The TBD partner will promote sustainability, in collaboration with the Kenyan Ministry of Health (MOH), the PEPFAR team, and the HHS/CDC office in Kenya, to strengthen, expand and initiate high quality, evidence-based HIV/AIDS combination interventions in Nyanza Province in Kenya. To avoid duplication, the TBD will work in collaboration with other stakeholders and implementing partners in Nyanza province.

The partner will focus on provision of integrated HIV/AIDS combination prevention interventions in Nyanza province targeting Youth, general population and MARPS, including fisher-folk and uncircumcised males in specific districts of Nyanza province. Nyanza province has unique HIV epidemiology in Kenya. According to the 2007 Kenya AIDS Indicator Survey, the province had an HIV prevalence rate of 15.3%, whereas Kenya's average rate was 7.4%. Specific districts within the Nyanza province bore the majority of the HIV burden and require targeted combination prevention interventions.

It is envisaged that the TBD partner will use a mix of innovative and evidence based preventive interventions. These include design and implementation of targeted age appropriate HIV behavioral prevention interventions among youth in and out of school that delay sexual debut, increase correct and consistent condom use, reduction of number of sexual partners and concurrency, and decreasing cross-generational sex; adaptation and implementation of activities that empower adults in close contact with youth (Parents, teachers, religious leaders) to provide supportive environment that fosters health and safer sexual behaviors among the youth, implementation of alcohol and substance abuse, transactional sex and gender based violence interventions to reduce HIV infection among young people in informal settlements in Kisumu city and other towns in Nyanza; implementation of evidence based behavioral and biomedical intervention in general population focusing on reduction of sexual partners, provision and promotion of consistent and correct condom use, reduction of concurrent sexual partnerships, HIV testing and counseling (including partner/couple testing and disclosure; implementation of HIV prevention strategies targeting MSM in Nyanza, implementation of PWP interventions especially targeting the youth, provision of HBCT and provision of correct male circumcision massaging and providing VMMC services where appropriate/selected districts. The TBD partner will develop models that link prevention to treatment and care programs.

The comprehensive goals and objectives under this TBD are to continue to strengthen, expand and initiate high quality, evidence-based HIV/AIDS combination interventions for the general population, youth and uncircumcised males in Nyanza Province in Kenya. To avoid duplication, the TBD will work in collaboration with other stakeholders and implementing partners in Nyanza province. The partner will focus on provision of integrated HIV/AIDS combination prevention interventions in Nyanza province targeting Youth, general population and MARPS, including fisher-folk and uncircumcised males in specific districts of Nyanza province. It will develop systems for quality assurance of these programs, and share experience, training, and lessons learned with the relevant Government of Kenya agencies. The TBD partner will support increasing access to combination HIV prevention services that incorporates behavioral, structural, and biomedical HIV-prevention interventions and will design and implement targeted HIV-prevention behavioral interventions. Biomedical interventions for preventing HIV transmission include HIV counseling and testing, incorporating all strategies including home-based, provider initiated, voluntary, couples, and special events counseling and testing. This TBD covers the general population and youth (both in and out of school) in Nyanza province and will reach 50,000 individuals from the target population who will receive test results. The partner will also train 100 staff to undertake HTC activities and establish 25 new outlets. Quality assurance informed by central policy guidelines and standards will guide the implementation of this program. The TBD partner will also be required to develop a robust M&E plan to inform the counseling and testing activities.

The TBD partner will promote sustainability, in collaboration with the Kenyan Ministry of Health (MOH), the PEPFAR team, and the HHS/CDC office in Kenya, to strengthen, expand and initiate high quality, evidence-based HIV/AIDS combination interventions in Nyanza Province in Kenya. To avoid duplication, the TBD will work in collaboration with other stakeholders and implementing partners in Nyanza province.

