Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 655
Country/Region: Ethiopia
Year: 2009
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $6,026,750

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $40,000

APRIL 2009 REPROGRAMMING

Alcohol/Substance Use and HIV Prevention and Control

As a result of the Prevention Portfolio Review, we have determined this activity to have 20% AB component

from the previous 100% OP activity.

This is a continuing activity. Introduce a communication strategy around alcohol and substance abuse

related to HIV/AIDS prevention. Decreasing khat and alcohol consumption in HIV-positive or at risk persons

reduces the spread of HIV and associated diseases. Khat (Catha edulis) is a stimulant that grows in

Ethiopia and a few other African countries, and it is chewed to increase energy. In many parts of the

country, khat use is closely associated with high alcohol consumption. Khat and alcohol use are associated

with high-risk sexual behaviors, which is the major mode of HIV transmission. In persons already infected,

the combination of heavy drinking, khat use and HIV has been associated with increased medical and

psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and

poorer HIV treatment outcomes. In FY06, & FY07, a national targeted evaluation investigated the

magnitude and pattern of alcohol and khat consumption and their role in the transmission of HIV infection

and ART adherence. The study showed that Alcohol drinking and khat chewing are widespread and the

consumption patterns can expose to risky sexual behaviors. Alcohol and khat use substantially and

significantly increase the likelihood of having multiple sexual partnerships; those who use alcohol and khat

are about twice likely to have MSPs compared to those who are not using these substances. Condom use

is less by at least 50% among alcohol and khat users compared to those who do not use these substances.

Increased occurrence of sexual violence and rape by persons under the influence of alcohol is noted by key

informants. A limited number of intervention activities were initiated, including strategy design to address the

problem. In FY08 interventions addressing factors identified by the evaluation is planned to start. In FYO9,

Interventions from FY08 will continue encompassing: 1) Interventions in multiple settings, such as

development of information, education, and education/behavior -change communication (IEC/BCC)

materials, including job aids 2) Application of recommendations to the Wegen Talk-Line and Addis Ababa

University, among others Specific interventions will include: 1) Offering IEC programs on HIV/AIDS,

including production of anti-alcohol materials (e.g., leaflets, posters, and brochures) targeting both the

general population and service providers. These will give detailed information on alcohol risks and suggest

actions to address the problem. Such materials are essential to increase community awareness of the

hazards of alcohol and khat. 2) Developing a roadmap to guide strategies and interventions at various

levels 3) Training professionals on the risks of khat and alcohol and on drug-use counseling 4) Linking ART

adherence interventions with drug-use counseling The pilot intervention is including provision of training

and external technical assistance on risk reduction counseling. Risk-reduction counseling involves providing

accurate HIV/AIDS and alcohol and khat information and training on personal risk assessment and

behavioral skills. The intervention was to have offered HIV counseling and testing for individuals who abuse

alcohol and khat, so that they can learn their sero-status. Alcohol and khat interventions were also to be

linked with other services, including screening for sexually transmitted infections and psychiatric services.

This is a continuing activity. Decreasing khat and alcohol consumption in HIV-positive or at risk persons

reduces the spread of HIV and associated diseases. Khat (Catha edulis) is a stimulant that grows in

Ethiopia and a few other African countries, and it is chewed to increase energy. In many parts of the

country, khat use is closely associated with high alcohol consumption. Khat and alcohol use are associated

with high-risk sexual behaviors, which is the major mode of HIV transmission. In persons already infected,

the combination of heavy drinking, khat use, and HIV has been associated with increased medical and

psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and

poorer HIV treatment outcomes. In FY06, a national targeted evaluation investigated the magnitude and

pattern of alcohol and khat consumption and their role in the transmission of HIV infection and ART

adherence. A limited number of intervention activities were initiated, including strategy design to address

the problem. In FY07, interventions addressing factors identified by the evaluation were to be carried out.

In FY08, interventions will address factors related with drinking; use of alcohol and khat is often thought to

be associated with lowering of self-control and greater risk-taking behavior with regard to sex. Bars and

nightclubs that sell alcohol and khat-selling houses are often popular meeting places and frequented by

people looking for commercial or casual sex. Alcohol and sexual activity are linked in both commercial and

social spheres. The alcohol trade is closely intertwined with commercial sex activity. Intervention

approaches will encompass: 1) Interventions in multiple settings, such as development of information,

education, and education/behavior-change communication (IEC/BCC) materials, including job aids 2)

Trainings to integrate alcohol and substance abuse into counseling and integrate referral linkage of

alcohol/substance abuse to HIV/AIDS services 3) Technical assistance to PEPFAR Ethiopia partners and

the Addis Ababa University psychiatry department on alcohol/substance abuse 4) Application of

recommendations to the Wegen Talk-Line and Addis Ababa University, among others Specific

interventions will include: 1) Offering IEC programs on HIV/AIDS, including production of anti-alcohol

materials (e.g., leaflets, posters, and brochures) targeting both the general population and service

providers. These will give detailed information on alcohol risks and suggest actions to address the problem.

Such materials are essential to increase community awareness of the hazards of alcohol and khat. 2)

Developing a roadmap to guide strategies and interventions at various levels 3) Training professionals on

the risks of khat and alcohol and on drug-use counseling 4) Linking ART adherence interventions with drug-

use counseling The pilot intervention was to have included provision of training and external technical

assistance on risk-reduction counseling. Risk-reduction counseling involves providing accurate HIV/AIDS

and alcohol and khat information and training on personal risk assessment and behavioral skills. The

intervention was to have offered HIV counseling and testing for individuals who abuse alcohol and khat, so

that they can learn their sero-status. Alcohol and khat interventions were also to be linked with other

services, including screening for sexually transmitted infections and psychiatric services.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.02:

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $487,000

Supporting National and Regional AIDS Resource Centers with AB Prevention Intervention

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

I. Support to National AIDS Resource Center (ARC):- This is a continuing AB focused activity from FY08.

This project is designed to expand access to AB (abstinence and be faithful) focused HIV/AIDS prevention

by enhancing the relevance of the activities carried out by the Johns Hopkins Bloomberg School of Public

Health/Center for Communication Programs (CCP) in support of the AIDS Resource Center (ARC), and by

building the capacity of partners and the HIV/AIDS Program Coordinating Office (HAPCO) to implement HIV

-prevention communication activities.

The CCP/ARC's user driven services and BCC activities are closely related and mutually reinforcing. Its

user driven services are modeled after CDC's national Prevention Information Network (NPIN) and include

a library, clearinghouse, a virtual information Center, IT training and Media events support. To date, the

CCP/ARC has developed and implemented evidence based BCC activities addressing a wide range of

issues including HIV prevention using the ABC model, stigma reduction, care and support.

CCP/ARC will promote AB prevention strategies through two interrelated activity areas. First, CCP/ARC will

continue to provide accessible, current, and accurate information on AB strategies and service uptake to

governmental and nongovernmental partners, journalists and media professionals, healthcare providers,

researchers, and the general public through its national and regional resource centers. The library houses

over 3,000 HIV/AIDS focused titles covering a wide range of interrelated topics. On average, the clearing

house distributes more than 14,000 copies of stocked materials per month to organizations nationwide.

Currently, the National resource center alone draws at least 90 visitors per day.

In FY09, CCP/ARC will focus on maintaining and strengthening its virtual-information center and library for

HIV/AIDS information resources. Particular areas of emphasis will be improved quality of library and IT

services, such as increasing the library's capacity to serve an increasingly number of the public. Other

areas of emphasis include a major overhaul of the library's collection and expansion of the library's resource

-monitoring and retention strategy. CCP/ARC will also work to establish defined areas in the resource

center that can serve populations with special needs (e.g. introducing audio booths and software for the

visually impaired).

