basic Health Care and Support, FY07 funds will be used to continue and strengthen FY06 activities in four regions (Lagunes, Bas-Sassandra, Moyen Comoé, and Zanzan) and to extend these activities into two new regions (Fromager and Haut-Sassandra).

Palliative-care activities are led by ACONDA at rural health centers and PSI at the community level. Building on ANADER's structure of HIV/AIDS action committees in 24 village sites per region, the project uses nationally approved approaches and materials to train community counselors, ANADER rural development agents, and rural health center and mobile CT unit staff to provide clinic- and home-based palliative-care services, palliative-care kits, psychosocial support and monitoring, ARV-adherence monitoring, and referral and counter-referral to medical and social services for PLWHA identified through HIV counseling and testing (CT) at rural health centers and the project's mobile CT units. They also promote the creation of peer support groups for PLWHA and their families and work to ensure linkages between palliative-care services and other health care (including HIV, TB, and STI treatment), CT, PMTCT, HIV prevention, and OVC services.

ANADER provides the palliative-care kits, which contain a 20-liter jerry can, two long-duration pesticide-impregnated bednets, and products replenished on a monthly basis, including male condoms (20), rehydration salt, water-purification solution, and cotrimoxazole tablets.

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), CARE International, HIV/AIDS Alliance, and EGPAF. Activities are coordinated through local, national, and district forums, with involvement of the district health management teams to maximize capacity-building and coordination with the MOH.

In 2006, palliative-care activities conducted with FY05 and FY06 funds include: 1. Identification of 96 village sites (each with multiple surrounding villages) for intervention 2. Identification of 20 rural health centers (five in each region) where palliative-care activities are aligned with fixed-site CT services 3. Training of 252 people to provide palliative-care services and psychosocial support (80 workers at rural health centers with integrated CT services, 76 workers at other rural health centers, and 96 community counselors) 4. Provision of home-based palliative care, including kits, psychosocial support, and referral to district health centers and social services, for 1,988 HIV-positive people 5. Production and distribution of 48,240 posters with stigma-reduction messages

In FY07, palliative-care activities will be informed by the new national palliative-care policy and guidelines that will define a standard package of care services.

ANADER will pilot income-generating activities to build self-sufficiency among PLWHA and their families and explore WFP wraparound programming for HIV-affected families identified as needing nutritional support. 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 147 service outlets (one per rural health center or village, plus three mobile CT units) providing HIV-related palliative care, train 126 people to provide PC services, and provide palliative-care services to 3,586 PLWHA (including 1,988 identified in FY06).

Activities with FY07 funds will include: 1. Identification of 48 village sites for intervention in the two new regions 2. Identification of 10 rural health centers (five per new region) where palliative-care activities will be aligned with fixed-site CT services 3. Training of 126 people to provide palliative-care services and psychosocial support (40 workers at rural health centers with integrated CT services, 38 workers at other rural health centers, and 48 community counselors) 4. Supply of palliative-care services and kits (or resupplies) and referral/counter-referral for 3,586 PLWHA (including 1,574 newly identified as HIV-positive in FY07)

ANADER will continue to implement an M&E plan based on national and USG requirements and tools. Data will be collected by village action committees using simple tools and will be transmitted to district, regional, and central units. Project reporting will occur monthly at the regional level and quarterly at the central level. The project will contribute to implementation of an integrated M&E system in collaboration with national and international stakeholders, including the ministries of AIDS, Health, and Social Affairs.

Sustainability and project effectiveness are enhanced by consortium members' past and current collaborations with multiple ministries (Health, National Education, Family and Social Affairs, and others) as well as RIP+ (Network of Persons Living with HIV/AIDS), Lumière Action, youth NGOs, and faith-based communities. Project partners have been successful in mobilizing internal resources and attracting EP, Global Fund, MSD, and other funds/partners to support their activities. ANADER has a broad rural development mandate with initiatives to address poverty, gender inequities, and food insecurity and seeks to maximize opportunities for wraparound activities. The World Bank, UNICEF, WFP, AfriJapan and others have offered or do offer ANADER such opportunities.

