This is an ongoing AB activity in prevention. It also relates to activity ID 10575 (OP) Federal Police Prevention Activity with non-AB Activities designed to address other activities outside of AB activities and also links with the Activity ID 10386 (AB) design and production of TA for MARCH. The objective of the intervention is to strengthen and integrate Federal Police's prevention, care, and treatment efforts for police men and women and their family members through AB activities employing MARCH model.

Data specific to police officers are sparse but indicate that HIV prevalence may be higher than in the general public. In 2003, the seroprevalence among ANC attendees of the Federal Police Referral Hospital was 30.2%. These data suggest that prevalence among police members and their families, including their wives, may be significant. The seroprevalence of HIV among police recruits from Addis Ababa in 2000 was 6.1% (Zewde A. et al., paper presented to the XXXVIIth Annual Medical Conference, Ethiopian Medial Association, 2001). Among recruits from Afar, one of the least developed regional states, the HIV-1 seroprevalence was 6.4% (Zewde et. al., 2002). These figures may be high, given that the recruits have not yet been exposed to the risky environments and behaviors that many officers face (e.g., away from home, with night shifts). The review of these epidemiologic and behavioral data indicates that the risk for HIV infection among Police requires more effective intervention efforts. Many current prevention efforts still focus on increasing knowledge about risks of transmission.

The MARCH project is behavioral change communication project that is designed to address the behavioral objectives that are identified by the formative assessment.

MARCH is a behavior change communications (BCC) strategy that promotes the adoption of HIV prevention behaviors and encourages community members to care for people living with HIV/AIDS (PLWHA) and children whose parents have died of AIDS. Addressing stigma and discrimination towards PLWHA, tackling the existing gender imbalances and the removal of stigma and discrimination is expected to contribute to reduction of risky behaviors and also encourage a comprehensive care and support on the part of the community, promote better service uptake and most specifically - abstinence and faithfulness among police members. There are two main components to the program: Entertainment as a vehicle for education (long running serialized printed dramas portraying role models evolving toward the adoption of positive behaviors) and interpersonal reinforcement at the community level. Key to the edutainment component is the use of role models in the context of a storyline to provide information about change, to motivate the viewer, and to enhance a sense of self-efficacy. The second element involves reinforcing the message through interpersonal strategies like peer group discussions. Research shows that effective interventions are often personalized ones. The MARCH reinforcement activities try to personalize the behavior change intervention. The objective of the reinforcement activities include: applying message in the drama to their own lives, provide accurate information about HIV/AIDS and behavior change, provide an opportunity to practice new skills that may be required in avoiding infection and supporting those infected.

The project utilizes models that reflect the existing characteristics of the police that face similar barriers and facilitators of behavioral change. These models are part of a printed serial drama that is published every two weeks and distributed among the police. Peer group discussions will be used as a reinforcement agent. These peer group discussions will be facilitated by trained peer leaders. Members of the peer groups are expected to identify themselves with the models and eventually undergo appropriate behavioral changes to prevent HIV/AIDS.

The project will foster a supporting environment for those members of the police who are infected or affected by HIV. Accordingly, the project will target men's cognitive style and behavior towards women as one behavioral objective. Furthermore, modifying all fallacious perceptions, in general, and stigma and discrimination, in particular, towards people living with HIV/AIDS, OVC, the use of services, such as, VCT, ART, etc. will be target areas.

The equilibrating the existing gender imbalances and the removal of stigma and discrimination is expected to minimize the rate of exposure of the police force to risky behaviors and also encourage a comprehensive care and support on the part of the

community, promote better service uptake and most specifically - abstinence and faithfulness among the police force.

MARCH office will coordinate the activities by the flow of data from the peer groups through a properly designed peer structure consisting of peer leaders, trainers /supervisors, and liaison officers.

In COP 05 and the first two quarters of 06 the project has developed formative assessment protocol, In addition, structural adjustment has been proposed and approved for the MARCH Office to make it under the commissioner office so that the office will have direct communication with all the main departments with in the Federal Police commission and also reduce bureaucratic procedures in procurement, financial management, and project implementation in the 3rd and 4th quarter of 06 the project has been working on undertaking formative assessment, developing peer training manual, producing printed serial drama and IEC material. In 2005, the Federal Police has identified its gaps in implementing MARCH project. The prevention project was placed under the hospital which is primarily a care and treatment center resulting in delay in implementation. The project has now restructured itself under the office of the Commissioner. The involvement of the higher officials representing different main departments through an advisory board will also increase the sense of ownership of the project, and facilitate the project implementation. The Commission is also developing various guidelines dealing with financial and personnel management issues. Thus the Commission will have implementing mechanisms in place for the planned activities. CDC Ethiopia believes that working with this partner is important to transfer knowledge and skill which is important in sustainability of the programs.