In FY09, CCP/ARC will also continue to systematize outreach activities by leveraging its existing resources.

Outreach activities will be targeted to the general public and special audiences such as youth aged 15-24,

students, health professionals and other individuals working in HIV/AIDS in Ethiopia. These activities will

include a regular schedule of single-session, drop-in, information-education-communication and behavior-

change communication (IEC/BCC) activities (e.g., classes, panel discussions, lunchtime presentations,

and/or discussion groups) pertaining to HIV/AIDS. CCP/ARC will also encourage groups and organizations

in the wider Addis Ababa region to use ARC space to conduct their own trainings and peer-education

sessions.

As part of its second activity area, CCP/ARC will work to strengthen the expanded Wegen Talkline's

capacity to respond to escalating demand and to provide accurate and valid information, referral, and

counseling services on AB focused prevention. The Wegen Talkline currently receives more than 6,000

calls per day. In FY09, the Talkline will have the capacity to provide service seven days a week. CCP/ARC's

current system for monitoring the Talkline and analyzing Talkline data will be streamlined to allow for easier

tracking of behavioral trends and appropriate development of IEC/BCC materials. CCP/ARC will compile,

analyze and utilize hotline data for program improvement and monitoring. CCP/ARC will also continue the

production of a newsletter highlighting findings of Talkline monitoring and a monthly article on top issues

addressed by Wegen counselors. These materials will be distributed to the general population and to

partner organizations to help them in the development of their own activities. CCP/ARC will also continue to

build the capacity of its own staff to retain hotline counselors.

II. Support to Regional AIDS Resource Centers (RARC):- In each region, the CCP/ARC Regional AIDS

Resource Centers have been integrated into the regional HAPCO, where staff receives orientation, training,

and ongoing technical support from CCP/ARC. CCP/ARC in collaboration with PEPFAR/CDC Ethiopia,

FHAPCO and Regional HAPCOs will standardize the role of the regional ARCs. The regional HAPCO is

responsible for management, funding, procuring equipment and supplying necessary operational materials.

In FY07 and FY08, CCP/ARC provided support to regional ARCs, enabling it to provide access to accurate

and up-to-date information on HIV/AIDS, sexually transmitted infections (STI), and tuberculosis (TB) in the

regions through activities including:

1) Support for HIV/AIDS-related projects and activities of regional HAPCO, regional health bureaus (RHB),

and PEPFAR Ethiopia implementing partners;

2) Support for development of culturally appropriate IEC/BCC materials specific to regional populations,

including mass media, print materials, and/or interpersonal communication tools and trainings;

3) Piloting of IEC/BCC outreach activities, including providing and hosting HIV/AIDS-related trainings for

local groups, expanded outreach for IEC/BCC programs, and drop-in sensitizations and classes;

4) Expansion of information-dissemination activities by facilitating outreach and distribution planning in the

regions;

5) Promotion of other ARC functions, such as the Wegen AIDS Talkline in the regions; and

6) Provision of Internet access through high-speed computer terminals for users to research current health

and HIV/AIDS-related issues. In addition, in FY08 an assessment was conducted to identify challenges the

regional ARCs faced regarding physical infrastructure, human resource capacity, IT infrastructure and

quality of services.

In FY09, CCP/ARC will build upon the result of the assessment and the progress made so far and will

continue to implement the following major activities:-

1) Strengthen the capacity of all existing regional AIDS Resource Centers, with clear linkages to existing

local services;

Activity Narrative: 2) Provide ongoing training and technical assistance to all existing regional ARC, HAPCO, and RHB in

monitoring, information technology, and materials distribution;

3) Strengthen information technology capacity of all regional ARCs;

4) Collaborate with regional HAPCO to develop or adapt IEC/BCC materials for use at the regional level.

These materials will be culturally and linguistically tailored to the regions, and will cover a wide range of

HIV/AIDS-related topics.

5) Expand outreach activities in regional AIDS Resource Centers. These outreach activities may include:

providing trainings for local groups; encouraging regional HIV/AIDS groups to use ARC space to conduct

their own trainings and activities; expanding reinforcement and outreach activities for CCP/ARC's existing

BCC programming, such as the Betengna Radio Diaries or the HIV/AIDS Services Communication Initiative;

and providing a regular schedule of single-session, drop-in IEC/BCC activities (such as classes, panel

discussions, or discussion groups) pertaining to HIV/AIDS.

6) Establish monitoring and evaluation systems at all regional ARC through staff training, implementing

outcome-evaluation protocols for user services modeled on those developed for the national ARC in FY06,

and conducting an impact evaluation of selected services at national and regional ARC.

III. Support to HAPCO for World AIDS Day: - World AIDS Day (WAD) is marked every year in Ethiopia,

providing an opportunity to commemorate and publicly share successes and achievements in the battle

against HIV/AIDS, and recognizing its global and national impact. CCP/ARC, supported by PEPFAR

Ethiopia, serves as an active member of the World AIDS Day Campaign, providing technical and financial

support to conduct the campaign. This includes developing messages and producing campaign materials

(posters, flyers, t-shirts, banners, billboards, press kits, press alerts, web pages, video and radio PSAs,

documentaries, and feature stories). In FY08, CCP/ARC assisted the Federal HAPCO with coordination of

all of PEPFAR Ethiopia's implementing partners for WAD, and gave direct technical assistance in special-

events management to Federal HAPCO to conduct an effective campaign.

In FY09, CCP/ARC will give direct technical and financial assistance to HAPCO to conduct an effective

campaign throughout the year, employing a multimedia approach. CCP/ARC will expand and increase its

World AIDS Day activities at both the national and regional levels, including nationally-broadcast mass

media (televised panel discussions, TV spots, and radio spots); extensive outreach events through the

regional ARC; and production of regionally-specific World AIDS Day promotional materials. CCP/ARC will

also work to involve parliamentarians and government ministries in advocacy and communication activities

for WAD. These activities will be in addition to CCP/ARC's continued coordination of PEPFAR Ethiopia's

implementing partners for WAD.

IV. Youth Focused radio program: CCP/ARC will also launch broadcasts and discussions in high school

radio clubs and university anti-AIDS clubs to encourage young people to address stigma, discrimination,

and prevention issues among their cohorts. This activity will also address delaying sexual debut, fidelity and

reduction of multiple concurrent sexual partnerships. The activity will be supported by mini-media and

school outreach programs and multi-media materials development. In addition to this, CCP/ARC will also

continue to strengthen and expand the School-Net program which has been started using FY08

supplemental funding and state-of-the-art ICT initiative established by the Ethiopian government in

collaboration with Ministry of Education and Educational Media Agency.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16580

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16580 10592.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $1,300,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

10592 10592.07 HHS/Centers for Johns Hopkins 5469 655.07 jhu-ccp $500,000

Disease Control & University Center

Prevention for Communication

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $180,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $360,750

MARCH and IEC/BCC Materials Production Technical Assistance (AB)

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

Substantive changes were made in the COP 08 narrative and are as follows: In FY09, CCP/ARC will

continue to build the capacity of all three MARCH partners through ongoing training, TA, and staffing, with

particular emphasis on program and materials development and implementation. NDFE with CCP/ARC

support will continue to strengthen its MARCH intervention in all its commands, with both print serial dramas

and reinforcement activities, as well as finalize the program evaluation that have been conducted in the two

NDFE commands where MARCH has been implemented for more than three years. CCP/ARC will build

upon its activities with AAU to conduct a feasibility study exploring the potential to expand MARCH to new

youth audiences, and may subsequently expand to new universities. Activities with the FPC will focus on

consolidation of progress to date, with an emphasis on building capacity and regional expansion

assessment. This will include ongoing TA to the FPC's public relations and television programming.

