1. LIST OF RELATED ACTIVITIES This activity relates to activities in Counseling and Testing (#8781), (#8777), (#8976), HIV/AIDS Treatment: ARV Services (#8813), (#8826), (#8765), Prevention of Mother-to-Child Transmission (#8764), (#8738), (#8729), and Palliative Care: Basic Health Care and Support (#8934), (#8931), (#8936).

2. ACTIVITY DESCRIPTION The overall goal of the multi-sectoral ROADS Project (branded SafeTStop) is to stem HIV transmission and mitigate the consequences of HIV/AIDS on vulnerable people along major East African transport corridors. There is a high HIV transmission rate among members of mobile populations, i.e. drivers and their assistants and the vulnerable populations of in- and out-of-school youth, OVC and low-income women in these host communities. Especially at cross-border stop-over sites truck drivers can be away from home for two to three months at a time and can be held up for days in customs clearance. Given that the poverty of the host communities is exceedingly high, the prevalence of transactional sexual behaviors involving not only community women but youth and orphaned children is also high. To date, ROADS has worked in 3 sites - Mariakani, Malaba and Busia - to reach over 42,000 youth, women, truck drivers and PLWHA, through nearly 500 peer educators from over 100 community and faith-based organizations (CBOs and FBOs) to convey AB messages with accurate information about available prevention, care and treatment services, and VCT referral and outreach services. ROADS builds the capacity of faith-based youth groups with abstinence-only messages for primary and secondary school students and out-of-school youth through magnet theatre, sports and other community mobilization activities. Faithfulness messages are delivered to truck drivers and the community men and women and married youth. FHI trains CBOs and FBOs to support AB activities and to reduce stigma and discrimination in their communities. Critically important to encouraging faithfulness is creating recreational alternatives for truck drivers and men that can reduce exposure to alcohol. This includes interactive health discussion groups, entertainment in non-alcohol establishments, and practical adult education sessions on topics identified by the truck drivers including managing alcohol consumption, gender-based violence, managing financial resources and road safety as well as referrals to VCT and other health services. ROADS also reduces the economic vulnerability of women and youth through job training and referral to microfinance institutions and thus facilitates abstinence and faithfulness. ROADS engages private sector pharmacists, businessmen, and faith leaders to reach out to men.

In FY 2007, ROADS will continue and strengthen this programming in its existing three sites and expand this programming to Mlolongo, a major truckstop outside of Nairobi where 300+ truck drivers are parked each night and many unemployed, poor women and out-of-school youth are drawn to find money. ROADS will continue to build community cohesion, sustainability and maximize coverage through its innovative "cluster model" that encourages joint program activities by over 100 community groups. Approximately $80,000 will be allocated to CBO clusters of youth and women and the truck driver association.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA ROADS contributes to overall abstinence and faithfulness efforts by implementing practical, effective strategies for helping vulnerable populations act on intentions to remain abstinent or reduce the numbers of casual partners. Specifcally, youth will be reached in school and through social networks with training to build knowledge and community theatre to model behavior skills. Mobile populations (truck drivers) will receive training to build their skills and will be provided with group-specific options to avoid high-risk environments.

4. LINKS TO OTHER ACTIVITIES ROADS is a multi-sectoral HIV and AIDS program that seeks to reduce stigma and discrimination through broad community dialogue and participation. Additionally, through ongoing coordination with other USAID/Kenya PEPFAR partners, ROADS links with, and creates demand for, clinic-based services (CT, PMTCT, STI diagnosis and management) strengthened through PEPFAR programming in these areas. ROADS will coordinate CT outreach in sites where truck drivers and community members meet: the truckers resource center, and the boda-boda (bicycle taxi) drivers community facility. We also plan to work with FBOs to encourage on-site CT mobilization in conjunction with their focused

outreach to truckers and community men around support for social norm change for partner reduction and faithfulness.