Furthermore, JHU CCP has also begun providing technical assistance to the Federal Police Commission in building the capacity of the project staffs as well as facilitating the implementation of the project in the area of producing peer training manual, printed serial drama, IEC material, training for the creative team and program staff. Please refer Activity # 10386 for detail on the role of JHU-CCP in providing TA to Federal Police.

As financial systems and bureaucratic process has been found to be the major barrier in the implementation of the MARCH project at FPC, budget has been redirected to JHU/CCP to facilitate the financial utilization.

The COP07 will build upon the COP06 accomplishment and focused on the existing major activities including: (1) Building the organizational capacity of the Federal Police and Addis Ababa Police Commissions; (2) Strengthen the necessary technical capacity in implementing MARCH project through training; (3) Continuing the production and dissemination of printed serial drama; and (4) Producing the necessary IEC materials augmenting the printed serial drama.

Federal Police Prevention Activities

This is the continuation of FY06 OP intervention in the FPC. It links to Federal Police Focused AB program (5633) and also to design and production of TA for MARCH (10386 and 10388).The objective is to strengthen and integrate FPC prevention, care, and treatment for police men and women and their family members through other prevention activities employing MARCH activities.

Data specific to police officers and their families are sparse but do indicate a higher HIV prevalence than in the general public. In 2003, the seroprevalence among ANC attendees of the Federal Police Referral Hospital was 30.2%. The seroprevalence of HIV among police recruits from Addis Ababa in 2000 was 6.1% (Zewde A. et al., paper presented to the 37th Annual Medical Conference, EMA, 2001). Among recruits from Afar, one of the least developed regions, the HIV-1 seroprevalence was 6.4% (Zewde et al., 2002). Review of these epidemiological and behavioral data indicates HIV infection among police requires more effective intervention. Many current prevention efforts still focus on increasing knowledge about transmission risk.

MARCH is a behavior change communications (BCC) strategy that promotes adoption of HIV preventive behaviors and encourages community members to care for PLWHA and children orphaned by the epidemic. This OP intervention will try to address problems related to stigma and discrimination towards PLWHA, promotion of consistent correct condom use; early treatment of STI and the uptake of services like VCT and ART similar to those within the military. These are expected to reduce risky behaviors, encourage a comprehensive community care and support approach, and promote service uptake. There are two main components to the MARCH program: entertainment as an educational vehicle, and reinforcement. The former uses long-running serialized printed dramas distributed among the police biweekly, portraying role models who gradually develop, encouraging audience identification, learning about positive behaviors. The reinforcement component reflects evidence on the successful nature of personalized interventions, employing peer group discussion led by trained group members. MARCH provides accurate information concerning HIV/AIDS and addresses related attitudes to gender, stigma, and risk perception. This activity fosters a supportive environment for police infected or affected by HIV/AIDS.

Due to financial and procurement challenges the MARCH office has been restructured and is now under the Office of the Commissioner rather than the police hospital, which will give the activity improved status with involvement of senior police officials on the advisory board. As financial systems and management have been major barriers to MARCH implementation, the budget has been redirected to JHU/CCP to facilitate financial aspects.

JHU CCP is now providing technical assistance and guidance to the FPC in building project staff capacity and facilitating project implementation in several areas: production of a peer training manual of entertainment/ IEC materials, staff training. Please refer to Activity #5777 for details on the role of JHU-CCP in providing TA to FPC.

The COP07 will build on COP06 accomplishments and continue to focus on the existing major activities, including capacity building of the FPC and Addis Ababa police. The project will also improve the necessary technical capacity to implementing MARCH Production of appropriate IEC materials with emphasis on consistent correct condom use will also be a further focus in COP07.

The activities are: -Build organizational capacity of the FPC and Addis Ababa Police Commissions -Strengthen the necessary technical capacity in implementing MARCH project through training -Continuing production and dissemination of printed serial dramas within the police population -Producing necessary IEC materials augmenting the printed serial drama