The overall goal of the Agriculture Market Development (AMD) wrap around program is to support OVC,caregivers, and PLHIV households to build assets, income and livelihoods through agricultural economic strengthening activities to increase resiliency to the socio-economic effects of HIV/AIDS. This is aligned with the GHI strategy to increase linkages with other sector programs and wrap-around opportunities including agriculture and FtF. AMD addresses the cross-cutting areas of income generation and gender. Coverage areas will be in 82 Woredas in the Amhara, Tigray, Oromia and SNNPR regions, selected based on the presence of booming business centers and high-volume agriculture production areas that attract a high influx of migrant workers during peak agricultural harvest periods. Objectives include: 1) Increasing livelihood opportunities (i.e. IGA) for households affected by HIV and AIDS; 2) Strengthening referral linkages with HIV/AIDS community service providers for economic strengthening activities 3) Increasing HIV/AIDS prevention knowledge in agricultural communities -with an emphasis on high-risk time periods and populations and 4) Incorporating economic risk reduction into livelihoods programs through program implementation methods. HH-level beneficiary needs assessments will be conducted by the CBO focal persons and support provided based on agreed upon criteria including HH food security, poverty indicators including assets and whether the HH is affected by HIV/AIDS. Existing community groups will be targeted for implementation through a small grants program. In addition, efforts will be made to address gender gaps in accessing livelihood and economic strengthening activities. 1 new vehicle is needed to support program implementation.

The AMD program provides economic strengthening/livelihood activities for HIV-infected adults and their families (PLHIV), OVC, caregivers and their households through social support via income generating activities (IGAs) in the agriculture sector. This program operates at the community level in urban and peri-urban areas in four regions (Amhara, Oromia, Tigray, and SNNPR) where HIV/AIDS prevalence is high. It will contribute to the Partnership Framework universal access goal by providing economic support and contributing to goals to reduce socioeconomic impacts of HIV by reaching more than direct beneficiary 1,000 households. CBO focal persons will be trained to engage PLHIV and OVC households in IGAs through standardized economic strengthening. These focal persons will then identify beneficiaries and refer them to IGAs that best accommodate their interests in order to promote ownership. Since women/females play a lead role in facilitating family member access to health care and social services, ACDI-VOCA in coordination with selected local NGOs and CBOs will ensure at least 60% of beneficiaries are female. The agriculture IGA activities will be embedded within an agriculture value chain approach to ensure that no single IGA is promoted without market demand. Four commodities will be focused on for value-chain includes coffee, wheat, maize and oil seeds. In coordination and collaboration with the other USG nutrition and FTF partners job aids and 1-2 page briefs will be developed to provide guidance for CSOs and agriculture stakeholder on how to implement IGAs. High impact, realistic IGAs that increase food security and nutrition status of the households will be implemented. AMD integrates with other USG-supported partners to improve linkages to other HIV services. For sustainability, CBO focal persons are given additional capacity building so that local CBOs can assume full activity responsibility in the future. ACDI/VOCA will be involved in the development of the referral forms to ensure correct ES indicators and data collection. M & E includes quarterly review meetings with the FMOH and implementing partners as well as regular meetings to discuss monthly indicators, program challenges and solutions.

ACDI/VOCA reaches highly vulnerable individuals concentrated in 82 woredas of 4 regions at the community and household levels. This funding will target behavior change for at risk youth and clients of commercial sex workers, permanent and seasonal farm laborers and local leaders. In and out of school youth (15-24 yrs) from higher education and secondary school students are more likely to engage in higher risk sex and HIV prevalence among women 15-19 years is three times higher than men. Female Sex Workers (FSW or CSW)-females who regularly or occasionally trade sex for money in drinking establishments, night clubs, local drink houses, chat and 'shisha' houses, 'on the street', around military and refugee camps (female). Clients of FSWs are diverse and include truck drivers, field workers, migrant workers, etc. Whenever CSWs are targeted their clients behaviors also need to be addressed. The HVAB funding will be primarily used to support a community dialogue tool and peer-outreach community activities with targeted messages for behavior change to reduce multiple sex partners, male norms, gender based violence, stigma and discrimination against PLHIV and promotion of positive sexual behavior. ACDI/VOCA staff will train CBO focal persons and community members as peer educators using national curricula on comprehensive HIV prevention. The quality of peer education and communication skills will be assessed using agreed upon tools. The peer educators will target farm laborer households, local leaders and those involved in trade and transportation of agricultural products. There will be regular monitoring to ensure the quality and consistency of comprehensive messages among the targeted populations. ACDI/VOCA will link with existing HCT partners so that AB prevention education efforts can be twinned with mobile CT outreach or referrals and transport to nearby testing sites.

Through the Other Sexual Prevention funding allocations ACDI/VOCA will reach 20,000 high-risk permanent and seasonal mobile workers including farm laborers, local community leaders, youth and the general population. This funding will increases access to prevention services among these groups in 82 agricultural growth woredas. MW are at risk for multiple concurrent sexual partners and are not well integrated into the communities. Peer educators from these groups will be trained in at least 8 intensive sessions on appropriate and consistent use of condom messages, combined STI referral and treatment and promotion of CT services. Peer educators will then conduct outreach with the existing farmers cooperatives, unions and other community agriculture groups. 82 condom service outlets will be established with partners and 5,000 permanent and seasonal farm laborers counseled and tested for HIV and STIs. In order to ensure sustainability, placement of condom distribution outlets will be planned so that it is more likely to remain after USG-funding ceases (commercial shopkeepers, etc.). M & E includes regular monitoring and assessments of the outreach/education with revised tools and joint supportive supervision with the Woreda Health Officer. ACDI/VOCA will actively participate in the food security, soil and water conservation and nutrition TWGs and food insecure households will be linked with other food and nutrition services.