Summary

In FY09, the new TWC curriculum will be rolled out with the completion of the adaptation and the training of

Field Managers and Peer Educators in the new content and its delivery. The new curriculum more

thoroughly addresses local risk and protective factors such as transactional sex, sexual coercion, cross-

generational sex, multiple concurrent partnerships, individual risk planning, and gender equity. The primary

target populations are primary and secondary students and out-of-school youth including orphan and

vulnerable children (OVC), restavec (marginalized domestic servants), and street youth ages 10-24 with a

focus on youth ages 15-19. TWC works through HRC branch offices in the following seven geographic

areas: Pétionville, Cité Soleil, Petite Goâve, Cap Haitian, Fort Liberté, Ounaminthe and Anse-à-Pitres.

Background:

TWC is a track 1 ABY program active in two other countries (Tanzania and Guyana) in addition to Haiti.

The project has been operational in Haiti since June 2004 and works in close collaboration with the Haitian

Ministry of Health and National AIDS Program (MSPP/UCC) and has recently established a partnership with

the Haitian Ministry of Youth. TWC is implemented in Haiti by the Haitian Red Cross which is a local

(indigenous) organization founded over 75 years ago. Curriculum and adult outreach interventions directly

address cross-generational sex, multiple sex partners and early sexual initiation norms and behaviors. The

project is currently seeking to improve female youth's access to life and job skills.

Activities and Expected Results:

Activity 1:

In FY09, the new TWC curriculum will be rolled out with the completion of the adaptation and the training of

Field Managers and Peer Educators in the new content and its delivery. The new curriculum more

thoroughly addresses local risk and protective factors such as transactional sex, sexual coercion, cross-

generational sex, multiple concurrent partnerships, individual risk planning, and gender equity. The new

curriculum will also increase interaction between youth participants (of curriculum-based sessions) and their

peers through the curriculum's built-in series of four take home assignments which include sharing key

TWC messages, facts, and skills through the use of: a decision making tool; IEC materials identifying risk

factors for HIV infections; referrals and site-visits to local sexual and reproductive health services; and role-

playing to resist pressure and to communicate assertively. The TWC program will continue to enhance

efforts to conduct follow-up interventions (FUI) through the roll out of guidelines that provide direction on

shaping the the content of follow up activities to meet the needs of local communities based on analysis

from our pre/post test database system, qualitative feedback from youth, and other relevant research. In

FY09 and FY10, the project will reach 70% of all youth who completed the initial TWC curriculum with one

or more FUIs. The project will continue to emphasize a focus on non-traditional youth by reaching 15% of

youth from this category.

TWC will increase its training and oversight of Field Managers through quarterly supervision visits, and will

offer specific training to Field Managers to improve their outreach to Community Councils and Town Hall

Meetings and to better address the needs of stakeholders and community members. To date, TWC has

reached over 320,000 youth with AB messages, and trained over 310 individuals in Haiti. Volunteer

retention rates for Peer Educators exceed 80%.

Activity 2:

In order to build the capacity of the HRC to manage and expand youth HIV prevention projects, the ARC will

continue to provide organizational development trainings and technical support for key areas including

volunteer management and training, project planning, finance and compliance, monitoring and evaluation

and curriculum adaptation. TWC uses partnership building as another main capacity building tool, allowing

the HRC to learn from and leverage each partner's expertise in the domain of HIV prevention, care and

treatment. Common goals, strategies and messages are established and duplication of efforts is reduced,

leading to a more efficient and rational use of project resources. The TWC project will maintain its existing

partnerships with MSPP/UCC, FOSREF, and PSI as well as the Emergency Plan BCC cluster group. In

addition, the project intends to forge new, multi-sectoral relationships with IDEJEN in order to provide TA on

HIV prevention, reach greater numbers of out-of-school youth and ensure TWC project beneficiaries obtain

better life and job skills and economic opportunities to better address economically driven risk factors.

Activity 3:

To enhance the community environment for the adoption of safer sexual practices, the TWC project will hold

town hall meetings reaching over 1,000 adults and form at least one community council at each project site.

