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
Updated April 2009 Reprogramming. Decreased by $105,000. Funds moved to IRDO (HVAB).
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+ ITM will expand their Healthy Choices intervention to youth in schools and will integrate the knowledge of
status into their intervention to promote comprehensive prevention approaches.
+ ITM has developed a Training of Trainers team for the Families Matter! Program and will focus more on
the Healthy Choices intervention in the assessment and development of a tool and subsequent training for
this program in FY09.
+ This activity will incorporate $150,000 to partner with HIV Free Generation activities that focus on youth.
COP 2008
The only changes to this activity since approval in the 2007 COP are:
• The evaluation of Families Matter! in Gem as part of a community based study;
• The evaluation of Healthy Choices in Asembo;
• The preparation of a toolkit for Healthy Choices;
• The development of a prevention intervention for adolescents living with HIV.
1. LIST OF RELATED ACTIVITIES
This activity relates to activities in Condoms and Other Prevention (#6948), Counseling and Testing,
(#8746).
2. ACTIVITY DESCRIPTION
The Institute of Tropical Medicine (ITM) will continue to assess a comprehensive youth intervention program
in the Asembo and Gem areas of Nyanza Province, which has the highest HIV prevalence rates in the
country. In Kisumu, the capital of Nyanza Province, a previous ITM study found very high rates of HIV
infection among young women. Young women, aged 15 to 19 years, had a 23% HIV prevalence rate in
contrast to their male counterparts with a 3.5% prevalence. A multi component program targeting
adolescents directly and through their families and the community, was begun in 2002 to adapt evidence
based interventions an African rural setting and to test these interventions in order to assess their
effectiveness in reducing HIV and STI infection and teen pregnancy. In this project, 54,257 individuals will
be reached with targeted HIV prevention messages and 377 people trained. Activities promoting abstinence
and delay of sexual debut in young people have been key in a multi-component intervention program to
improve adolescents' sexual and reproductive health. This comprehensive youth intervention program
includes two AB activities. One activity being conducted by ITM is the implementation of a "Families Matter"
curriculum targeting parents or guardians of 9 to 12 year olds. It is an adaptation of "Parents Matter"
curriculum which CDC has evaluated in the US. The program brings together small groups of parents and
aims to promote positive parenting practices and improve effective communication about sexuality and
sexual risk reduction between parents and their children. Preliminary analysis of a recent assessment of
Families Matter, 15 months post-intervention, seems to indicate a sustained positive effect in terms of
parenting and communication skills reported by participants and their children separately. To date, parents,
community and religious leaders in Asembo and Gem are very supportive of this approach of enabling
parents to take a more active role in HIV prevention for their adolescent children. The program has been
scaled-up and 1,800 families have participated in the intervention so far. Another activity is an abstinence
based curriculum targeting school-going children aged 10 to 14 years old. "Healthy choices for a better
future" is an adaptation of "Making A Difference", a curriculum that was selected by CDC as an effective
intervention. The adapted curriculum has been piloted, and ITM is currently developing a proposal to
evaluate this component as well. Efforts to change the social norms which contribute to this high risk for
young girls are part of this intervention. The project has also found that the lack of skills and employment
opportunities contributes to high risk behavior among girls and boys, so one aspect of the project is the
provision of vocational skills and opportunities for income generating activities for these youth.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This project will contribute to the Kenya Five-Year Strategy which focuses on HIV prevention in youth, since
the primary target group is young people, including children aged 10 to 14. Targets in this project will
contribution to HIV infections averted through reaching 54,257 youth and parents and training 377
community leaders and facilitators.
4. LINKS TO OTHER ACTIVITIES
This activity will be linked to KEMRI AB activity (#6943), KEMRI OP activities in Kisumu (#6948) and ITM
CT activities (#8746). KEMRI and ITM work together on this program and KEMRI provides the bulk of the
human resource who implement this program. Referral linkages between these programs have also been
established.
5. POPULATIONS BEING TARGETED
The primary population being targeted is primarily a rural community including both in-school and out-of-
school youth. Ages of youth targeted range from 10 to the early 20's. Age-appropriate curricula are used
with each group. In addition, their parents and family members, mainly men and women of reproductive
age, and HIV/AIDS affected families are targeted. Community and religious leaders as well as volunteers
are targeted by the project. The project will work with teachers in in-school programs.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This project will have a strong gender component, including increasing young women's access to income
and productive resources, addressing male norms and behaviors and increasing gender equity in HIV/AIDS
programs.
7. EMPHASIS AREAS
The primary emphasis area is human resources, as the project has a large staff needed to implement and
assess the impact of these interventions. IEC activities to educate the youth and their parents about
abstinence and faithfulness as well as training are minor emphasis. The project will train implementers and
provide very close Quality Assurance, Quality improvement and Supportive Supervision in the curricula
Activity Narrative: adaptation process.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14833
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14833 4217.08 HHS/Centers for Institute of 6954 443.08 $705,000
Disease Control & Tropical Medicine
Prevention
6903 4217.07 HHS/Centers for Institute of 4232 443.07 $500,000
4217 4217.06 HHS/Centers for Institute of 3248 443.06 $400,000
Emphasis Areas
Gender
* 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 3.3.02:
Updated April 2009 Reprogramming. Decreased by $105,000. Funds moved to IRDO (HVOP).
+ This activity will incorporate $56,000 to partner with HIV Free Generation activities that focus on youth.
+Geographic coverage has been revised to include Siaya and Bondo Districts in Nyanza Province.
+Clients of CSWs will be targeted with specific interventions that focus on consistent and correct use of
condoms and knowing their HIV status.
•The only changes to the program since approval in the 2007 COP are:
•Geographic coverage has been revised (or expanded) to include 3-4 other clinics of Family Health Options
Kenya (Nakuru, Nairobi and 2 others);
•Other changes include the development of prevention interventions for sex workers living with HIV
This activity relates to activities in Abstinence and Be Faithful Programs (#6903) and Counseling and
Testing (#8746), (#6941).
This activity is being implemented by the Institute of Tropical Medicine (ITM) in collaboration with Family
Health Options Kenya, a local partner. ITM is already implementing a project targeting youth, their families,
and the local community in several rural areas of Nyanza province. In June 2006, ITM expanded its
activities to Kisumu town to target young vulnerable women, including sex workers, with HIV prevention and
care services. Free health services are offered at an integrated clinic, including management of STIs, HIV
testing and ART for HIV-positive clients. A network of peer educators is being established to promote safer
sex practices. Towards the end of 2006, ITM, in collaboration with CDC and the Kenya Medical Research
Institute, plans to conduct a needs assessment and baseline survey of HIV, STI and associated risk
behavior. The findings of this assessment will be used to refine the interventions; Nyanza Province is the
area of Kenya with the highest HIV incidence and prevalence, and therefore this activity with highly at-risk
populations is of great urgency. In this project, 389 people will be trained to deliver the intervention. 130,934
individuals will be reached with targeted HIV prevention messages. ITM will also integrate an alcohol and
HIV prevention initiative that will reach 934 men. 235 condom outlets will be established.
This project will contribute to the Kenya Five-Year Strategy which focuses on HIV prevention in youth, as
the primary target group will be young women. Targets in this project will contribution to HIV infections
averted among 130,934 at-risk individuals. 389 people will be trained, and 235 condom outlets will be
This activity will be linked to KEMRI CT activity (#6941) implemented by other CDC partners in Kisumu
(KEMRI) and will be linked to the Institute of Tropical Medicine AB activity (#6903) and CT activity (#8746)
already being implemented by ITM in Nyanza province.
Young male and female adults, both those already engaged in CSW and out-of-school young girls and
women living in the environs of Kisumu who are vulnerable to beginning CSW, will be targeted by these
activities. This project will also work with PLWHAs and a mainly most at risk populations including
commercial sex workers. Important entry points to this work will be through targeting brothel owners,
community leaders and community as well as NGO organizations.
This project will have a strong gender component, including increasing women's access to income and
productive resources as an alternative to engaging in full time or part time commercial sex work. Services
will be provided to these women, including detection and treatment of both HIV and other STIs, counseling
for behavior change, and services to help these vulnerable young women with alternate sources of
employment and income. This will also address gender equity in HIV/AIDS programs and male norms and
behavior through targeting at risk men. Stigma and discrimination will be addressed through these efforts.
The main emphasis area covered by this activity is Human resources. Minor emphases include the
development and implementation of Information, Education and Communication activities, conducting
needs assessment, training and providing quality assurance, quality improvement and supportive
supervision. This will support an expansion of existing 07 COP activities implemented by the Institute of
Tropical Medicine (ITM)'s Pambazuko project. The expansion will cover additional areas of Kisumu hotspots
targeting young vulnerable women, including sex workers and their clients. It will also target at-risk men,
including MSM. An important addition to this intervention will be provision of lubricant gels alongside
condom promotion to increase condom use, efficiency and acceptability. This expanded activity will also
provide interventions for Positive Prevention among positive people and their partners including linkages to
partner counseling and testing, increased access to treatment of STIs for HIV-positive patients and their
partners and an active involvement of PLWHA in spearheading PWP activities. There will also be increased
support to the sub-partner, Family Health Options Kenya to allow the project develop an autonomous
management structure through co-location with the implementing agency.
Continuing Activity: 14834
14834 4852.08 HHS/Centers for Institute of 6954 443.08 $445,000
6904 4852.07 HHS/Centers for Institute of 4232 443.07 $650,000
4852 4852.06 HHS/Centers for Institute of 3741 3741.06 $300,000
* Addressing male norms and behaviors
Table 3.3.03:
ACTIVITY UNCHANGED FROM COP 2008
This activity relates to activities in AB and OP.
The Institute of Tropical Medicine (ITM) has a long international history of operational research on HIV in
Africa including Kenya. In previous years, they have received Emergency Plan funds, through CDC, for the
implementation of AB and OP activities in Nyanza Province, the region that has the highest HIV prevalence
in Kenya. The main of strength of ITM has been their work with youth in HIV prevention and evaluation. In
FY 2009 they will continue to work with youth to support HIV in prevention, but they will also carry out
specific CT activities in the same region. This includes expanding the scope of the two stand-alone VCT
sites and facilitating mobile and outreach VCT services in areas where VCT services are not available.
Mobile VCT will be provided in markets, beaches, near schools and during community events. Mobile VCT
will be preceded with extensive community mobilization and awareness creation. In the past, ITM has
facilitated the establishment of support groups for HIV positive youth. In FY 2009 these established groups
will be used to disseminate information about CT in the community. This will improve uptake of CT services
as well as reduce HIV-related stigma in the area. All these efforts should lead to at least 10,000 being
counseled and tested for HIV. This will require an additional 10 counselors to be trained, both for the 10
stand-alone and the mobile VCT services.
As stated above, Nyanza province has the highest HIV prevalence in Kenya. The Kenya Demographic and
Health Survey of 2003 showed that majority of the HIV positive Kenyans (including those in Nyanza) do not
know their HIV status. Despite the relatively small numbers of people projected to receive CT services in FY
09, by working with the youth, ITM will be working towards achievement of national CT targets. They will
also be working towards the realization of Kenya's five-year strategy of preventing infections among the
youth. But apart from this longer term contribution, ITM will promote greater access to comprehensive
HIV/AIDS care, through increased knowledge of status.
This activity will be linked to AB and OP activities implemented by the Institute of Tropical Medicine in
Nyanza province. Personnel that carry out community mobilization can pool resources to maximize the
benefit. Also, the OP and AB activities can be used to increased uptake of CT.
The primary population being targeted is rural youth, including both in-school and out-of-school youth. Ages
of youth targeted range from 13 to the early 20's. In addition, their parents and community and religious
leaders are targeted by the project.
and productive resources. The activity will also facilitate stigma reduction through community mobilization
and through widespread CT activities.
assess the impact of these interventions. Community mobilization to change social norms which encourage
delay in sexual debut is also an important component of this project, along with IEC activities to educate the
youth and their parents about abstinence, faithfulness and safer sex practices.
Continuing Activity: 14835
14835 8746.08 HHS/Centers for Institute of 6954 443.08 $100,000
8746 8746.07 HHS/Centers for Institute of 4232 443.07 $60,000
Table 3.3.14:
