This is a continuing activity. Johns Hopkins Center for Communication Programs/AIDS Resource Center (JHU/CCP) works closely with the AIDS Resource Center and other partners to implement a behavior change communication (BCC) and stigma reduction program that actively reaches out to and engages people. JHU/CCP has helped to design and implement BCC programs including multi-media youth interventions, Dagu radio program, 'Dagu Net' and 'Dagu Kit'; maternal and child health campaigns with a focus on PMTCT, and strategies that address gender norms and multiple concurrent partnerships. JHU/CCP provides technical assistance on behavioral interventions targeting highly vulnerable population including uniformed services to partners implementing comprehensive peer education using the Modeling and Reinforcement to Combat HIV/AIDS (MARCH) approach with the National Defense Forces, the Federal Police, and local Universities. In addition, the aim of this program is to increase the use and improve the quality of ART counseling services and strategic behavioral interventions as a main piece of biomedical interventions. JHU/CCP has in place a system to regularly monitor and report on program performance and uses lessons learned from prior years of implementation to further guide program implementation. The JHU/CCP program supports the goals of the GOE's National Strategic Plan II (SPMII) and is aligned with the goals of the GOE and USG HIV/AIDS Partnership Framework and Global Health Initiative.

HIV testing and counseling (HTC) services are now available in all regions of Ethiopia. Given that the epidemic is mixed and heterogeneous with marked regional variations, HTC services are targeted to both general and most-at-risk populations (MARPS), however in the case of the latter, these populations have difficulty accessing services. An increase in the demand and utilization of HTC is imperative at this stage in the epidemic. Better and more targeted communication strategies are needed to increase access to and uptake of HTC among hard-to-reach populations. In the past, CCP/ARC contributed to the increased demand for and the quality of HTC by providing targeted multi-channeled communication materials. In addition, JHU/CCP played a major role in establishing the annual National HTC Day on the eve of the Ethiopian New Year, and since then, has coordinated the last six national HTC Day campaigns in Addis Ababa and in each of the regions of Ethiopia. The number of people reached through community wide events in 2010 campaign was around 4 million. JHU/CCP will continue to support the GOE in promoting and coordinating HTC Day at national and regional levels by producing campaign materials, and organizing and coordinating media coverage. JHU/CCP will strengthen campaign efforts by developing promotional messages for a variety of target audiences. In support of the GOE's leadership on the campaign, JHU/CCP will assist with the development of an operational plan to more efficiently implement the campaign. The plan will be monitored and feedback solicited from stakeholders and participants to improve quality control. HTC campaign activities in selected towns and locations will be targeted to identified hot spots with higher HIV prevalence. In these areas, JHU/CCP will target MARPs and couples to increase uptake of HTC. JHU/CCP will utilize networks and collaborative relations with the GOE's regional health bureaus and regional HIV prevention efforts to ensure continuity and foster increased ownership of the annual HTC campaign efforts. JHU/CCP will strengthen its monitoring and evaluation system to better respond to the USG new generation indicators.

JHU/CCP will continue to implement the Youth Media Program called "Dagu" reinforced by mini-media activities through trained facilitators in selected high schools. This activity will also include mini-media capacity building to schools and students that engages the anti-AIDS clubs and reproductive health service providers. The target population for Dagu is at-risk youth aged 15 to 24 years. Social topics addressed through Dagu include the risks of using alcohol and chat in relation to HIV/AIDS, multiple concurrent sexual partnerships, use of condoms, and linking to other HIV/AIDS services. Complimenting the Dagu media program will be the development of an HIV/AIDS services directory targeted to youth. To support Dagu program efforts, JHU/CCP will provide TA to improve health education and promotion post-graduate training for health workers at Jimma University. It is envisioned that eventually Jimma University will become a technical support leader in the area of strategic communication and provide technical support to other in-country activities. Another activity that JHU will implement is the Betegna radio diaries, which is an innovative media activity that promotes healthy sexual behavior through sharing interactive real diaries from PLHWA on situations that exposed them to HIV and what could have been done to prevent HIV infection. The target population is the general public, discordant couples and other specific groups based on the diaries developed and disseminated. JHU/CCP will also provides technical assistance to the National Defense Force of Ethiopia, Federal Police commission and Addis Ababa University in their efforts to implement behavioral interventions among specific high risk groups. Please refer to the implementing mechanism details for these partners for specific information on their activities. JHU/CCP is evaluating the MARCH approach, which is being used by multiple USG partner BCC activities. Results from this evaluation will be used to further strengthen USG partner behavioral interventions.

JHU/CCP aims to implement a comprehensive communication program to create demand for quality HIV/AIDS service provision and increase ART adherence. JHU/CCP will generate awareness among the general public and develop communication materials targeted to PLHIV, their caregivers, health providers, and community leaders. Communication efforts will focus on promoting both pediatric and adult ART and will be adapted and targeted to meet regional community needs and promote adherence. JHU/CCP will collaborate with PLHIV associations to strengthen the communication and counseling skills of PLHIV community workers. These capacity-building activities will use existing support systems as springboards to engage PLHIVs in their communities. JHU/CCP will adapt the already successful capacity-building activities with the Ethiopian Orthodox Church and Muslim leaders to other religions. JHU/CCP has developed new tools to support community conversations around ART, including a documentary video and an accompanying discussion guide. In addition, efforts will be made to reach low-literacy audiences. JHU/CCP will collaborate with US universities and other partners to ensure that similar activities are coordinated and duplication of efforts is minimized. The Federal MOH will be actively supported to lead activities related to this project in order to build local in-country capacity and sustain activities in the long-term.