There are no TA targets for MARCH with this activity, as it is assistance toward the targets reported with

AAU, FPC and NDFE activities.

II. Information, education and behavior change communication (IEC/BCC) Material Production TA: -

Strategic information, education and communication for prevention and treatment of HIV and AIDS is crucial

to engender sustained behavior change. In addition to programs implemented with other partners, the

CCP/ARC also develops communication strategies, BCC materials and packaging of HIV and AIDS tools for

use by health professionals. The materials cover a range of topics including HIV prevention, positive living,

ART, PMTCT, VCT and infection prevention. To date, CCP/ARC produced a variety of IEC/BCC and media

materials designed to strengthen quality of care at service sites supported by PEPFAR partners operating at

all levels. These materials are used by the general public, partner organizations and by the CCP/ARC user

driven services and BCC programs. Evidence based materials produced using these strategies are in use in

multiple health centers, HIV programs and hospitals across the nation.

In FY09, CCP/ARC will continue to develop and produce appropriate IEC/BCC materials for service

providers and youth audiences promoting comprehensive ABC strategies. These materials and

accompanying discussion materials will be distributed to support additional private hospitals and health

centers, new public health sites and will target youth audiences.

In addition, CCP/ARC will help providers identify gender-based violence; train providers on use of

counseling and educational aids; and monitor and evaluate use of materials. CCP/ARC will also develop

and implement communication activities to address prevention-for-positives messaging. Other materials will

target young people and married couples (including discordant couples and those with concurrent partners),

and will highlight themes such as gender norms and masculinity, transactional sex, sexual networks and

healthy sexuality. These materials will respond to feedbacks from Wegen AIDS talkline and will address

PEPFAR wraparound areas with greater integration of HIV prevention and other health topics. Whenever

possible, CCP/ARC will involve local partners in the development of materials.

CCP/ARC will also strengthen links with other prevention partners to ensure broad distribution and use of

these materials. All materials will be disseminated and reinforced through expanded outreach and

community mobilization activities such as trainings, seminars and discussions groups, peer-education

sessions, mini classes, and panel discussions to be conducted by CCP/ARC at national and selected

regional sites and by partners nationwide. These activities will be implemented in close collaboration with

national and regional HIV/AIDS Prevention and Control Offices (HAPCO) through establishment of national

and regional IEC/BCC working groups. Through these IEC/BCC materials, 15,000 individuals will be

reached with a comprehensive ABC message and 300 individuals will be trained with these IEC/BCC

materials to encourage use and effectiveness.

I. MARCH Technical Assistance:- Johns Hopkins Bloomberg School of Public Health/Center for

Communication Programs (CCP) provides technical support for all partners implementing Modeling and

Reinforcement to Combat HIV/AIDS (MARCH), including the National Defense Forces of Ethiopia (NDFE),

Addis Ababa University (AAU), and the Federal Police Commission (FPC). CCP began providing technical

assistance (which now includes financial management for AAU and FPC) to these CDC-Ethiopia partners in

FY06 to facilitate the MARCH project among these three key audiences. Intensive HIV-prevention activities

among the military, police, and university students are critical for these most at-risk populations, which are

highly mobile groups frequently away from home.

Targeted interventions to most-at-risk subgroups are essential to stem the spread of the epidemic.

Sustained success of these programs is therefore a crucial aspect of the national response. There are two

main components to the MARCH program: entertainment as a vehicle for education (serialized printed

dramas portraying role models evolving towards positive behaviors), and interpersonal reinforcement at the

community level. Printed serial dramas published every one month are distributed among the target

populations and discussions are held every two weeks, while informal discussions among peers continue

throughout. Peer discussions explore issues raised by the serial dramas and give individuals community

support for behavior change.

In FY08, CCP/ARC continued to work with CDC Ethiopia and CDC Atlanta to provide technical assistance

(TA) and guidance to the partners in the areas of planning and designing projects, monitoring activities,

organizing trainings, and assisting with materials production, including both modeling and reinforcement

materials and activities. CCP/ARC provided training to the creative team and program staff for the three

MARCH partners. The training resulted in the development of high-quality, research-based, information,

education, and communication (IEC) and behavior change communication (BCC) materials on relevant

HIV/AIDS topics. CCP/ARC also provided TA to partners on monitoring and evaluation of reinforcement

activities and data collection and dissemination; conducted site-level support and training; and helped AAU

Activity Narrative: develop and implement its certificate curriculum program through a collaborative TA relationship with

AfriComNet.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16579

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16579 10386.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $975,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $97,500

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $1,948,000

AIDS Resource Center

ACTIVITY MODIFIED IN THE FOLLOWING WAYS:

I. National AIDS Resource Center (ARC):-This is a continuing OP focused activity from FY08. This project is

designed to expand access to non-AB-focused (abstinence and be faithful) HIV/AIDS prevention by

enhancing the relevance of the activities carried out by the Johns Hopkins Bloomberg School of Public

Health/Center for Communication Programs (CCP) in support of the AIDS Resource Center (ARC), and by

building the capacity of partners and the HIV/AIDS Program Coordinating Office (HAPCO) to implement HIV

-prevention communication activities.

The CCP/ARC's user driven services and BCC activities are closely related and mutually reinforcing. Its

user driven services are modeled after CDC's national Prevention Information Network (NPIN) and include

a library, clearinghouse, a virtual information Center, IT training and Media events support. To date, the

CCP/ARC has developed and implemented evidence based BCC activities addressing a wide range of

issues including HIV prevention using the ABC model, stigma reduction, care and support.

CCP/ARC will promote non-AB prevention strategies through two interrelated activity areas. First, CCP/ARC

will continue to provide accessible, current, and accurate information on non-AB strategies (including

condom use, sexually transmitted infections, and counseling and testing) and service uptake to

governmental and nongovernmental partners, journalists and media professionals, healthcare providers,

researchers, and the general public through its national and regional resource centers. The resource center

houses over 3,000 HIV/AIDS focused titles covering a wide range of interrelated topics. On average, the

clearing house distributes more than 14,000 copies of stocked materials per month to organizations

nationwide. Currently, the National resource center alone draws at least 90 visitors per day.

In FY09, CCP/ARC will focus on maintaining and strengthening its premier virtual information center and

library for HIV/AIDS information resources. Particular areas of emphasis will be improved quality of library

and information technology services, such as increasing the library's capacity to serve an increasingly tech-

savvy public.

Other areas of emphasis include a major overhaul of the library's collections and expansion of the library's

resource-monitoring and retention strategy. CCP/ARC will also work to establish defined areas in the

resource center that can service populations with special needs (e.g., introducing audio booths and

software for the visually impaired).

CCP/ARC will also continue to systematize outreach activities by leveraging its existing resources.

Outreach activities will be targeted to the general public and special audiences such as youth aged 15-24,

Most at Risk populations, married young women, university students, health professionals and other

individuals working in HIV and AIDS in Ethiopia. These activities will include a regular schedule of single-

session, drop-in information, education, and communication and behavior change communication

(IEC/BCC) activities (such as classes, panel discussions, lunchtime presentations, and/or discussion

groups) pertaining to HIV/AIDS. CCP/ARC will also encourage groups and organizations in the wider Addis

Ababa region to use ARC space to conduct their own trainings and peer education sessions.

