This is a new award with single eligibility for the Addis Ababa HIV/AIDS Prevention and Control Office (AAHAPCO), an indigenous prime partner implementing two model voluntary counseling and testing (VCT) centers since March 2001 in collaboration with the Organization for Social Services for AIDS (OSSA) and the Addis Ababa Health Bureaus Zewditu Memorial Hospital. Direct USG funding to an indigenous governmental partner optimizes cost-efficiency and promotes sustainability. The AAHAPCO works in close collaboration with the AA Health Bureau to strengthen various HIV/AIDS services. The purpose of this new program is to use these model VCT sites as centers of excellence to demonstrate, replicate best practices of the national VCT program, test innovative approaches to increase uptake and test quality assurance interventions, establish referral and networking systems, and track HTC trends. In addition, the program aims to build technical and institutional capacity of HIV counseling and testing service providers in an environment of high staff turnover. Care and support services are built on a continuum of care model, incorporating psycho-social, nutrition, and spiritual care, and will be delivered in two service outlets in Addis Ababa. Referral linkages will be strengthened with hospitals for care and support services and nutrition support, literacy, and other resources in the community. The program is aligned with the goals of the GOE and USG HIV/AIDS Partnership Framework and Global Health Initiative. AAHAPCO regularly conducts supportive supervision visits to each program site and has in place a system to routinely monitor program performance.

Under COP2012, the program will serve as the prime partner to the Organization for Social Services for AIDS (OSSA) Addis Ababa branch to implement and expand the palliative care programs to PLHIVs enrolled at health facilities in Addis Ababa. To increase the continuum of care services, the OSSA Addis Ababa branch will use funds from this program via a sub award to establish and strengthen community-based service outlets for nine public and 14 private hospitals and 27 health centers in Addis Ababa. These community based service outlets link PLHIVs in need of clinical care to facilities for which the service outlets are designated to serve. These outlets also receive PLHIVs referred from the various nearby facilities to provide care and support services. It organizes forums with religious organizations to obtain spiritual counseling services in order to address the major life events that cause people to question themselves, their purpose and their meaning in life. The service outlets participate in the multidisciplinary catchment area meetings in order to facilitate referral systems. It works closely with urban HEWs, case managers, adherence supporters and volunteers to trace LTFU PLHIVs in their respective catchment areas. Each service outlet will have key performance measurement indicators and will review these on a regular basis to assess and compare its achievements. The service outlets assist HIV-positive persons to disclose test results to sexual partners and family members and encourage HIV testing for couples and families. Service outlets provide preventive and supportive post-test services for HIV positive couples through peer support groups. These service outlets will also engage PLHIVs in different income generating activities and vocational trainings with special emphasis on women and girls.

The new program will continue supporting national model VCT sites with a special focus on couples, family, child counseling, disabled and MARPS. The sites currently provide VCT services to more than 50,000 individuals and couples. Couple testing increased from 4% to 23% since 2010. Through "door to door" testing and counseling services via outreach mobile units, more first time testers and females are being reached. Under COP2012, the program will continue to provide VCT services at the two national model centers and via mobile units and satellite sites. The existing satellite VCT sites will be graduated to become self-sustaining. Mobile VCT services will be targeted to schools, business/commercial places, work places, and markets in and around Addis Ababa. All client information will be entered into a computer system and used to generate reports for national and USG reporting. The program will document best practices of the two model VCT sites and share them with other relevant organizations that are offering similar services. The program will strengthen the quality of VCT services through mentorship, and case conference. In collaboration with the regional laboratory, the program will work to ensure quality HIV testing at the centers and support the sites with burnout management and refresher training. The model centers in collaboration with partners will provide short-term training on management and supervisory skills for VCT project coordinators and senior counselors. The centers will start to provide basic counseling training in collaboration with AA Health Bureau and conduct regular management meetings with site coordinators to review the progress with site level implementation. Regular VCT promotions will be conducted using different media to increase use of services. The program will organize special events during world AIDS day and HCT day and encourage people to test as couples and with their family members, as well as the program will use community VCT promoters including community conversation facilitators and anti AIDS club to promote VCT.