Community is defined here as adult stakeholders who influence directly or indirectly the environment in

which youth live and make safe or unsafe sexual decisions. These adult stakeholders include parents and

teachers as well as religious and secular community leaders from the public, non-governmental, informal,

faith based and private sectors. The project uses town hall meetings to inform, seek the permission to

conduct sexual education activities, and solicit direct involvement of these adult stakeholders in the fight

against HIV/AIDS and in the safer reproductive lives of youth. Project staff works with local community

councils and organizations such as school administrations on day to day project implementation. Examples

of direct community council engagement include help in planning TWC workshops in schools, consensus

building on appropriate messaging for younger youth, in-kind contributions to project activities, promoting

TWC sessions via letters to parents, and offering feedback after observing project activities- the greater the

community involvement and ownership, the greater the sustainability of the program.

New/Continuing Activity: Continuing Activity

Continuing Activity: 19566

Continued Associated Activity Information

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

System ID System ID

19566 19566.08 U.S. Agency for American Red 8889 8889.08 $200,000

International Cross

Development

Table 3.3.02:

SUMMARY:

The activities in this country-funded concept paper are new, and represent both an expansion in geographic

and programmatic scope. Specifically, the three new activities entail scaling up core TWC activities

(curriculum based interventions, peer to peer outreach, and eductainment events as well as partnership

building, capacity building and the engagement of adult stakeholders) through expansion to two new sites in

Nippes and the North West; free condom distribution; and promoting adult-child communication. TWC's

emphasis area is gender (through outreach that addresses male norms and behaviors and increases

gender equity in HIV/AIDS programming). The primary target populations are primary and secondary

students and out-of-school youth including OVC, restavec (marginalized domestic servants) and street

youth ages 10-24 with a focus on youth ages 15-19. TWC will work through HRC branch offices in the two

new sites in Nippes and the North West, as it does already in seven current geographic areas which include

Pétionville, Cité Soleil, Petite Goâve, Cap Haitian, Fort Liberté, Ounaminthe and Anse-à-Pitres.

BACKGROUND:

TWC is a track 1 ABY program active in two other countries (Tanzania and Guyana) in addition to Haiti.

The project has been operational in Haiti since June 2004 and works in close collaboration the Haitian

Ministry of Health and National AIDS Program (MSPP/UCC) and has recently established a partnership with

the Haitian Ministry of Youth. TWC is implemented in Haiti by the Haitian Red Cross which is a local

(indigenous) organization founded over 75 years ago. The project addresses gender issues through

assuring that 50% of their staff from project coordinators to peer educators are female, and through

ensuring that outreach addresses both female and male norms, and resonates with both female and male

participants. Curriculum and adult outreach interventions directly address cross-generational sex, multiple

(concurrent) sex partners and early sexual initiation norms and behaviors.

ACTIVITIES AND EXPECTED RESULTS

Activity 1: Addition of 2 new TWC Project Sites in order to increase the protective knowledge, attitudes, and

skills among an additional 13,142 youth in FY09 and 10,877 in FY10.

Building on TWC's strong track record for success since 2004, exceeding its five year goal in year three

while continuing to improve program quality, TWC will expand into the North-West and Nippes regions.

Drawing on a base of branch offices with active youth an adult volunteer networks, HRC will recruit 2 FMs in

each region who will establish the TWC regional presence and programming through an existing branch

office. In turn, with support from the head office, the FMs will hire 20 PEs in each site to operate in the

larger vicinity spanning two of the four targeted cities in Nippes, and two of the five targeted cities in the

North West.

With the addition of these new sites, TWC will reach over 20,000 youth through curriculum, peer-to-peer,

and edutainment outreach activities over the 21 month period in FY09 and FY10. Due to ARC's strong

partnerships with organizations serving high risk youth such as IDEJEN, over 15% of these beneficiaries will

be non-traditional youth between the ages of 13-24, a category that includes high risk youth such as

orphans, restavek (marginalized domestic servants), street children, and out-of-school youth. The

remainder will be in-school youth.