As part of its second activity area, CCP/ARC will work to strengthen the expanded Wegen Talkline's

capacity to respond to escalating demand and to provide accurate and valid information, referral, and

counseling services on non-AB focused prevention, by hiring additional counselors fluent in key local

languages. The Wegen Talkline currently receives more than 6,000 calls per day. In FY09, the Talkline will

have the capacity to provide service seven days a week. CCP/ARC's current system for monitoring the

Talkline and analyzing Talkline data will be streamlined to allow for easier tracking of behavioral trends and

appropriate development of IEC/BCC materials. CCP/ARC will continue to compile and analyze hotline data

to recommend a mechanism for feedback and dissemination of data for program improvement and

monitoring.

CCP/ARC will also continue production of a newsletter highlighting findings of Talkline monitoring and a

monthly article on top issues addressed by Wegen counselors. These materials will be distributed to the

general population and to partner organizations to help them in the development of their own activities.

CCP/ARC will also continue to build the capacity of its own staff to retain hotline counselors.

II. Support to Regional AIDS Resource Centers (RARC):-In each region, the ARC has been integrated into

the regional HAPCO, where staff receives orientation, training, and ongoing technical support from

CCP/ARC. CCP/ARC in collaboration with PEPFAR/CDC Ethiopia, FHAPCO and Regional HAPCOs will

standardize the role of the regional ARCs. The regional HAPCO is responsible for management, funding,

equipment procurement, and supplying necessary operational materials. In FY07, CCP provided support to

the regional ARC, enabling them to provide access to accurate and up-to-date information on HIV/AIDS,

sexually transmitted infections, and tuberculosis in the regions through activities including:

1) Support for HIV/AIDS-related projects and activities of regional HAPCO, regional health bureaus (RHB),

and PEPFAR Ethiopia implementing partners

2) Support for development of culturally appropriate IEC/BCC materials specific to regional populations,

including mass media, print materials, and/or interpersonal communication tools and trainings

3) Piloting of IEC/BCC outreach activities, including providing and hosting HIV/AIDS-related trainings for

local groups, expanded outreach for IEC/BCC programs, and drop-in sensitizations and classes

4) Expansion of information-dissemination activities by facilitating outreach and distribution planning in the

regions

5) Promotion of other ARC functions, such as the Wegen AIDS Talkline in the regions

6) Provision of Internet access through high-speed computer terminals for users to research current health

and HIV/AIDS-related issues

In addition, in FY08 an assessment was conducted to identify challenges the regional ARCs faced

regarding physical infrastructure, human resource capacity, IT infrastructure and quality of services

In FY09, CCP/ARC will build upon the result of the assessment and the progresses made so far to

implement the following major activities:-

Activity Narrative: 1) Strengthen the capacity of all existing regional AIDS Resource Centers, with clear linkages to existing

local services;

2) Provide ongoing training and technical assistance to all existing regional ARC, HAPCO, and RHB in

monitoring, information technology, and materials distribution;

3) Strengthen information technology capacity of all regional ARC;

4) Collaborate with regional HAPCO to develop or adapt IEC/BCC materials for use at the regional level.

These materials will be culturally and linguistically tailored to the regions, and will cover a wide range of

HIV/AIDS-related topics.

5) Expand outreach activities in regional AIDS Resource Centers. These outreach activities may include:

providing trainings for local groups; encouraging regional HIV/AIDS groups to use ARC space to conduct

their own trainings and activities; expanding reinforcement and outreach activities for CCP/ARC's existing

BCC programming, such as the Betengna Radio Diaries or the HIV/AIDS Services Communication Initiative;

and providing a regular schedule of single-session, drop-in IEC/BCC activities (such as classes, panel

discussions, or discussion groups) pertaining to HIV/AIDS.

6) Establish monitoring and evaluation systems at all regional ARC through staff training, implementing

outcome-evaluation protocols for user services modeled on those developed for the national ARC in FY06,

and conducting an impact evaluation of selected services at national and regional ARC.

III. Support to HAPCO for World AIDS Day: - World AIDS Day (WAD) is marked every year in Ethiopia,

providing an opportunity to commemorate and publicly share successes and achievements in the battle

against HIV and AIDS, and recognizing its global and national impact. CCP/ARC, supported by PEPFAR

Ethiopia, serves as an active member of the World AIDS Day Campaign, providing technical and financial

support to conduct the campaign, developing messages and producing campaign materials (posters, flyers,

t-shirts, banners, billboards, press kits, press alerts, web pages, video and radio PSAs, documentaries, and

feature stories). In FY08, CCP/ARC assisted the Federal HAPCO with coordination of all of PEPFAR

Ethiopia's implementing partners for WAD, and gave direct technical assistance in special events

management to Federal HAPCO to conduct an effective campaign.

In FY09, CCP/ARC will continue to give direct technical and financial assistance to HAPCO to conduct an

effective campaign throughout the year, employing a multimedia approach. CCP/ARC will expand its World

AIDS Day activities, with increased activities at both the national and regional levels, including: nationally

broadcast mass media (televised panel discussions, TV spots, and radio spots); extensive outreach events

through the regional ARC; and production of regionally-specific World AIDS Day promotional materials.

CCP/ARC will also work to involve parliamentarians and government ministries in advocacy and

communication activities for WAD. These activities will be in addition to CCP/ARC's continued coordination

of PEPFAR Ethiopia's implementing partners for WAD.

IV. Strengthen media role in the fight against HIV/AIDS: In FY09, CCP/ARC will continue to provide

technical and financial support to EVMPA (Ethiopian Volunteer Media Professionals against AIDS) to

strengthen and scale up media related activities which have been started using FY08 supplemental funding.

The objective of the project is to enhance the role of mass media both public and private to raise the public

awareness, Sensitize media managers to enhance the media coverage, mobilize the community, reduce

stigma and discrimination, promote services like STIs, TB, CT and ART and Promote treatment adherence

through innovative programs and positive living.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16582

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16582 5793.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $950,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

10388 5793.07 HHS/Centers for Johns Hopkins 5469 655.07 jhu-ccp $300,000

Disease Control & University Center

Prevention for Communication

Programs

5793 5793.06 HHS/Centers for Johns Hopkins 3770 655.06 $200,000

Disease Control & University Center

Prevention for Communication

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $107,500

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03:

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $1,443,000

MARCH and IEC/BCC Materials Production Technical Assistance

ACTIVITY MODIFIED IN THE FOLLOWING WAYS:

Substantive changes were made from the COP 08 Narrative and are as follows:

I. MARCH Technical Assistance:- Johns Hopkins Bloomberg School of Public Health/Center for

Communication Programs (CCP) provides technical support for all partners implementing Modeling and

Reinforcement to Combat HIV/AIDS (MARCH), including the National Defense Forces of Ethiopia (NDFE),

Addis Ababa University (AAU), and the Federal Police Commission (FPC). CCP began providing technical

assistance (which now includes financial management for AAU and FPC) to these CDC-Ethiopia partners in

FY06 to facilitate the MARCH project among these three key audiences. Intensive HIV-prevention activities

among the military, police, and university students are critical for these most at-risk populations, which are

highly mobile groups frequently away from home.

Targeted interventions to most-at-risk subgroups are essential to stem the spread of the epidemic.

Sustained success of these programs is therefore a crucial aspect of the national response. There are two

main components to the MARCH program: entertainment as a vehicle for education (serialized printed

dramas portraying role models evolving towards positive behaviors), and interpersonal reinforcement at the

community level. Printed serial dramas published every one month are distributed among the target

populations and discussions are held every two weeks, while informal discussions among peers continue

throughout. Peer discussions explore issues raised by the serial dramas and give individuals community

support for behavior change.