5. POPULATIONS BEING TARGETED ROADS reaches out to those for whom abstinence and be faithful messages can be most effective. Abstinence activities are directed to primary and secondary school students as well as out-of-school youth and to people living with HIV and AIDS. Partner reduction/be faithful strategies will be addressed to truck drivers and their attendants who are away from their families for three months or more and community men and women. In addition to addressing target populations at risk, ROADS strengthens community resources- -business, community and religious leaders with moral authority and the capacity to offer support to women and youth to reduce their vulnerability--as well as public and private health care providers and teachers who can promote HIV education and health-seeking behavior.

6. KEY LEGISLATIVE ISSUES ADDRESSED ROADS programming will include (1) focused campaigns with bar/lodging owners and religious leaders to reduce alcohol abuse as a partner reduction strategy among truck drivers and community men, (2) advocacy to reduce alcohol access by youth, (3) programming to address gender-based violence (GBV) as a key HIV risk factor and barrier to CT and partner communication. Specific activities will include programs to change male sexual networking norms and to reduce stigma and discrimination. Detailed discussions on alcohol and GBV issues and program options have already been started in the sites.

7. EMPHASIS AREAS ROADS activities are community-driven as a result of ongoing focused community dialogue and mobilization. Targeted peer education, community theatre, and outreach are used to promote AB behaviors and skills. ROADS builds referrals to public and private health and social services. Most important is the emphasis on developing the capacity of a broad range of community-based groups: business, community and religious leaders, teachers and health workers to ensure that programming is sustained within the communities.

1. LIST OF RELATED ACTIVITIES (#8781), (#8777), (#8976), (#8813), (#8826), (#8765) (#8934), (#8931), (#8936). 2. ACTIVITY DESCRIPTION The overall goal of the multi-sectoral ROADS Project (branded SafeTStop) along the Transport Corridor Initiative (TCI) is to stem HIV transmission and mitigate the consequences of HIV/AIDS on vulnerable people along major East African transport corridors which see high HIV transmission rates among drivers and their assistants and vulnerable groups of in- and out-of-school youth, OVC and low-income women in these host communities. Truck drivers can be away from home for two to three months at a time and held up for days in customs clearance. The high poverty rates and joblessness of the host communities often results in transactional sexual behaviors involving not only community women but youth and OVC. To date, ROADS has worked in three sites- -Mariakani, Malaba and Busia--to reach over 41,000 youth, women, truck drivers, PLWHA, through nearly 2000 peer educators to mobilize prevention behaviors and skills beyond abstinence and faithfulness for those who need this assistance. In FY 07 200 peer educators will reach a further 25,000 people. Working through over 100 CBOs and FBOs as well as the Kenya Long-Distance Truck Driver Welfare Association, the Kenya National Chamber of Commerce and Industry, and the African Development and Emergency Organization, ROADS conveys HIV risk reduction messages that include but go beyond AB. Peer educators focus on HIV/AIDS skills and knowledge, including condom negotiation skills and correct use. "Other" messages, as well as condoms, are disseminated to truck drivers, commercial sex workers, other men and women, and out-of-school youth through peer education, community mobilization events, pharmacies/drug shops and SafeTStop resource centers established in the sites. ROADS is establishing another 50 condom outlets through the SafeTStop model, which links bars, guest houses, pharmacies/drug shops, health providers and other venues through shop/point-of-purchase branding. ROADS partners refer pregnant women for PMTCT services. In FY 2007, ROADS will reinforce peer education, magnet theatre and other community mobilization activities through HIV and AIDS updates, refresher training, training of new peer educators/mobilizers (including local business leaders and additional bar/lodging owners in alcohol-HIV programming; expand peer family discussion groups; fortify HIV prevention training for health care providers, pharmacists/drug shop providers; build entrepreneurial and marketing skills for women, out-of-school youth and secondary school students, and strengthen community savings schemes; and develop focused BCC for older orphans, a key underserved group.