Activities will strive to build capacity among CBOs and village and district AIDS action committees to achieve local ownership and sustainability. Training of community counselors (members of village HIV/AIDS action committees) and rural health center staff and initiation of income-generating activities are designed to enable communities to carry on palliative-care activities after EP funding for the project has ceased.

This activity complements ANADER activities in AB (9932), Condoms and Other Prevention (#9944), Basic Health Care and Support (#9930), CT (#9933), and ARV Services (#9927).

This activity is part of a broad four-year project launched in FY 2005 to build a local response to HIV/AIDS in underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and education services, accompanying expansion of these services as national programs scale up. The implementing consortium brings together and applies the expertise of: . The National Agency for Support to Rural Development (ANADER) for rural community mobilization and HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees . The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC, including training, local radio, and use of its lexicon to communicate about HIV/AIDS in 16 local languages . PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for palliative care . ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care provision and referral to ARV treatment

MSD Interpharma and the HIV/AIDS Alliance are providing technical assistance.

In the program area of OVC, activities conducted with FY05 and FY06 funds include training 220 people (including 96 rural development agents and 96 community counselors) in OVC identification and care and identifying and providing services (including support for schooling and vocational training, legal aid, and referral and counter-referral to social services) to at least 4,000 OVC.

FY07 funds will be used to continue and strengthen FY06 activities in four regions (Lagunes, Bas Sassandra, Moyen Comoé, and Zanzan) and to extend them into two new regions (Fromager and Haut Sassandra).

OVC activities in 2007 will be informed by baseline assessments conducted in FY06 and results of the 2005 national AIDS Indicator Survey. They will complement and build on other EP-funded efforts, including Ministry of Education (MEN), Ministry of the Fight Against AIDS (MLS), Ministry of Family and Social Affairs, HIV/AIDS Alliance, CARE International, and Hope Worldwide activities in support of youth and OVC. The project will operate in consultation with the National OVC Program and the national OVC committee (CEROS-EV).

ANADER works through HIV/AIDS action committees in 24 village sites (each with several surrounding villages) per region, which help coordinate its OVC, HIV prevention, CT, and care activities in collaboration with other actors and relevant ministries. ANADER's OVC strategy is to educate and mobilize communities around the need for OVC identification and support; to identify and refer vulnerable children and their families through CT at rural health centers and the project's mobile CT units (self-identified HIV-positive clients) as well as trained community counselors and ANADER rural development agents; and to ensure that identified OVC receive the minimum package of care, including psychosocial support and monitoring, educational and legal assistance (school fees, vocational training, birth certificates), support packages (school kits, basic health-care supplies, impregnated bednets, safe-water products), and referral to needed health (including HIV and TB) and social services. Follow-up at the household level will identify and address needs of different OVC groups, including HIV-infected children and their families, children of HIV-infected parents, adolescent girls, orphans requiring grief support, and different age groups.

FY07 funds are expected to provide OVC services to at least 6,000 children (2,000 identified in FY07, plus continued support for 4,000 identified in FY06) and to train at least 340 people in OVC identification and care.

Based on FY06 experience, ANADER will add training in OVC identification and care for schoolteachers, in collaboration with MEN's life-skills approach, and rural health center

employees. ANADER will also pilot income-generating activities to build self-sufficiency among OVC and their families, with links to school feeding programs in collaboration with MEN and with WFP wraparound programming for OVC and host families identified as needing nutritional support.

Working mainly in the emphasis area of community mobilization/participation, development of network/linkages/referral systems, and training, and on the key legislative issues of stigma/discrimination and wraparounds, specific activities to be carried out with FY07 funds include: 1. Community sensitization by community counselors about the importance of community-based support for OVC and HIV-affected families, including information about and referral to existing sources of care, support, and educational support for OVC. 2. Stigma reduction through local radio and community outreach using REPMASCI's expertise and materials. 3. Provision of the minimum package of OVC care to at least 6,000 children. 4. Training in OVC identification and care for 96 community counselors (two per site in the two new regions), 144 village schoolteachers and 144 rural health center personnel (one each per site in all six regions), and 52 ANADER employees (48 rural development agents and four zone committee members). 5. Procurement and distribution of support packages for OVC and other children in host families. ANADER will also manage procurement for HIV/AIDS Alliance. 6. Initiation of income-generating agriculture/school canteen activities in 24 village sites.

ANADER will implement a project-specific monitoring and evaluation (M&E) plan based on national and USG requirements and tools. Data will be collected by rural health center personnel and community counselors and will be transmitted to ANADER's district, regional, and project central units. Project reporting will occur monthly, quarterly and yearly. The project will contribute to the implementation of an integrated M&E system in collaboration with national and international stakeholders, including the ministries of AIDS, Health, and Family and Social Affairs.

Both sustainability and project effectiveness are enhanced by consortium members' past and current collaborations with multiple ministries (Health, National Education, Family and Social Affairs, and others) as well as RIP+ (Network of Persons Living with HIV/AIDS), Lumière Action, youth NGOs, and faith-based communities. Project partners have been successful in mobilizing internal resources and attracting EP, Global Fund, MSD, and other funds/partners to support their activities. ANADER has a broad rural development mandate with initiatives to address poverty, gender inequities, and food insecurity and seeks to maximize opportunities for wraparound activities. The World Bank, UNICEF, WFP, AfriJapan and others have offered or do offer ANADER such opportunities.

Activities will strive to build capacity among CBOs and village and district AIDS action committees to achieve local ownership and sustainability. Training of community counselors (members of village HIV/AIDS action committees), rural health center staff, and village schoolteachers and initiation of income-generating activities are designed to enable communities to carry on OVC identification and care activities after EP funding for the project has ceased.

Plus up funds will enable ANADER to provide services for an additional 1,000 oVC and provide refresher training for 224 caregivers.

This activity complements ANADER activities in AB (9932), Condoms and Other Prevention (#9944), Basic Health Care and Support (#9930), OVC (# 9934), and ARV Services (#9927).

This activity is part of a broad four-year project launched in FY05 to build a local response to HIV/AIDS in underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and education services, accompanying expansion of these services as national programs scale up. The implementing consortium brings together and applies the expertise of: . The National Agency for Support to Rural Development (ANADER) for rural community mobilization and HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees . The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC, including training, local radio, and use of its lexicon to communicate about HIV/AIDS in 16 local languages . PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for palliative care . ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care provision and referral to ARV treatment

MSD Interpharma and the HIV/AIDS Alliance are providing technical assistance.

In the program area of CT, EP-funded partners ACONDA and EGPAF are integrating CT, HIV/TB, and PMTCT services at health facilities; HIV/AIDS Alliance is supporting local authorities to establish sustainable community CT centers; PSI and FHI are providing CT and other services to the uniformed services, truckers, and sex workers; and CARE International, with Global Fund support, is expanding access to CT services in underserved areas of the North and West. ANADER's CT activities complement these activities by extending CT services and promotion to rural areas while strengthening a referral network linking CT services to HIV prevention, PMTCT, palliative care, and treatment services.

The project provides mobile outreach CT and basic health and support services at 24 village sites (each with several surrounding villages) per region, in collaboration with the Ministry of Health, and trains health workers at rural health centers in CT service delivery, including pre- and post-test counseling, couples counseling (discordant and accordant), family counseling, and referral services. Community counselors are trained to conduct community-mobilization, uptake-promotion, and stigma-reduction activities (using existing tools, such as a documentary film on PLWHA testimonials); to identify, visit, and follow up newly diagnosed PLWHA to reduce the number of clients "lost from view" and promote a « family-centered » approach to CT with referrals to treatment and care (HIV, TB, STI, etc.) at local and district health centers; and to provide CT services in conjunction with ANADER's mobile units.

Each mobile unit serves two regions and is staffed by a driver/screener, a laboratory technician provided by the MOH, and two counselors, who are joined at each stop by the village site's three trained community counselors. Besides CT services, unit staff provide TB screening, deliver palliative-care kits for HIV-positive clients and their families, and work to educate about HIV prevention and PMTCT services, to facilitate links to palliative care and ARV, and to help ensure adherence to ARV.

Quality is assured through supervisory visits and training by ACONDA and PSI. Quality assurance for HIV tests is provided by the RETRO-CI laboratory in collaboration with PNPEC and local health authorities. Project activities are coordinated through village, district, regional, and national forums, in consultation with relevant ministries and other EP partners.

In 2006, CT activities conducted with FY05 and FY06 funds include: 1. Identification of 96 village sites for intervention. 2. Creation and strengthening of community HIV/AIDS action committees in all 96 villages through HIV/AIDS risk-mapping and provision of sensitization kits (one per committee), each comprising three bicycles, 10 T-shirts and caps, a carton of male condoms, three wooden penises, a megaphone, and posters.

3. Community sensitization on CT through local radio spots and educational programs using REPMASCI's HIV/AIDS lexicon in Adjoukrou, Dioula, Baoulé, and Kroumen (local languages), as well as video/film projections on CT in all villages. 4. Training in counseling and testing and CT promotion for 288 community counselors (three per site), four ANADER counselors, and eight health-district counselors in counseling and testing. 5. Training of eight laboratory technicians for two mobile CT units. 6. Establishment, equipping, and training for 20 integrated CT service outlets at rural health centers. 7. Equipping, staffing, and operating two mobile CT units. 8. Provision of CT services according to national and international standards to 9,792 people through the two mobile units.

FY07 funds will be used to continue and strengthen FY06 activities in four regions (Lagunes, Bas-Sassandra, Moyen Comoé, and Zanzan) and to extend these activities into two new regions (Fromager and Haut-Sassandra). Activities will draw on baseline assessments in FY06 and the MOH/PSI-supported evaluation of CT services in 2005 and will work mainly in the emphasis areas of development of network/linkages/referral systems, community mobilization/participation, and training and on the key legislative issue of stigma/discrimination. FY07 activities will include adding one mobile unit to provide CT services in the two new regions. Peer-support groups will encourage members to disclose their status, conduct anti-stigmatization activities, share insights on PWLHA-specific issues, and create additional support groups. FY07-funded CT activities will support 33 service outlets (including 10 new fixed sites and one new mobile unit in FY07), provide CT training for 260 people, and provide CT services for 15,360 people through the mobile units.

Other activities with FY07 funds will include: 1. Identification of 48 village sites for intervention in the two new regions. 2. Community mobilization and CT sensitization kits for all 48 villages. 3. Equipping of one additional mobile CT unit. 4. Training by ACONDA in CT service delivery for 40 health workers at rural health centers with integrated CT services (four per center). 5. Training by PSI in CT promotion and referral for 76 health workers at health centers without CT services (two per center) 6. Training by PSI in CT service delivery, promotion, and referral for 144 community counselors (three per village site). 7. Community-awareness campaigns conducted by village AIDS action committees in local languages to promote CT for individuals, couples, and pregnant women. 8. Psychosocial support for PLWHA and their families and facilitation of peer support groups by community counselors and nurses. 9. HIV counseling and testing for 15,360 people through three mobile units.

ANADER 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, including the ministries of AIDS, Health, and Social Affairs.

Activities will strive to build capacity among CBOs and village and district AIDS action committees to achieve local ownership and sustainability. Training of community counselors (members of village HIV/AIDS action committees) and rural health center staff are designed to enable communities to carry on CT activities after EP funding for the project has ceased.

This activity complements ANADER activities in AB (9932), Condoms and Other Prevention (#9944), Basic Health Care and Support (#9930), CT (#9933), and OVC (# 9934).

This activity is part of a broad four-year project launched in FY05 to build a local response to HIV/AIDS in underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and education services, accompanying expansion of these services as national programs scale up. The implementing consortium brings together and applies the expertise of: . The National Agency for Support to Rural Development (ANADER) for rural community mobilization and HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees . The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC, including training, local radio, and use of its lexicon to communicate about HIV/AIDS in 16 local languages . PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for palliative care . ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care provision and referral to ARV treatment

MSD Interpharma and the HIV/AIDS Alliance are providing technical assistance.

In the program area of ARV Services, FY07 funds will be used to continue and strengthen FY06 activities in four regions (Lagunes, Bas-Sassandra, Moyen Comoé, and Zanzan) and to extend these activities into two new regions (Fromager and Haut-Sassandra). These activities, designed to expand treatment access and treatment literacy into rural areas, will develop and promote referral to comprehensive clinical care for PLWHA at the district level, including EGPAF/ACONDA-supported sites and community CT and support centers created with EP support.

ARV Services activities planned with FY07 funds will complement and build on other EP-funded efforts, including Ministry of the Fight Against AIDS (MLS) and JHU-CCP activities to develop effective BCC materials and approaches and mobilize faith-based communities and opinion leaders; HIV/AIDS Alliance support for CBO/FBOs and PLWHA; and Ministry of Health (MOH) and EGPAF/ACONDA support for expanded HAART, palliative care, and CT.

Referrals are made to district general hospitals and other public/private health-care centers that are adequately equipped to provide HIV/AIDS care, including ART. Clients who test HIV-positive at rural health centers (five with integrated CT per region) are referred to the nearest accredited health facility for treatment, including ART. Clients who test HIV-positive through ANADER's mobile CT units are referred to the nearest rural health center, which in turn refers them to an appropriate health facility for care and treatment. Nurses at rural health centers with integrated CT are trained to follow up ART treatment and provide psychological support to PLWHA under the supervision of the district health team. Community counselors are also trained to provide psychological support and follow up ART.

Community counselors and peer-support groups ensure adherence to treatment, contribute to referral activities, and promote treatment literacy. The project creates links to services by public providers, NGOs and FBOs supported by EP, Global Fund, EGPAF, ACONDA, AIBEF, and others.

In 2006, ARV Services activities conducted with FY05 and FY06 funds include: 1. Participatory assessment of stigma and treatment literacy and prioritization of needs involving PLWHA, conducted in partnership with RIP+ (network of PLWHA) and drawing on data from other sources, including the 2005 national AIDS Indicator Survey. 2. Training of 80 health workers at rural health centers with integrated CT (four per center) according to national and international standards. 3. Training of 96 community counselors (one per village site) using local languages, in partnership with REPMASCI. 4. Promotion of adherence to treatment and secondary prevention with establishment of links to available services.

5. Referral of 1,988 clients to accredited health services, including ART.

ARV Services activities in FY07 will be informed by quantitative and qualitative assessments in FY06 and the 2005 national AIDS Indicator Survey and work mainly in the emphasis areas of development of network/linkages/referral systems and training. Expanded FY07 funding will allow strengthening the referral system for clients who test HIV-positive through ANADER's mobile units by training nurses at the rural health centers without integrated CT (19 centers per region) to make referrals, follow up ART treatment, and provide psychosocial support.

FY07-funded activities will include: 1. Participatory assessment of stigma and treatment literacy and prioritization of needs involving PLWHA in the two new regions, conducted in partnership with RIP+ and drawing on data from other sources, including the 2005 national AIDS Indicator Survey. 2. Training of 116 health workers in the two new regions, including 40 in rural health centers with integrated CT (four per center) and 76 in rural health centers without CT (two per center) according to national and international standards. 3. Training of 96 community counselors (two per village site) using local languages, in partnership with REPMASCI. 4. Promotion of adherence to treatment and secondary prevention with establishment of links to available services. 5. Referral of 3,586 clients to accredited health services, including ART.

ANADER will continue to implement an M&E plan based on national and USG requirements and tools. Data will be collected by village action committees using simple tools and will be transmitted to district, regional, and central units. Project reporting will occur monthly at the regional level and quarterly at the central level. The project will contribute to implementation of an integrated M&E system in collaboration with national and international stakeholders.

Project activities will be coordinated through village, district, regional, and national forums and will strive to build capacity among CBOs and village and district AIDS action committees to achieve local ownership and sustainability