In FY08, CCP/ARC continued to work with CDC Ethiopia and CDC Atlanta to provide technical assistance

(TA) and guidance to the partners in the areas of planning and designing projects, monitoring activities,

organizing trainings, and assisting with materials production, including both modeling and reinforcement

materials and activities. CCP/ARC provided training to the creative team and program staff for the three

MARCH partners. The training resulted in the development of high-quality, research-based, information,

education, and communication (IEC) and behavior change communication (BCC) materials on relevant

HIV/AIDS topics. CCP/ARC also provided TA to partners on monitoring and evaluation of reinforcement

activities and data collection and dissemination; conducted site-level support and training; and helped AAU

develop and implement its certificate curriculum program through a collaborative TA relationship with

AfriComNet.

In FY09, CCP/ARC will continue to build the capacity of all three MARCH partners through ongoing training,

TA, and staffing, with particular emphasis on program and materials development and implementation.

NDFE with CCP/ARC support will continue to strengthen its MARCH intervention in all its commands, with

both print serial dramas and reinforcement activities, as well as finalize the program evaluation that have

been conducted in the two NDFE commands where MARCH has been implemented for more than three

years. CCP/ARC will build upon its activities with AAU to conduct a feasibility study exploring the potential

to expand MARCH to new youth audiences, and may subsequently expand to new universities. Activities

with the FPC will focus on consolidation of progress to date, with an emphasis on building capacity and

regional expansion assessment. This will include ongoing TA to the FPC's public relations and television

programming.

There are no TA targets for MARCH with this activity, as it is assistance toward the targets reported with

AAU, FPC and NDFE activities.

II. Information, education, and communication and behavior change communication (IEC/BCC) Material

Production TA: -Strategic information, education and communication for prevention and treatment of HIV

and AIDS is crucial to engender sustained behavior change. In addition to programs implemented with other

partners, the CCP/ARC also develops communication strategies, BCC materials and packaging of HIV and

AIDS tools for use by health professionals. The materials cover a range of topics including HIV prevention,

positive living, ART, PMTCT, VCT and infection prevention. To date, CCP/ARC produced a variety of

IEC/BCC and media materials designed to strengthen quality of care at service sites supported by PEPFAR

partners operating at all levels. These materials are used by the general public, partner organizations and

by the CCP/ARC user driven services and BCC programs. Evidence based materials produced using these

strategies are in use in multiple health centers, HIV programs and hospitals across the nation.

In FY09, CCP/ARC will continue to develop and produce appropriate IEC/BCC materials for service

providers and youth audiences promoting comprehensive ABC strategies. These materials and

accompanying discussion materials will be distributed to support additional private hospitals and health

centers, new public health sites and will target youth audiences..

In addition, CCP/ARC will help providers identify gender-based violence; train providers on use of

counseling and educational aids; and monitor and evaluate use of materials. CCP/ARC will also develop

and implement communication activities to address prevention-for-positives messaging. Other materials will

target young people and married couples (including discordant couples and those with concurrent partners),

and will highlight themes such as gender norms and masculinity, transactional sex, sexual networks and

healthy sexuality. These materials will respond to feedbacks from Wegen AIDS talkline and will address

PEPFAR wraparound areas with greater integration of HIV prevention and other health topics. Whenever

possible, CCP/ARC will involve local partners in the development of materials.

CCP/ARC will also strengthen links with other prevention partners to ensure broad distribution and use of

these materials. All materials will be disseminated and reinforced through expanded outreach and

community mobilization activities such as trainings, seminars and discussions groups, peer-education

sessions, mini classes, and panel discussions to be conducted by CCP/ARC at national and selected

regional sites and by partners nationwide. These activities will be implemented in close collaboration with

national and regional HIV/AIDS Prevention and Control Offices (HAPCO) through establishment of national

and regional IEC/BCC working groups. Through these IEC/BCC materials, 15,000 individuals will be

Activity Narrative: reached with a comprehensive ABC message and 300 individuals will be trained with these IEC/BCC

materials to encourage use and effectiveness.

III. People Living with HIV (PLWH) Betengna Radio Diaries:- This cross-cutting activity prioritizes involving

PLWH in programs. It primarily addresses stigma reduction and prevention strategies such as abstinence,

condom use, and prevention for HIV-positives at the care and treatment settings. HIV thrives in a climate

where PLWH face blame, discrimination, and stigma. Effective HIV/AIDS care and prevention depends on

social change, which instead of socially isolating PLWH, allows their voices to be heard within their

communities and beyond. In Ethiopia, research reveals high levels of stigma and low perceptions of risk.

Evidence in other sub-Saharan countries shows that personal acquaintance with someone with HIV/ AIDS

is a major influence in adoption of safer behavior, and that people respond to personal stories and make

behavioral decisions more on emotional than on rational grounds.

The Betengna radio program features short, intimate accounts of daily life narrated by real people, followed

by a feature that delves more intensely into issues discussed in the diarist's interview. A PLWH radio diarist

creates a personal relationship with thousands of people simultaneously as s/he relates his/her daily

struggle. Audiences hear how very like themselves HIV-positive people are. Gradually, listeners develop a

relationship with the diarist, and share in their trials and challenges. During broadcasts, Betengna links

listeners with the nearest health service centers for health issues discussed and refers listeners to the

Wegen AIDS Talkline.

In FY2007, an assessment was conducted in order to determine exposure to the program and the extent to

which program is brining a change among the targeted population. The assessment which was conducted

in four regions in Ethiopia, found that the Betengna program has made considerable inroads among the

population. In the targeted regions, 29% of the population was exposed to the program. Furthermore,

exposure to the program was associated with a number of positive outcomes. Given that one of the primary

objectives of the program is to reduce stigma toward people living with HIV, a number of findings noted in

this report point to the strong indication that the program is achieving this goal. Overall, the program

appears to be making an impact on lowering stigma and promoting greater knowledge and positive

attitudes.

Based on the result of the assessment, In FY08, CCP/ARC strengthened the Betengna program in the

Amhara, Oromiya, and Tigray regions to broaden their scope. To reach people who do not have radio

access, or who are outside the coverage, CCP/ARC produced and distributed the diaries in audiocassette

form for discussion groups and health-centers and health-post waiting rooms. A discussion group guide

used during these discussions refers participants to the nearest available health services.

In FY09, CCP/ARC will build upon its progress in this area by strengthening and updating the Betegna

website, creating audio listening stations at the national AIDS resource Center and developing and

broadcasting new radio diaries and promotional materials for new regions, where culturally specific

HIV/AIDS communication materials and radio transmission in local languages is very limited and stigma is

high. Betengna will also train new radio producers and diarists to produce a new set of diaries. Expanded

monitoring and strategic information services will also be a priority in FY09, with CCP/ARC maintaining and

establishing streamlined systems for gathering escalating feedback related to the program from Wegen

AIDS Talkline callers, the website, letters from listeners, and from Betengna's special call-in line. CCP/ARC

will also produce a 20-minute audio special highlighting the program's impact on diarists and listeners.

Through the PLWH radio diaries, CCP/ARC will outreach 15,000 listeners through comprehensive ABC

activities and community outreach. 25 individuals will be trained to promote HIV/AIDS prevention through

other behavior change beyond abstinence and/or being faithful through the radio diaries. An established

LDGs are expected to be paired in selected regions through partnership with other implementers.