Provides support to numerous community-based sub-recipients for activities integral to the program. ROADS builds community cohesion, sustainability and maximizes coverage through its innovative "cluster model" that promotes joint programming by over 100 community groups. Approximately $125,000 will be allocated directly to CBO clusters of older youth and women and the truck driver association and local pharmacies and business leaders. 3. CONTRIBUTIONS TO OVERALL PROGRAM AREA ROADS reaches out to those whose sexual activity puts them at significant risk of acquiring or transmitting HIV. Men who are away from home for months at a time will often have sexual partners along the transport route. Unemployed women with no other source of income to feed and shelter their children will often rely on informal financial support from truck drivers and other community men. Given the "regular" nature of these relationships, condom use will be low, creating a major route for HIV infection among mobile and community populations. The high number of youth out of school, many of whom may be economically vulnerable orphaned heads of households, also become involved in transactional sex to sustain themselves and their siblings. Messages and skills encouraging abstinence and partner reduction will accompany skills building in risk reduction through increased condom use, addressing sexually transmitted infections, and promoting CT including PMTCT services. Support for other low-risk strategies for increasing economic opportunities will also be pursued through the local private sector in terms of job creation and skills building as well as providing limited food support as a strategy for reducing partners. 4. LINKS TO OTHER ACTIVITIES Multi-sectoral HIV and AIDS program that seeks to reduce stigma and discrimination through broad community dialogue and participation. Additionally, through ongoing coordination with other USAID/Kenya PEPFAR partners, ROADS links with, and creates demand for, clinic-based services (CT, PMTCT, treatment of OIs and STIs) strengthened through PEPFAR programming in these areas. ROADS will coordinate CT outreach in sites

where truck drivers and community members meet - the truckers' resource center, and the boda-boda (bicycle taxi) drivers' community facility. We also plan to work with FBOs to encourage on-site CT mobilization in conjunction with their focused outreach to truckers and community men around support for social norm change for partner reduction and faithfulness. 5. POPULATIONS BEING TARGETED ROADS will work closely with most-at-risk populations including commercial sex workers, truck drivers and their attendants and sexually active older youth. Additionally, ROADS targets low-income women who don't self-identify as sex workers but who may have "regular relationships" with select truckers and community men due to economic vulnerability. A particularly underserved group includes older, head-of-household OVC who may rely on transactional sex to provide for their siblings. ROADS strengthens community resources--business, community and religious leaders--who can provide support to vulnerable community women and youth to reduce their vulnerability--as well as public and private health care providers and teachers who can promote HIV education and health-seeking behavior. 6. KEY LEGISLATIVE ISSUES ADDRESSED (1) focused campaigns with bar/lodging owners and religious leaders to reduce alcohol abuse among truck drivers and community men, (2) advocacy to reduce alcohol access by youth, (3) programming to address GBV as a key HIV risk factor and barrier to CT and partner communication. Specific activities will include programs to change male social norms and to reduce stigma and discrimination. Detailed discussions on GBV issues and program options have already been held in the sites. 7. EMPHASIS AREAS community-driven as a result of ongoing focused community dialogue and mobilization. Targeted peer education, community theatre, and outreach promote OP behaviors and skills; mobilizing pharmacies and drug shops to stock condoms and to talk about risk reduction strategies. ROADS proactively refers to public and private health and social services. Most important is the emphasis on developing the capacity of many community-based groups: business, community and religious leaders; teachers and health workers to ensure that programming is sustained beyond the project.

This activity is an expansion of an existing activity for the Transport Corridor Initiative (TCI). With additional funding of $50,000, TCI will expand their activities targeting 5000 high-risk youth and adults along the transport corridor by training an additional 40 peer educators. HIV Prevention activities targeting glue-sniffing youth, a growing IDU population, and other alcohol and susbstance abusers will be expanded along the transport corridor. Other activities will focus on HIV prevention targetting male and female sex workers to promote alternatives to commercial sex work as well as protective barriers to prevent HIV transmission both with commercial partners and steady boyfriends/girlfriends and husbands/wives.

1. LIST OF RELATED ACTIVITIES This activity also relates to AB programs (#8701), Palliative Care: Basic Care and Support (#8766) and Other Prevention (#8780).

