PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED
REFERENCES TO TARGETS AND BUDGETS.
The only changes to the program since approval in the 2007 COP are:
• In 2007 this activity was funded under HVOP as a Targeted Evaluation at the level of $150,000
1. LIST OF RELATED ACTIVITIES.
This activity relates to the Population Council HVOP activity with adolescents and substance abuse and
AED Capable Partners HVOP activities with substance-abusers. The activity will implement alcohol and
drug treatment programs for out-of-school youth in three informal settlement areas within Nairobi and
possibly one in Mombasa. The conclusions of this study will feed into all the provincial APHIA II prevention
activities with substance-abusing populations. In 2008 an application will be submitted by Support for
Addictions Prevention and Treatment in Africa Trust (SAPTA Centre) for assistance under the New Partner
Initiative.
2. ACTIVITY DESCRIPTION
This activity began as a baseline evaluation funded under Targeted Evaluations in 2007. The Population
Council, working in partnership with the SAPTA Centre will assess the alcohol risk behavior of urban slum-
dwelling adolescents in Nairobi and possibly Mombasa. A baseline survey, to be implemented in early 2008,
will serve as a basis on which interventions aimed at alcohol risk reduction among slum-dwelling youth can
be implemented, with a view towards linking youth with CT and/or ART resources. The assessment will be
in the form of a quantitative survey with about 1000 slum-dwelling males and females in 4-5 informal
settlements in Nairobi, and about 500 of their counterparts in Mombasa. The baseline evaluation will be
conducted among primarily out-of-school youth in the informal settlements of Kibera, Kangemi, and Mukuru
slums of Nairobi, and possibly an additional area in Mombasa. The justification for focusing on out-of-school
youth is based on previous studies which have found that out-of-school youth in Kenya are at a markedly
higher risk of engaging in both risky sexual behavior and alcohol and drug consumption. The baseline
evaluation is to collect information on demographic and social characteristics, sexual behavior, and alcohol
and drug use. Upon completion of the baseline survey, and upon receipt of intervention funding, SAPTA
Centre will implement intervention activities under separate 2008 COP funding. The intervention will include
training peer educators in HIV prevention, as well as the implementation of ICE activities including poster
distribution and video den education sessions. Key intervention activities will also include identifying (via
baseline survey activities) youth who are in need of alcohol and/or drug treatment referrals, and enroll these
youth in treatment programs to be implemented via partners in the slum areas. Other prevention activities
will also be implemented focusing on non-drinking youth to prevent underage drinking, and other harm
reduction strategies. During 2008 the Population Council will implement a follow-up survey to evaluate the
intervention.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
During the 2008 project period, a total of 1500 youth will be identified, interviewed, and assessed for alcohol
and drug abuse.
4. LINKS TO OTHER ACTIVITIES
This activity relates to AED Capable Partners' work with substance abusers, including the SAPTA project,
and APHIA II Coast if they need to expand activities to Mombasa.
5. POPULATIONS BEING TARGETED
This activity will target young men and women of reproductive age, primarily out-of-school in three informal
settlement areas of Nairobi. Linkages will be established with health care providers in both the private and
public sector providing HIV-related services in these areas.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity will address youth issues by increasing awareness of underage alcohol and drug use, and the
interaction of substance use with risky sexual behavior.
7. EMPHASIS AREAS
Major emphasis will be on human resources to identify and engage youth in treatment programs, as well as
on Information, Education and Communication. Linkages with other sectors, especially the health sector
and the development of referral systems will be enhanced. Training of peer educators will also be
emphasized.