ACTIVITY 2:

Building on TWC's provision of complete information around condom use and negotiation to its youth

beneficiaries in accordance with Emergency Plan ABC guidance, including the recent new addition of a take

home activity in the new curriculum whereby beneficiaries locate and visit condom sales pints and other

reproductive and sexual health services, TWC plans to increase the demand for and access to condoms by:

increasing the reliable supply of condoms through supplying free condoms through Together We Can

(TWC) project activities as well as at Haitian Red Cross branch offices; and better integrating a Behavior

Change Communication (BCC) approach around condoms into TWC programming through disseminating

Haitian Red Cross (HRC) Information Communication & Education (IEC) materials in coordination and

harmonization with partner organizations

At the branch level, HRC will work with local partners to facilitate a planning process for the dissemination of

condoms and BCC materials (by conducting community meetings with the participation of community

councils, HRC branch staff, volunteers, and potential private sector and CSO partners who together can

determine the best approach for making condoms available to the community).

Additionally, Peer Educators (PE) will increase self-efficacy of TWC participants by providing reliable

sources for male condoms and BCC messages at TWC sessions follow up activities, community

mobilization and edutainment events. Where needed, condoms will be distributed as part of a knowledge

and skills-building activity that advocates the twin TWC messages of risk reduction and risk elimination

through promoting ABC approaches to prevent HIV, STIs, and unintended pregnancy/parenthood. By doing

so, PEs, while typically at least 3 years older than the youth they target, will be promoting positive peer

norms and support for condom and contraceptive use, a positive determinant for condom use, and a

protective factors against HIV, STIs, and unintended pregnancy and parenthood.

Consistent with these messages, PEs will give out BCC materials in the form of a newly produced brochure

that features leading Haitian singer Belo, and key messages designed to personalize risk and spur action

along the lines of A, B, or C.

ACTIVITY 3:

The ARC and HRC will use their expertise in community mobilization and curriculum design to enhance

community based outreach to adults in order to improve adult-youth communication around sex and

contraceptives. In FY10, the ARC and HRC will train 1500 youth and 1500 adults/parents in a new three-

day adult-youth communication curriculum recently rolled out by the ARC in Tanzania which features a mix

of youth-only sessions, adult-only sessions, as well as combined intergenerational activities — all which

Activity Narrative: complement and build on one another. Participants include youth who have completed TWC workshops,

who then in turn invite an influential adult in their lives to attend the workshop. These adults can be parents,

aunts or uncles, teachers, or older brothers and sisters.

In addition to providing the means for protection (condoms), promoting parent (or trusted adult)-youth

communication aims to enhance the protective factor of prevention of HIV, other STIs, and unintended

pregnancy by strengthening parents/adults' ability to communicate adequately with their children about

these topics. In each branch, FMs will be trained in the merits of parent/adult-youth communication and the

specific strategies for encouraging effective communication. Specifically, FMs - representing the generation

between the parent/trusted adult and child - will be trained in delivering a two to three day curriculum to a

group of 10-20 parent/trusted adults and youth (with youth and parents/trusted adults coming together for a

joint activity on the second/third day) on a monthly basis. Curriculum content addresses the following topics:

raising awareness among adults about the sexual risks youth face; encouraging general effective mentoring

practices; improving adult-youth communication; and promoting beneficial social and gender norms.

Key areas of legislative interest addressed under these three activities are: stigma and discrimination; and

gender through addressing male norms and behaviors, increasing gender equity, and reducing violence and

coercion particularly as it relates to inter-generational and transactional sex. These results contribute to the

Emergency Plan 2-7-10 goals by preventing new HIV infections among Haitian youth through the

improvement of knowledge, attitudes and skills pertaining to HIV/AIDS, as well as access to commodities

and services.

New/Continuing Activity: Continuing Activity

Continuing Activity: 19569

Continued Associated Activity Information

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

System ID System ID

19569 19569.08 U.S. Agency for American Red 8889 8889.08 $150,000

International Cross

Development

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: