Detailed Mechanism Funding and Narrative

Years of mechanism: 2007 2008 2009

Details for Mechanism ID: 5093
Country/Region: Kenya
Year: 2007
Main Partner: Kenya Medical Research Institute
Main Partner Program: NA
Organizational Type: Host Country Government Agency
Funding Agency: HHS/CDC
Total Funding: $335,000

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $205,000

1. LIST OF RELATED ACTIVITIES This activity relates to activities in Abstinence and Be Faithful Programs (#6876), (#6943), Counseling and Testing (#6875), (#4255), Palliative Care: Basic Health Care Support (#6870).

2. ACTIVITY DESCRIPTION This activity has two components, the first component will involve activities to promote correct and consistent use of condoms among the Non-Military Uniformed Service Personnel who are most at risk of HIV infection and who engage in high risk behaviors. Proper condom supply channels will be put in place to ensure availability in all the Uniformed Services camps, stations and parks country-wide. Regular monitoring of condom utilization will be done through a requirement for all units to file reports on both male and female condom use on monthly basis. The second component will involve activities focusing on young recruits entering the Uniformed Services, including the Kenya Prisons Service, National Youth Service, the Kenya Wildlife Service, Administration Police and the Kenya Police. These services recruit about 8,000 young men and women in the age group 18 to 24 years annually. Though this group is being targeted in the focused program referred to as "‘Men as Partners" (MAP) under the AB program area, an additional element will be introduced in the training institution to include those who may not be covered by this program and those who do not adhere to the intended behavior change of either abstaining or being faithful. 60 Uniformed Service personnel will be trained to carry out this activity. 5,000 members of the uniformed services will be reached through this activity, and 50 condom outlets will be established.

3. CONTRIBUTION TO OVERALL PROGRAM AREA OP activities within the Uniformed Services will contribute to the overall Emergency plan for FY 2006 prevention targets for Kenya. This activity contributes to Kenya's Five-Year Strategy emphasis of reducing the risk of HIV transmission among young people. The Uniformed Services will integrate their OP program with other sexually transmitted infection (STI) clinics and reproductive health clinics at the various Uniformed Services health facilities.

4. LINKS TO OTHER ACTIVITIES This activity is linked to CHF CT activity (#6875) targeting to serve uniformed services personnel, since all OP activities will at all times encourage routine counseling and testing among the Uniformed Services community. This OP activity is also linked to Uniformed Services KEMRI/USP AB activity (#6876) by partnering with other activities that promote prevention among the youth of the Uniformed Services community. Persons requiring HIV care and treatment will be served under the CHF HBHC activity (#6870).

5. POPULATION BEING TARGETED The OP activities will reach the most at risk population by targeting the Uniformed Services personnel, discordant couples and prisoners. It will also reach the civilian population living and working in the Uniformed Services work places and also the host population living in the Uniformed Services neighborhood. Medical personnel working in these uniformed services will also be targeted for appropriate training. HIV/AIDS affected families PLWHAs will be a target on positive prevention.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity will address the issues of male norms and behaviors, as many (though not all) of the members of these uniformed services are young men. It will also challenge traditional male norms that have been identified as contributing to sexual coercion and multiple sexual partners. The USP OP program will also address stigma and discrimination that often is a significant obstacle to adopting behaviors that contribute to HIV prevention.

7. EMPHASIS AREAS The major emphasis area for this activity will be on a workplace program for the Non-Military Uniformed Services. Training will also be an emphasis area to ensure that Uniformed Services personnel receive the STI/HIV prevention services this activity provides. Other emphasis areas will be information, education, and communication to promote behavior change. Supervision and quality assurance will be supported.

Funding for Testing: HIV Testing and Counseling (HVCT): $130,000

1. LIST OF RELATED ACTIVITIES This activity is related to activities in ARV (#6954), PMTCT (#6953), LAB (#6940), TB-HIV (#6951), SI (#6946), AB (#6943), OP (#9228) and CT (#6875)

2. ACTIVITY DESCRIPTION Please take note that this project has been renamed. It is no longer the Uniformed Services project, but is now referred to as the Prisons Project (PP). This is because in FY 2006 there was a reprogramming of funds, which moved part of this project to Community Housing Fund (CHF), thus leaving only the prisons project to be supported by KEMRI. In FY 2007 the KEMRI Prisons Project plans to establish six additional CT sites, hereby increasing its total outlets from 29 to 35. Mobile VCT activities will also be expanded to increase access to CT to the smaller outlying prison communities that are currently underserved. Mobile VCT activities will be regionalized and increased to 18 in 2007. An additional 14 VCT counselors will be trained to provide services in the expanded facilities. Post Test clubs will also be initiated in at least 21 CT sites. Through these efforts the PP will provide CT to 21,500 clients thereby contributing 4% of the total USG CT target for Kenya in FY 2007. Program of quality assurance (QA) for both counseling and testing will be expanded to cope with increased service uptake during the planned scale up in FY 2006. Training in Quality Assurance (QA) and supervision will be enhanced with 6 CT supervisors trained. QA of counseling will involve monthly support supervision to practicing counselors in groups and on a one-to-one basis. QA for testing will involve validation of test results from 10% of clients served. Linkages between counseling and testing centers and care outlets will be strengthened to improve utilization of care opportunities created through the President's Emergency Fund. All CT sites will use the special uniformed services VCT data collection tool to enable evaluation of data on the uniformed community separately from civilians attending USP sites.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA VCT and diagnostic testing in USP will contribute to the overall Emergency Plan CT targets for Kenya, for both primary Prevention and care. Planned mobile VCT services will improve equity in access to HIV prevention and care services in remote areas without fixed VCT sites and in overcrowded prisons. This activity contributes to Kenya's 5-Year Strategy that encourages Kenyans to learn their status both for primary prevention and as a strategy for early diagnosis of HIV infection.

4. LINKS TO OTHER ACTIVITIES This activity is part of a comprehensive HIV program targeting uniformed service personnel and is linked to PMTCT (#6953), AB (#6943), OP (#9228). Information Education and communication (IEC) materials relevant to the uniformed services will be developed jointly. This activity is also linked to KEMRI activities in ART (#6954), TB-HIV (#6951), Lab (#6940), SI (#6946) and counseling activities with Cooperative Housing Foundation (#6941).

5. POPULATIONS BEING TARGETED This activity targets uniformed staff and their dependants, prison inmates and civilians accessing the KPS facilities. The USP services comprise a large proportion of young men and women who often serve away from their homes and are thus vulnerable to risky behavior. New sites will include facilities that are youth friendly to accommodate people who may be uncomfortable seeking services in traditional medical settings.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity will promote stigma reduction efforts, through increased access to HIV/AIDS information. This will be achieved through all approaches to CT. In provider-initiated CT, patients will be informed that CT is part of the package of care.

7. EMPHASIS AREAS This activity includes major emphasis on human resources and a minor emphasis in community mobilization and training as detailed in the activity description in Section 1 above.