IV. Secondment of Staff:-A prevention advisor seconded to the Federal HAPCO and a behavior-change

communication advisor seconded to the Health Extension and Education Center (HEEC) will continue to

provide their technical assistance to the two institutions to ensure integration of the support being rendered

to the overall HIV-prevention system.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16581

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16581 5777.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $828,750

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

10387 5777.07 HHS/Centers for Johns Hopkins 5469 655.07 jhu-ccp $162,500

Disease Control & University Center

Prevention for Communication

Programs

5777 5777.06 HHS/Centers for Johns Hopkins 3770 655.06 $160,000

Disease Control & University Center

Prevention for Communication

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03:

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $160,000

Alcohol/Substance Use and HIV Prevention and Control

ACTIVITY MODIFIED IN THE FOLLOWING WAYS

This is a continuing activity. Decreasing khat and alcohol consumption in HIV-positive or at risk persons

reduces the spread of HIV and associated diseases. Khat (Catha edulis) is a stimulant that grows in

Ethiopia and a few other African countries, and it is chewed to increase energy. In many parts of the

country, khat use is closely associated with high alcohol consumption. Khat and alcohol use are associated

with high-risk sexual behaviors, which is the major mode of HIV transmission. In persons already infected,

the combination of heavy drinking, khat use, and HIV has been associated with increased medical and

psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and

poorer HIV treatment outcomes.

In FY06,& FY07,a national targeted evaluation investigated the magnitude and pattern of alcohol and khat

consumption and their role in the transmission of HIV infection and ART adherence.The study showed that

Alcohol drinking and khat chewing are widespread and the consumption patterns can expose to risky sexual

behaviors. Alcohol and khat use substantially and significantly increase the likelihood of having multiple

sexual partnerships; those who use alcohol and khat are about twice likely tohave MSPs compared to those

who are not using these substances. Condom use is less by at least 50% among alcohol and khat users

compared to those who do not use these substances. Increased occurrence of sexual violence and rape by

persons under the influence of alcohol is noted by key informants. A limited number of intervention activities

were initiated, including strategy design to address the problem.

In FY08 interventions addressing factors identified by the evaluation is planned to start.

In FYO9, Interventions from FY08 will continue encompassing:

1) Interventions in multiple settings, such as development of information, education, and education/behavior

-change communication (IEC/BCC) materials, including job aids

2) Trainings to integrate alcohol and substance abuse into counseling and integrate referral linkage of

alcohol/substance abuse to HIV/AIDS services

3) Technical assistance to PEPFAR Ethiopia partners and the Addis Ababa University psychiatry

Department on alcohol/substance abuse

4) Application of recommendations to the Wegen Talk-Line and Addis Ababa University, among others

Specific interventions will include:

1) Offering IEC programs on HIV/AIDS, including production of anti-alcohol materials (e.g., leaflets, posters,

and brochures) targeting both the general population and service providers. These will give detailed

information on alcohol risks and suggest actions to address the problem. Such materials are essential to

increase community awareness of the hazards of alcohol and khat.

2) Developing a roadmap to guide strategies and interventions at various levels

3) Training professionals on the risks of khat and alcohol and on drug-use counseling

4) Linking ART adherence interventions with drug-use counseling

The pilot intervention is including provision of training and external technical assistance on risk reduction

counseling. Risk-reduction counseling involves providing accurate HIV/AIDS and alcohol and khat

information and training on personal risk assessment and behavioral skills. The intervention was to have

offered HIV counseling and testing for individuals who abuse alcohol and khat, so that they can learn their

sero-status. Alcohol and khat interventions were also to be linked with other services, including screening

for sexually transmitted infections and psychiatric services.

This is a continuing activity. Decreasing khat and alcohol consumption in HIV-positive or at risk persons

reduces the spread of HIV and associated diseases. Khat (Catha edulis) is a stimulant that grows in

Ethiopia and a few other African countries, and it is chewed to increase energy. In many parts of the

country, khat use is closely associated with high alcohol consumption. Khat and alcohol use are associated

with high-risk sexual behaviors, which is the major mode of HIV transmission. In persons already infected,

the combination of heavy drinking, khat use, and HIV has been associated with increased medical and

psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and

poorer HIV treatment outcomes.

In FY06, a national targeted evaluation investigated the magnitude and pattern of alcohol and khat

consumption and their role in the transmission of HIV infection and ART adherence. A limited number of

intervention activities were initiated, including strategy design to address the problem.

In FY07, interventions addressing factors identified by the evaluation were to be carried out.

In FY08, interventions will address factors related with drinking; use of alcohol and khat is often thought to

be associated with lowering of self-control and greater risk-taking behavior with regard to sex. Bars and

nightclubs that sell alcohol and khat-selling houses are often popular meeting places and frequented by

people looking for commercial or casual sex. Alcohol and sexual activity are linked in both commercial and

social spheres. The alcohol trade is closely intertwined with commercial sex activity.

Intervention approaches will encompass:

1) Interventions in multiple settings, such as development of information, education, and education/behavior

-change communication (IEC/BCC) materials, including job aids

2) Trainings to integrate alcohol and substance abuse into counseling and integrate referral linkage of

alcohol/substance abuse to HIV/AIDS services

3) Technical assistance to PEPFAR Ethiopia partners and the Addis Ababa University psychiatry

department on alcohol/substance abuse

4) Application of recommendations to the Wegen Talk-Line and Addis Ababa University, among others

Specific interventions will include:

1) Offering IEC programs on HIV/AIDS, including production of anti-alcohol materials (e.g., leaflets, posters,

Activity Narrative: and brochures) targeting both the general population and service providers. These will give detailed

information on alcohol risks and suggest actions to address the problem. Such materials are essential to

increase community awareness of the hazards of alcohol and khat.

2) Developing a roadmap to guide strategies and interventions at various levels

3) Training professionals on the risks of khat and alcohol and on drug-use counseling

4) Linking ART adherence interventions with drug-use counseling

The pilot intervention was to have included provision of training and external technical assistance on risk-

reduction counseling. Risk-reduction counseling involves providing accurate HIV/AIDS and alcohol and khat

information and training on personal risk assessment and behavioral skills. The intervention was to have

offered HIV counseling and testing for individuals who abuse alcohol and khat, so that they can learn their

sero-status. Alcohol and khat interventions were also to be linked with other services, including screening

for sexually transmitted infections and psychiatric services.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16626

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16626 6455.08 HHS/Centers for To Be Determined 7484 5483.08 TBD/CDC

Disease Control &

Prevention

10653 6455.07 HHS/Centers for To Be Determined 5483 5483.07 TBD/CDC

Disease Control &

Prevention

6455 6455.06 HHS/Centers for Ethiopian Public 3772 674.06 $300,000

Disease Control & Health Association

Prevention

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03:

Funding for Treatment: Adult Treatment (HTXS): $648,000

HIV/AIDS Service Provider Call Center (Fitun Warmline)

ACTIVITY WITH ONLY MINOR CHANGES FROM FY2008

InFY08, JHU-CCP/ARC has established a National HIV/AIDS treatment service provider call center (Fitun

Warmline) for health care providers working in ART service outlets. The call-in center provides health care

providers with up-to date HIV clinical information and expert case consultation with immediate response to

problems and constraints they encounter while providing ART services. The call-in center works with callers

and PEPFAR partners to address their HIV/AIDS-related service gaps. The center is a valuable asset for

service providers wishing to gain one-on-one consultations, patient specific information, materials on

HIV/AIDS topics and to address gaps in HIV care and treatment related supplies and equipment.

InFY08, CCP/ARC has helped to install dial-up Internet connectivity at 39 hospitals in three regions and has

been providing technical assistance to hospitals by overseeing the introduction of Internet connectivity at

100 hospitals nationwide, a move which will allow for more effective data collection on HIV/AIDS services as

well as potential for enhanced information exchange with and support to providers working in HIV/AIDS

services. This also supports capacity building at the regional level, through deepened collaboration between

regional HAPCOs, hospitals, and regional AIDS Resource Centers.