+ In 2007 this was funded as a targeted evaluation in HVOP at $150,000
1. LIST OF RELATED ACTIVITIES
This activity relates to Population Council HVAB activity working with the same target population and the
AED Capable Partners HVOP activities with substance-abusers. In 2008 an application will be submitted by
Support for Addictions Prevention and Treatment in Africa Trust (SAPTA Centre) for assistance under the
New Partner Initiative. The conclusions of this study will feed into all the provincial APHIA II prevention
activities with substance-abusing populations. The activity will implement alcohol and drug treatment
programs for out-of-school youth in three informal settlement areas within Nairobi and possibly one in
Mombasa.
in the form of a quantitative survey with about 1,000 slum-dwelling males and females in 4-5 informal
During the 2008 project period, a total of 1,500 youth will be identified, interviewed, and assessed for
alcohol and drug abuse.
and possibly APHIA II Coast if they need to expand activities to Mombasa.
PHE CONTINUING STUDY:
Project Title: Feasibility of integrating alcohol risk reduction counseling into Provider-Initiated Counseling
and Testing
Name of Local Co- Investigator: Population Council - Horizons, Liverpool VCT and SAPTA
Project Description:
This operations research project is piloting the feasibility of integrating alcohol risk reduction education and
counseling into VCT service provision. It started with a baseline survey in June 2006 in eight districts in
Kenya. The survey documented that VCT providers were ill-prepared to address alcohol risk reduction with
their clients. The intervention comprised of training 30 VCT counselors to formally address clients' alcohol
use. All VCT clients are currently screened for alcohol use, offered a Brief Intervention and offered
appropriate referrals. 4000 such clients have already been screened. Existing posters and brochures on
alcohol were distributed. The follow-up evaluation survey is currently ongoing.
Timeline:
FY 2008 = Year 3 of activity
Year started: 2005
Expected year of completion: 2008
Funding:
Funds received to date: $150,000
Funds expended to date: $150,000
Funds requested to complete the study:
FY 08: $200,000
Beyond FY08: $200,000, to hand over to NASCOP for integration into national CT guidelines
Describe funds leveraged/contributed from other sources:
None.
Status of Study:
Follow up data collection currently ongoing; expected to end July 31, 2007
Lessons Learned:
Baseline finding s documented that 1 in 3 male VCT clients are drinkers and 67% are hazardous drinkers as
assessed by WHO AUDIT scale. Regression analysis shows that both male and female drinkers are several
times more likely to be sexually active as non-drinkers, more likely to have multiple partners, more likely to
have violent relationships and no more likely to use condoms. Put together, this paints a picture of potent
transmitters of HIV.
Information Dissemination Plan:
Data interpretation meeting, reports, research updates and summaries; national dissemination August 29,
2007
Planned FY08 Activities:
Population Council has received funds for expanding alcohol risk reduction training to 15 additional sites.
During COP 08, Population Council would like to assess the alcohol use profile of patients receiving
provider-initiated counseling and testing. During 2005, Population Council will also support NASCOP and
Liverpool VCT to scale up and integrate program into national guidelines
Budget Justification for FY2008 Budget (USD):
Salaries/ fringe benefits: $51,000
Equipment: $ -
Supplies/office costs: $9,000
Travel: (Local)$3,000
Participant Incentives: $ -
Laboratory Testing: $ -
Other: (Research and subcontracts)$80,000
Indirect $57,000
Total: $200,000
Project Title: Increasing Testing, Diagnosis and Treatment of Pediatric HIV infections
Name of Local Co- Investigator: Population Council, Eastern Deanery AIDS Relief Program, Elizabeth
Glaser Pediatric AIDS Foundation, Christian Health Association of Kenya, and Kenya Network of Women
with AIDS
Population Council has just completed a survey of 1,200 caretakers and 200 health workers (HWs) involved
in pediatric AIDS management in 6 districts. The objective of the study is to assess demand- and supply-
side barriers to pediatric HIV testing. During COP 07, study partners will design and implement community-
based interventions informed by the survey. These activities will continue into COP 08 during when an
evaluation will be conducted. The research will adopt a quasi-experimental design with half the study sites
as intervention and the others as comparison sites.
Year started: 2006
Expected year of completion: 2009
Funds received to date: 350,000
Funds expended to date: 350,000
FY 08: $100,000
N/A.
Analysis is presently under way.
Preliminary findings suggest that the cost of health care has deterred at least 1/3 of caretakers from
bringing their pediatric age children for treatment, and at least 50% have been deterred by the costs of
drugs. Food is emerging as a major barrier to care with many community health workers noting that the
opportunity costs of bringing children for treatment is often outweighed by the opportunity costs of earning
money for food. Results are also indicting that many parents are willing to have their children tested for HIV
were they offered the chance by the providers.
A data interpretation workshop with the study partners is planned for the 2nd week of August. There will
also be a national dissemination on August 29, 2007. Population Council will continue disseminating study
results at various other times including at small meetings, national scientific gatherings and internationally.
Summary and full study reports are expected and will be widely disseminated electronically and hard
copies. Peer-reviewed papers are also planned.
During COP 08, Population Council will intensify community-based interventions to increase uptake of
testing and diagnosis of pediatric HIV infections. BCC strategies to reach caretakers and health care
workers, where appropriate, with appropriate information on pediatric disease, will be developed based on
the findings of the survey. The intervention will strengthen four service outlets to provide counseling and
testing incorporating pediatric counseling and testing (indicator 6.1) and will include activities to increase
awareness about HIV in children, how and where to access services (VCT and ART), and to support
caregivers seek services. The intervention will also target caregivers in various clinical settings (e.g.
PMTCT, VCT, FP, in-patient facilities) in order to encourage them to take their children for testing. The
intervention will be evaluated after eight months of implementation.
Salaries/ fringe benefits: $25500
Supplies/office costs: $4500
Travel: (Local)$1500
Other: (Research and subcontracts)$40,000
Indirect $28,500
Total: $100,000
Project Title: Prevention with Positives: A community-based approach
Name of Local Co- Investigator: Population Council and International Center for Research on Health (ICRH)
A recently-completed Population Council study in Mombasa shows that 40% of HAART patients do not
know the status of their regular partner, and 20% had not disclosed own HIV status to regular partner. 72%
of married HAART patients have had unprotected sex with their spouse during the previous 12 months. In
Kenya, 90% of HIV+ individuals are well, living in the community and not necessarily linked to the health
system. There is need to reach them with prevention messages to avoid their own re-infection, and
encourage them not to infect others. The present study explores the risk behaviors of community-based HIV
-infected individuals (n=800) in Mombasa.
FY 2008 = Year 2 of activity
Year started: 2007
Funds received to date: $200,000 (COP 06)
Funds expended to date: $200,000
FY 08: $50,000
Data collection ends July 31, 2007. Data collection using snow-balling techniques with members of PLHIV
as seeds. Interviews being conducted on Palm Pilots. Study is exploring risk exposure, disclosure, and
concurrent partnership through a grid method. Project has been funded at $200,000 for COP 07. During
COP 07, the data will be used to design a community-based PwP intervention using CDC-developed
materials (discussions with CDC at advanced stages). Intervention will use community health workers and
peer educators in health centers and in post test clubs to reach HIV+ individuals.
Data collection still under way. But study indicates that HIV+ individuals can be identified in the community
using these methodologies. In addition, Palm Pilot data collection is feasible with minimal input.
Data interpretation workshop for partners to be held when baseline completed. After data cleaning, results
to be shared publicly. Summary reports and full report to be prepared and disseminated electronically and
hard copies.
In COP08 Population Council and ICRH will finalize intervention and evaluate it. Targets proposed for
COP08 are: Four service outlets strengthened to provide counseling and testing incorporating PwP
strategies (indicator 6.1); 400 individuals receiving C&T for HIV and receive their test results including PwP
counseling (indicator 6.2); four local organizations (i.e. health facilities provided with technical assistance for
strategic information activities in PwP approaches (indicator 11.1); and 20 individuals provided with strategic
information and training (indicator 11.2).
Salaries/ fringe benefits: $13,000
Supplies/office costs: $2,000
Travel: (Local) $1,000
Other: (Research and subcontracts) $20,000
Indirect $14,000
Total: $50,000