This partner will focus on provision of integrated HIV/AIDS combination prevention interventions in Nyanza province targeting Youth, general population and MARPS, including fisher-folk and uncircumcised males in specific districts of Nyanza province. The capacity of facilities serving residents in Luo districts in Nyanza will be increased to provide Voluntary Medical Male Circumcision (VMMC) in response to increased demand for services likely to result from near-universal awareness of HIV status among many clients who will be referred from Home based CT services (HBVCT). Through this activity, the partner will train Health Care workers and provide minimum package of VMMC for HIV prevention to 32,140 Men. Outreach and/or mobile MC services will involve high quality high-volume standardized approach through trained mobile teams and will follow MOH guidance. Mobile teams will work at temporary sites including existing buildings and tents that will be equipped for minor surgical procedures and pre- and post-operative services. Mobile MC Teams may geographically follow HBVCT teams as they move through the target geographical area to ensure coverage and no missed opportunities.

The comprehensive goals and objectives under this TBD are to continue to strengthen, expand and initiate high quality, evidence-based HIV/AIDS combination interventions for the general population, youth and uncircumcised males in Nyanza Province in Kenya. To avoid duplication, the TBD partner will work in collaboration with other stakeholders and implementing partners in Nyanza province. It will focus on provision of integrated HIV/AIDS combination prevention interventions in Nyanza province targeting Youth, general population and MARPS, including fisher-folk and uncircumcised males in specific districts of Nyanza province. The partner will develop systems for quality assurance of these programs, and share experience, training, and lessons learned with the relevant Government of Kenya agencies. It will support increasing access to combination HIV prevention services that incorporates behavioral, structural, and biomedical HIV-prevention interventions and will design and implement targeted HIV-prevention behavioral interventions. Adaptations of evidence-based behavioral interventions (e.g., interventions from the Diffusion of Behavioral Interventions project or Replicating Effective Programs project [www.effectiveinterventions.org and www.cdc.gov/hiv/topics/prev_prog/rep/index.htm]) are also encouraged. Behavioral interventions should focus on increasing condom use, reducing number of sexual partners and concurrent partnerships, and decreasing cross-generational sex. This TBD covers the general population and youth (both in and out of school) in Nyanza province and will reach 12,500 adults with programs encouraging fidelity and 12,500 youth with programs to delay the initiation of sex. Quality assurance informed by central policy guidelines and standards will guide the implementation of this program. The TBD partner will also be required to develop a robust M&E plan to inform the prevention programs.

The comprehensive goals and objectives under this TBD are to continue to strengthen, expand and initiate high quality, evidence-based HIV/AIDS combination interventions for the general population, youth and uncircumcised males in Nyanza Province in Kenya. To avoid duplication, the TBD will work in collaboration with other stakeholders and implementing partners in Nyanza province. The partner will focus on provision of integrated HIV/AIDS combination prevention interventions in Nyanza province targeting Youth, general population and MARPS, including fisher-folk and uncircumcised males in specific districts of Nyanza province. It will develop systems for quality assurance of these programs, and share experience, training, and lessons learned with the relevant Government of Kenya agencies. The partner will support increasing access to combination HIV prevention services that incorporates behavioral, structural, and biomedical HIV-prevention interventions and will design and implement targeted HIV-prevention behavioral interventions. Adaptations of evidence-based behavioral interventions (e.g., interventions from the Diffusion of Behavioral Interventions project or Replicating Effective Programs project [www.effectiveinterventions.org and www.cdc.gov/hiv/topics/prev_prog/rep/index.htm]) are also encouraged. Behavioral interventions should focus on increasing condom use, reducing number of sexual partners and concurrent partnerships, and decreasing cross-generational sex. This TBD covers the general population and youth (both in and out of school) in Nyanza province and will reach 25,000 adults and youth out of school with programs encouraging condom use and reducing number of partners and eliminating concurrent partners, 1250 Commercial sex workers, 500 MSM and 3250 fisher-folk with the PEPFAR Kenya defined minimum package for each target population. Quality assurance informed by central policy guidelines and standards will guide the implementation of this program. The TBD partner will also be required to develop a robust M&E plan to inform the prevention programs.