In FY 09, CCP/ARC will bring the utilization of the "Fitun" Warmline to full fruition and potentially integrate

and strengthen ART related health areas such as Family Planning and maternal and child health. CCP/ARC

will continue to provide technical assistance for health facilities on the use of the Fitun Warmline, including

increase in demand for the phone service and website; ARC/CCP will approach this through promotional

and advocacy activities and provider feedback on how to make the Fitun services even more user friendly;

knowledge management and monitoring of use, good team management; refresher trainings and flexible

scheduling to prevent staff burn-out and attract the best talent for this particular service; strong networking

with all university partners, government and private sector health centers to reach all ART hospitals and

health centers in need; fully operational logistics management and gap analysis with a proven way of

reporting back to partners and funders. In FY09, CCP/ARC will support the following key activities:

oIncrease internet access for 19 hospitals and 100 health centers

oProvide phone access for 100 hospitals and 150 health centers to overcome the biggest barrier to use of

the Fitun Warmline services

oExpand service hours from 8am up to 7 pm on call night shifts

oHire more staff including admin assistant and specialist consultation

oExpand to other HIV treatment and care related health fields such as Reproductive

Health (Family Planning), Maternal and Child Health including training for staff and

focal persons

New/Continuing Activity: Continuing Activity

Continuing Activity: 16584

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16584 10606.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $720,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

10606 10606.07 HHS/Centers for Johns Hopkins 5469 655.07 jhu-ccp $600,000

Disease Control & University Center

Prevention for Communication

Programs

Table 3.3.09:

Funding for Treatment: Adult Treatment (HTXS): $540,000

Public Awareness on ART

ACTIVITY UNCHANGED FROM FY2008

The Johns Hopkins University—Center for Communications Programs' (JHU-CCP) AIDS Resource Centers

(ARC), together with other ART-implementing partners, will undertake national and regional public

awareness activities. With the scale-up of ART services in Ethiopia, and rapid decentralization of the

national program, it is critical to generate awareness among both the general public and high-risk groups in

order to enhance and optimize uptake of services.

In FY07, in concert with the Federal HIV/AIDS Prevention and Control Office's (HAPCO) Millennium AIDS

campaigns, print media about ART have been produced and successfully disseminated. The print materials

were distributed to all regions to enhance the public's awareness level. In FY08, CCP/ARC continued the

development of a comprehensive communication program to support the continuum of HIV/AIDS services

from VCT to PMTCT to ART. This includes development of content for communication materials targeting

people living with HIV/AIDS (PLHA) on ART and eligible for ART, their treatment supporters such as PLHA

Associations and family and friends, care takers of HIV + children and youth, as well as religious leaders

and ART provider. These materials intend to increase the uptake and adherence to ART. In this regard, In

FY08, the following major activities were accomplished in the implementation of the program:

•Finalized 12 ART drug use guides, low literacy materials, SMARTER Client and Provider campaign aimed

at increasing demand for quality services, including Warmline promotion, Smarter provider training module;

10 job aids, client adherence calendar, posters, 1 slide video, 3 radio spots, treatment supporter print

material.

•13 materials adapted and translated into 3 local languages. 500,000 copies printed and distributed through

partners, including regular briefing on materials and.

•Two community conversations on faith based ART-related misconceptions, and Greater Involvement of

PLHA (GIPA) documented and adapted into educational videos and radio spots. Faith-based TOT

curriculum finalized, tested and produced and used in 2 trainings with clergy.

•Conducted literature review and developed communication strategy to specifically aim materials

development at the current uptake challenges.

•Developed and updated a comprehensive ART page on the ARC website and finalized plan and developed

and used monitoring tools to understand challenges with distribution and use of materials.

In FY09, public-awareness activities will be consolidated and scaled up to a greater degree to enhance

demand for ART services, as well as to increase ART service uptake, with particular emphasis on rural

settings. This will contribute immensely to national and regional efforts to prevent the expansion of the

epidemic from urban and semi-urban areas to rural areas, where 85% of the Ethiopian population resides.

In addition to ART for adults, there will be an increased focus on promoting pediatric ART, allowing for a

more holistic communication initiative that truly reflects the treatment options now available in Ethiopia.

Experience gained in generating general awareness about HIV and AIDS in major cities across the country

will be used to organize campaigns and events (e.g., workshops, symposia) to generate awareness about

the ART program. The scale-up of service expansion will require a concomitant increase in awareness

among providers and clients across the country and—most important—among the rural population. Along

with the expansion of ART, intensive work will be done to increase the use of HIV/AIDS services. In

collaboration with the ARC and others, JHU-CCP will continue to develop materials to meet regional needs,

taking cultural and language differences into consideration. In support of this, 2-3 of the most popular ART

promotion materials will be adapted for use in the regions, including translating them into local languages.

JHU-CCP will continue to develop new tools to support community conversation around ART, including a

documentary video and an accompanying discussion guide. In addition, there are plans to continue work to

reach low-literacy audiences in rural and urban areas by printing and distributing "speaking books" that

address a variety of HIV/AIDS treatment themes. ART communication will also play a larger role in both the

national and regional ARC's user-driven services.

The activity will be linked with different USG and non-USG partners, particularly those working in different

regions of the country. It will involve local organizations with proven experience of developing and

disseminating awareness generation activities, including mass media campaigns. They will collaborate with

the US universities and other implementing partners to organize and implement public awareness

campaigns on ART. Awareness campaigns will involve national and local media, mini-media, and other

forms of promotional activities, and will be conducted using various local languages. MOH and HAPCO will

be actively supported to lead activities related to this project in order to build the country's capacity to meet

immediate implementation needs, as well as to sustain the activities in the long term. This will be done in

collaboration with the Community Planning Project and other partners on the ground, and will build

leadership capacity at various levels, including community leaders and associations for people living with

HIV/AIDS, to support activities enhancing ART access and uptake. Technical support will strengthen ART

program activities in hospitals and assist treatment-adherence initiatives. The activities outlined above will

enhance demand and increase effective uptake of the fast-expanding ART services in urban and rural

New/Continuing Activity: Continuing Activity

Continuing Activity: 18872

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18872 18872.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $600,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

Table 3.3.09:

Funding for Prevention: HIV Testing and Counseling (HVCT): $160,000

Creating Demand for Counseling and Testing through Promotional Activities

ACTIVITY UNCHANGED FROM FY2008

COP 08 NARRATIVE:

This continuing activity links to activities AB (ID10386, 10590, 10592 and 10605), Other Prevention (ID

10387 and 10388), Treatment (ID 10606 and 10623), Other Policy (ID 10422, 10423 and 10428) and all

HCT activities.

In view of expanding HIV counseling and testing (HCT) service availability, it is important that public

demand and utilization continue to increase. Since its inception, the Johns Hopkins University/Center for

Communication Programs AIDS Resource Center (CCP\ARC) has not only empowered people to access

voluntary counseling and testing (VCT), but also targeted service providers to provide quality VCT services.

JHU CCP/ARC produced print and multimedia materials encouraging use of VCT and distributed VCT

communication materials to service providers. CCP/ARC also conducted three national VCT Day promotion

campaigns in collaboration with partners. CCP/ARC played a major role in establishing the annual National

HCT Day on the eve of the Ethiopian New Year. As more people and organizations observe HCT Day, use

of services and efforts to improve quality will increase.

In FY08 JHU-CCP designed a communication strategy with participation of 30 prominent organizations

working on HCT in Ethiopia. In consultation with partners selected the theme of the year to focus on youth

between the ages of 18-24. The information was distributed to the regions.

On the VCT day (Sept 10 2008) a mass rally was organized involving 2,000 (two thousand) young people

from the various sub-cities. A huge billboard was unveiled at Public Square in Addis Ababa. Similarly the

regions have conducted events mostly related to community mobilization. Different educational materials

were produced and distributed.

In FY09, CCP/ARC plans to continue promotion via two approaches:

1) Implementation of HCT Day 2009 with local and international partners, in both Addis Ababa and in all of

the regions

2) Development of a long term HIV counseling and testing BCC campaign aimed at increasing quality and

uptake of services

3) Creation of synergy between its HCT promotion activities and those of the Millennium AIDS Campaign

through shared messaging, images, sponsorship, or events

4) Closely work with HAPCO to harmonize with the Ethiopian government's HIV/AIDS social mobilization

strategy

CCP/ARC will continue to support HAPCO and partners for HCT Day 2009 by producing campaign

materials (posters, flyers, radio/TV spots, and newspaper ads), creating web pages, organizing and

coordinating media coverage, and facilitating and providing information through its Wegen Talkline and

Warmline for service providers. CCP/ARC will support HCT Day activities at both the national and regional

levels.

In addition to the HCT Day communication strategy JHU CCP/ARC will support FHAPCO to development of

National HCT communication strategy for the longer-term campaign, which will likely target different

audiences than HCT Day activities (including youth and residents in rural areas) will serve as an important

entry point in HIV prevention and early access to treatment, care and support.

CCP/ARC will promote both VCT and provider-initiated counseling and testing to create demand and

reduce stigma against people living with HIV/AIDS.

The campaign will use traditional and modern channels to develop region-specific promotion messages,

support annual HIV-testing campaigns, lead development of an HCT communications strategy; and support

development of national HIV counseling and testing themes and logos. This campaign will complement

other CCP/ARC activities, including the Betengna Radio Diaries program and other prevention activities

carried out through CCP/ARC's website, as well as materials distribution and outreach at the regional

ARCs. These new mass media and community mobilization activities will be complemented by training

journalists and other partners in HCT reporting and communication. This expanded HCT campaign will be

supported through the addition of key staff.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16583

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16583 10585.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $160,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

10585 10585.07 HHS/Centers for Johns Hopkins 5469 655.07 jhu-ccp $132,000

Disease Control & University Center

Prevention for Communication

Programs

Table 3.3.14:

Funding for Health Systems Strengthening (OHSS): $240,000

IT Clearinghouse Systems Strengthening

ACTIVITY WITH ONLY MINOR CHANGES FROM FY2008

This is a continuation of activity from FY08.This project is designed to expand access to HIV/AIDS

information and services by strengthening the collaboration between the Johns Hopkins Bloomberg School

of Public Health/Center for Communication Programs (CCP) and the AIDS Resource Center (ARC).

CCP/ARC will strengthen existing information systems through building capacity of its partners and national

and regional HIV/AIDS Prevention and Control Offices (HAPCO) to conduct HIV/AIDS programming. This

activity has three interrelated components.

The first focuses on strengthening and maintaining the quality of a multi-target interactive website and

increasing its popularity as part of CCP/ARC's premier virtual information center for HIV/AIDS resources,

including access to online databases and satellite websites. The main CCP/ARC website serves the

national and regional HAPCO by posting policies and guidelines, data, and information, education and

communication and behavior-change communication (IEC/BCC) materials focused on international and

Ethiopia-specific HIV/AIDS issues. The website aims to increase information provision through the ARC on

specific programmatic and thematic areas such as ART, voluntary counseling and testing (VCT), and

PMTCT.

The ARC website (www.etharc.org) is the nation's first comprehensive on-line resource on HIV/AIDS,

sexually transmitted infections (STI), and tuberculosis (TB). It provides stakeholders, policy makers,

university students, teachers, and the general public with the latest HIV-prevention news, events, resources,

and information. The website also provides access to the ARC database for organizations, funding,

materials, conference calendars, PEPFAR-Ethiopia Training Information Management System (TIMS)

summary reports, news, and employment vacancies. These databases, in particular the organization

information and conference calendars, provide a useful means by which to coordinate and network the

different HIV/AIDS organizations and activities in the country. The news, vacancy, conference, and events

databases are updated every week.

In FY07, CCP/ARC continued to strengthen and maintain the www.etharc.org website as well as the ARC

listserv. This included conducting continuous updates to the website's news, vacancy, and publications

postings as well as circulation of news digest via the listserv. Specifically, 670 news items, 153 vacancy

listings and 76 new HIV/AIDS related publications were posted to the website. Thirty-six news digests were

send out weekly via etharc.org's listserv and the website experienced a total of 3,391,840 hits. Other

updates include ART updates and uploading of Betengna Radio Diaries programs which continue to

contribute to the high number of website hits and visitors. Additionally, results from a usability study

conducted in the first and second quarter of this reporting period were used to inform the restructuring and

redesign of www.etharc.org that is currently underway. Furthermore, CCP/ARC designed information

sharing website for CDC partner's activities; developed content for a youth website, and initiated design of

websites for CCP/ARC's Betengna Radio Diaries and Fitun Warmline service center.

The AIDS in Ethiopia Online Database is one of the most popular, interactive online database applications

with useful information on AIDS epidemic in Ethiopia. It presents the trend of HIV/AIDS in Ethiopia from

1982-2008 with charts, indicators, and publications. The people living with HIV (PLWH) website is also a

very useful resource, with resources for living positively and testimonies of HIV-positive people. Regional

HAPCO websites are also hosted on the ARC website, enabling regions to disseminate region-specific

information.

In FY09, JHU/CCP will expand the technical assistance and training to different regional HAPCOs in

addition to the existing ones. This includes providing maintenance and configuration support and training on

how to manage and use new applications and services. In FY09, JHU/CCP will also improve the quality of

services that ARC offers by structuring a manageable and hierarchical network by replacing the old network

switches with new intelligent switches, replacing the cascaded old network topology with hierarchical

standard network which will have core, distribution and access layer and establishing a redundant core for

the network for high availability and performance. Further, an effort will be made to establish a full fledged

datacenter with a capacity of supporting central and regional resource centers. This will be done by

establishing air conditioned datacenter with enough space for the available servers, adding new servers to

split roles between servers and upgrading server operating systems to latest operating systems for security

and compatibility; upgrading the IT structure such as the storage servers, internet connection and

bandwidth to comply with the growing file sizes, number of employees and heavy traffic of data.

In this activity, the ARC website will also be modified in terms of content and look to include WebPages for

the Fitun Warmline, Betengna Radio Diaries, MARCH and ABY programs. In order to strengthen the

distribution of IE/BCC materials, CCP/ARC will acquire a new medium-sized heavy duty printing machine to

facilitate the reprinting of various ARC produced and all HIV surveillance materials and guidelines issued by

HAPCO and Ministry of Health. This will also support the need to establish mini-resource centers in high

schools, universities and development agencies.

In FY09, CCP/ARC will also continue maintaining the clearinghouse database. It will deploy to the main

database server and make resources available by posting them on CCP/ARC website. This will allow

materials to be searched for distribution through an online material ordering system. In order to reach

people with visual impairment, CCP/ARC will also acquire an embosser and other related hardware &

software to produce Braille materials on HIV/AIDS that will enable ARC to reach marginalized populations

especially visually impaired.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16585

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16585 10422.08 HHS/Centers for Johns Hopkins 7474 655.08 Expansion of the $240,000

Disease Control & University Center Wegen National

Prevention for Communication AIDS Talkline

Programs

and MARCH

Model Activities

10422 10422.07 HHS/Centers for Johns Hopkins 5469 655.07 jhu-ccp $200,000

Disease Control & University Center

Prevention for Communication

Programs

Table 3.3.18:

Cross Cutting Budget Categories and Known Amounts Total: $385,000
Human Resources for Health $180,000
Human Resources for Health $97,500
Human Resources for Health $107,500