2. ACTIVITY DESCRIPTION The overall goal of the multi-sectoral Transport Corridor Initiative (branded SafeTStop) is to stem HIV transmission and mitigate the consequences of HIV/AIDS on vulnerable people along major East African transport corridors. There is a high HIV transmission rate among members of mobile populations: drivers and their assistants, commercial sex workers, and members of the uniformed services, all of whom tend to congregate at stop-over sites, and the vulnerable populations of OVC and low-income women in these host communities. Services at these high-risk sites such as HIV counseling and testing, prevention of mother-to-child transmission, and management of sexually transmitted infections tend to be fragmented at best and/or unavailable or unwelcoming to those in greatest need. Especially at cross-border stop-over sites where truck drivers can be held up for days or weeks in customs-clearance and where the poverty of the host communities is exceedingly high, the prevalence of transactional sexual behaviors involving not only community women but orphaned children is also high.

SafeTStop, implemented through the Regional Outreach Addressing AIDS through Development Strategies (ROADS) Project, targets these high-risk mobile populations and the communities that host them with regionally coordinated messages and new or improved services tailored to meet their needs. It thereby adds value by maximizing the effectiveness of most at-risk population country-level interventions and thus the results of country programs. The SafeTStop model includes classic prevention, care, treatment and mitigation activities, as well as essential wrap-around programming (HIV and alcohol, gender-based violence, economic empowerment) to reduce vulnerability to HIV and barriers to care and treatment-seeking. Such programming goes to the heart of continued risk behavior and low service uptake despite significant investment by the USG and other donors.

In Kenya, the project launched in FY 2006 in Mariakani, the first stop for the East-West flow along the Northern Transport Corridor, and Malaba and Busia, two critical Kenya/Uganda border crossing towns. In FY 2007, ROADS will implement OVC activities in six of the seven core program areas defined by the President's Emergency Plan for AIDS Relief, focusing on the three existing SafeTStop sites. The six areas: food/nutrition, shelter and care, protection, health care, psychosocial support, economic strengthening are embedded within the ROADS multi-sectoral, community-focused approach and are consistent with ROADS comparative advantages. The project will work with child-welfare organizations, faith-based organizations, local officials and, importantly, the private sector/business community to meet the daily needs of OVC. One strategy will be to expand the community farming model implemented in Malaba to enhance the food security of orphan-headed households. However, ROADS' efforts will go beyond daily sustenance of OVC, attempting to secure the long-term viability of orphan-headed households. This will entail job training, job creation and other economic opportunities for OVC breadwinners through the LifeWorks Initiative, which already has Global Development Alliances in place with General Motors and Unilever. The project will also develop HIV risk-reduction and care strategies specifically for older OVC, including heads of households, linking them with C&T, sexually transmitted infection (STI) services, psychosocial support and emergency care in cases of rape and sexual assault.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA Planned activities in Kenya will directly reach 2,900 OVC, building on FY 2006 efforts to mobilize communities around OVC issues and enumerate orphan-headed households. The project will train 725 caretakers. Older orphans, a large and underserved population, will be a key focus, recognizing their unique challenges and needs. Orphans who raise siblings are under severe pressure to earn income, often driving them into transactional sex for survival of the family.

4. LINKS TO OTHER ACTIVITIES ROADS OVC activities are linked closely with FHI activities to promote AB (#8701), Palliative Care: Basic Care and Support (#8766) and OP (#8780).

5. POPULATIONS BEING TARGETED Due to the integrated nature of the ROADS project, the populations being targeted include OVC and their caregivers, HIV/AIDS-affected families and HIV+ children. In addition, community and faith based organizations will be targeted for capacity building.

6. KEY LEGISLATIVE ISSUES ADDRESSED The key legislative issue being addressed is stigma and discrimination. By providing a supportive environment OVC will have greater access to schooling, an improved home environment and improved nutrition. All of these factors will allow the children to grow up in a more stable, safe environment and decrease the chance of stigma and discrimination.

7. EMPHASIS AREAS The major area of emphasis is the development of Network/Linkages/Referral Systems with child-welfare organizations, faith-based organizations, local officials and, importantly, the private sector/business community to meet the daily needs of OVC. Minor areas of emphasis include areas connected to meeting the essential needs of the OVC such as food/nutrition, local organization capacity development, needs assessment, community organization/participation as well as training.