Linked to Activity 9260

SUMMARY: This activity builds upon previous SMARTWork efforts, as well as linking to other prevention and counseling and testing services in-country. Activities will support expansion of prevention and voluntary counseling and testing (VCT) mobilization efforts targeting workforce populations through key critical activities: working with enterprises to establish workplace programs with anti-stigma policies; working directly with workers to provide them with behavior change prevention information about fidelity, secondary abstinence, and partner reduction. These activities are conducted through workplace channels where workers are reached through unions and enterprises using workshops, information, education and communication (IEC) materials, special events and ongoing outreach. About 86% of this activity is funded through the OP budget BACKGROUND: Initiated in 2002, Strategically Managing AIDS Responses Together in the Workplace (SMARTWork) fosters social dialogue around workplace HIV/AIDS prevention at national and enterprise levels, and fosters stigma and discrimination reduction. Taking a bipartite (business-labor) approach at the enterprise level and a tripartite (business-labor-government) approach at the national level, SMARTWork works to reduce HIV transmission through effective prevention programs, and encourage policies that provide for workplace protection and human rights of individuals affected and infected by HIV. SMARTWork has assembled a multi-sectoral group of implementing partners who will work together (unions, enterprises, and the Haitian government through the ministries of Health, Education, and Labor) to promote behavior change through prevention education and outreach. Currently, SMARTWork conducts prevention activities through workshops, outreach, dissemination of IEC materials, and ongoing technical support through health educators to businesses and unions. The workplace is a critical channel to provide HIV/AIDS and sexually transmitted infection (STI) prevention interventions. SMARTWork does this through workshops, outreach, and special events using a core group of trainers and outreach workers to deliver messages that foster fidelity, secondary abstinence, and partner reduction. Complementing and reinforcing these messages are workplace policies, IEC materials, and referrals to counseling and testing, STI, and care and treatment services. In FY 2007, there will be a greater emphasis on targeted evidence-based interventions to foster behavior change around fidelity, secondary abstinence, partner reduction, mutual monogamy to prevent HIV infection and transmission. FY 2007 activities will include technical assistance to private sector enterprises to establish workplace HIV/AIDS and STI prevention policies and to translate those policies into other prevention programs for employees. Other behavior change communication (BCC) messages and materials designed by the USG BCC Cluster and endorsed by the MOH, will be adapted to target specific HIV/AIDS and STI prevention needs of segments of the workforce, depending on their occupations, ages, gender and other risk factors. A key component of the intervention will be to encourage workers and their partners to access counseling and testing, STI, and other prevention services. For those testing positive or in need of STI treatment or treatment of opportunistic infections (OIs), referral mechanisms will be in place so that employees can easily access USG-supported sites where quality STI/HIV/AIDS care and treatment services are available. Linkages will also be made to other prevention and reproductive health and family planning services.

ACTIVITES AND EXPECTED RESULTS: Activity 1: SMARTWork will develop a "manly man" strategy that is culturally appropriate to Haiti but emphasizes that "Manly Men" are sexually healthy by reducing the number of partners and preferably are faithful to one partner. These activities will be implemented in male-dominated workplaces such as bottling companies and light manufacturing plants. The campaign will work to build upon positive aspects of male identity and combine these with HIV/AIDS behavior change messages that begin with self-risk assessment and move to developing risk reduction strategies. This activity will be done in close collaboration with the USG BCC Working Group.

Activity 3: SMARTWork will develop an IEC campaign for the transport sector which will include working with key informants identified by the drivers who are already existing resources of information on fuel, food, and repairs at fuel and rest stops along transit routes to communicate critical behavior change messages. These key leaders will receive training and IEC materials from SMARTWork and encourage greater attention to self-risk assessment and risk reduction strategies. To complement this activity, SmartWork

proposes developing a "Transit Tunes" activity where popular local Haitian music is interspersed with behavior change messages (e.g. fidelity, secondary abstinence, reducing partners, changing social norms). There will also be dissemination of IEC materials such as pamphlets and leaflets with key prevention messages contained in them. Activity 4: SMARTWork will work to build upon its experience with female workers to target them with key IEC messages that emphasize women's empowerment, second abstinence and fidelity messages to protect themselves from HIV transmission.

Monitoring and Evaluation of these activities including data collection, use, quality and feedback will also be a continued and focused effort in FY07.

Linked to Activities 9258, 9346, 9322, 11058.

SUMMARY: This activity builds upon previous SMARTWork efforts, as well as linking to other prevention and counseling and testing services in-country. Activities will support expansion of prevention and voluntary counseling and testing (VCT) mobilization efforts targeting workforce populations through key critical activities: working with enterprises to establish workplace programs with anti-stigma policies; working directly with workers to provide them with behavior change prevention information about fidelity, partner reduction, and consistent condom use (including condom distribution) as well as HIV counseling and testing promotion. These activities are conducted through workplace channels where workers are reached through unions and enterprises using workshops, information, education and communication (IEC) materials, special events and ongoing outreach. About 14% of this activity is funded through the AB budget

BACKGROUND: Initiated in 2002, Strategically Managing AIDS Responses Together in the Workplace (SMARTWork) fosters social dialogue around workplace HIV/AIDS prevention at national and enterprise levels, and fosters stigma and discrimination reduction. Taking a bipartite (business-labor) approach at the enterprise level and a tripartite (business-labor-government) approach at the national level, SMARTWork works to reduce HIV transmission through effective prevention programs, and encourage policies that provide for workplace protection and human rights of individuals affected and infected by HIV. SMARTWork has assembled a multi-sectoral group of implementing partners who will work together (unions, enterprises, and the Haitian government through the ministries of Health, Education, and Labor) to promote behavior change through prevention education and outreach. Currently, SMARTWork conducts prevention activities through workshops, outreach, dissemination of IEC materials and condoms, and ongoing technical support through health educators to businesses and unions. The workplace is a critical channel to provide HIV/AIDS and sexually transmitted infection (STI) prevention interventions. SMARTWork does this through workshops, outreach, and special events using a core group of trainers and outreach workers to deliver messages that foster fidelity, partner reduction and condom use. Complementing and reinforcing these messages are workplace policies, IEC materials, condom distribution, and referrals to counseling and testing, STI, and care and treatment services. In FY 2007, there will be a greater emphasis on targeted evidence-based interventions to foster behavior change around fidelity, partner reduction, mutual monogamy, correct and consistent condom use, and counseling and testing to prevent HIV transmission and promote knowledge of serostatus. FY 2007 activities will include technical assistance to private sector enterprises to establish workplace HIV/AIDS and STI prevention policies and to translate those policies into other prevention programs for employees. Other behavior change communication (BCC) messages and materials designed by the USG BCC Cluster and endorsed by the MOH, will be adapted to target specific HIV/AIDS and STI prevention needs of segments of the workforce, depending on their occupations, ages, gender and other risk factors. A key component of the intervention will be to encourage workers and their partners to access counseling and testing and STI services. For those testing positive or in need of STI treatment or treatment of opportunistic infections (OIs), referral mechanisms will be in place so that employees can easily access USG-supported sites where quality HIV/AIDS and STI care and treatment services are available. Linkages will also be made to reproductive health and family planning services.

ACTIVITES AND EXPECTED RESULTS: Activity 1: SMARTWork will leverage union partnerships by providing technical assistance to Haitian union confederations to establish union-based prevention activities using union gatherings, and written communication materials to expand SMARTWork's efforts to reach all 10 Haitian departments. The labor unions all have well-developed communications channels (written, ongoing meetings, and regular gatherings) and can rapidly and effectively communicated key prevention messages to a broader audience of union members and officials outside of the capital city. Specifically, SMARTWork will engage with union leaders and union members as a primary channel for conducting behavior change outreach activities. These activities will be linked to USG-supported counseling and testing sites including PSI's planned mobile services as well as STI treatment. Activity 2: SMARTWork will develop a "manly man" strategy that is culturally appropriate to Haiti but emphasizes that "Manly Men" consistently and correctly use condoms, do not abuse alcohol and drugs, reduce the number of partners, and preferably are faithful to one

partner. These activities will be implemented in male-dominated workplaces such as bottling companies and light manufacturing plants. The campaign will work to build upon positive aspects of male identity and combine these with behavior change messages. This activity will be done in close collaboration with the USG BCC Working Group. SMARTWork is partnering with other PEPFAR partners in country and the USG Team to ensure condoms are available across all prevention activities. Activity 3: SMARTWork will develop an IEC campaign for the transport sector which will include working with key informants identified by the drivers who are already existing resources for information on fuel, food, and repairs at fuel and rest stops along transit routes to communicate critical HIV/AIDS behavior change messages. These key leaders will receive training and IEC materials from SMARTWork and encourage greater attention to self-risk assessment and condom use. To complement this activity, SmartWork proposes developing a "Transit Tunes" activity where popular local Haitian music is interspersed with behavior change messages (condom use, risks of concurrent partnerships, and counseling and testing and STI service locations along key transit routes). There will also be dissemination of IEC materials such as pamphlets and leaflets with key prevention messages. Activity 4: SMARTWork will work to build upon its experience with female workers to target them with key IEC messages that emphasize women's empowerment and usage of condoms and key negotiation strategies to protect themselves from HIV transmission. Monitoring and Evaluation of these activities including data collection, use, quality and feedback will also be a continued and focused effort in FY07.

Llinked to Activities 9260, 9362, 9360.

SUMMARY: In FY 2007, SmartWork will expand its existing counseling and testing (CT) services from three sites targeting workers to five sites to serve workers at the Carrefour Industrial Park, drivers registered at the Drivers Union (DU), and members of the School Teachers Associations (STA).

BACKGROUND: One of the challenges in Haiti has been limited access to counseling and testing services targeted specifically at workers and industrial areas. In FY 2006, the USG Team funded SMARTWork to develop and maintain three (CT) centers targeting workers. SMARTWork will continue, in FY 2007, to provide operational support to these three centers and promote CT among workers of the formal business sector and also will expand to establish two additional centers to provide counseling and testing services for the informal sector in Carrefour and downtown Port-au Prince.

ACTIVITIES AND EXPECTED RESULTS: Activity 1: SMARTWork will expand its counseling and testing services from three sites to four sites in order to scale up access to counseling and testing services and build upon the momentum of the project's prevention efforts as well as the growing momentum of care, treatment and support services in Haiti. For the two additional sites, SMARTWork will be responsible for the minor refurbishing to adapt the space at these locations in order to meet counseling needs for privacy and confidentiality; it will also pay the rental fee for the space made available by the DU and the STA in their respective buildings. SMARTWork will develop a referral system that will link these CT centers to antiretroviral treatment (ART) and palliative care and support services in the metropolitan area for those who test positive as well as provide post-test counseling to ensure that those tested have adequate prevention information as well. Post-test counseling will include risk reduction counseling, encouragement to have partners tested and counseling for discordant couples, as appropriate. A peer counseling network will be encouraged through the facilities. The services will be available to workers as well as their partners and primary contacts. Staff for the new CT sites will be trained at the I-TECH/INHSAC training program (see ITECH CT activity.)

Activity 2: Work closely with efforts to be carried out by USG partner Futures Group/Health Policy Initiative to encourage employing institutions to adopt antidiscrimination policies for HIV positive workers.

This activity will contribute to the PEFAR 2-7-10 goals by increasing the number of people who are tested, receive their results, and are linked to care, treatment and support services as well as receiving post-test counseling to ensure strengthened prevention.