IRDO is a Kenyan NGO based in Kisumu, Nyanza Province. Its principal mandate is to design, implement and evaluate public health programs and research. In October 2004, IRDO was funded by PEPFAR, through a CoAg with CDC, to design and implement a HIV prevention program that promotes abstinence and being faithful among the youth living in the informal (slum) settlements of Kisumu City. The program has expanded both in geographical coverage (from 5 small slums to the entire Kisumu East, Suba, Kisumu West, Nyando, Siaya, Bondo and Rarieda districts) and expanded the programmatic areas scope to cover more comprehensive preventions programs including male circumcision, EBIs and biomedical interventions.Its goals for 2012 are to reach out to 7,600 members of the general population and youth aged 915 with individual or small group HIV prevention interventions that are evidence-based (Families Matter! Program and Healthy Choices I) and meet the minimum standards required; Provide 146,000 individuals with testing and counseling services for HIV with all receiving their test results. Provide services to 13,450 most at risk populations (MSM, Fisherfolk, FSWs) and 16,183 youths 15-24 years with evidence based HIV prevention interventions that meet the minimum standards. MARPs will receive community PwP, FSW program, MSM program, stepping stones and sister-to-sister. Provide 5,000 PLHIV with minimum package of Community-PwP interventionsThe general population will be provided with 5,000 RESPECT services.

IRDO purchased 2 vehicles in FY 2011 which will be used during the planning period, it would be both cost-effective and convenient to purchase the vehicles instead of renting. The vehicles will be used entirely for PEPFAR project activities. This activity supports GHI/LLC

IRDO will support the implementation of HIV prevention services in Kisumu East, Nyando, Rongo, and Bondo/Rarieda Districts with interventions targeting the youth age 9 to 17 years of age. The objective is to provide the youth with information to help them make informed choices about their sexual and reproductive health. IRDO will support provision (individually or in small groups) of the selected and appropriate age specific and evidence/theory-based HIV/AIDS prevention interventions to 7,600 youth aged 9 15yearsHealthy Choices (HC) I &IIHCI targets in-school youth aged 10-14 years and aims to delay sexual debut by providing knowledge and skills to negotiate abstinence, avoid negative peer pressure, avoid or handle risky situations and to improve communication with a trusted adult. HC I consists of 8 modules of approximately one hour each. It can be delivered in 4 sessions of 2 hours each or in 8 sessions of 1 hour each. The Youth out of school will be identified through their social networks, trained peer leaders and youth activities like sports and music extravaganzas. Culturally sensitive and relevant IEC materials specific to sex and age groups will be designed, developed and distributed for promoting HVAB. Mature minors will be linked to HIV testing and counseling services.The Families Matter! Program (FMP)FMP is an evidence-informed, parent-focused intervention for parents, guardians, and other primary caregivers (hereafter referred to as parents) of preadolescents ages 912 years. Delivered in 5 weekly sessions to give parents time to internalize new information and practice skills, the program promotes positive parenting practices such as positive reinforcement and parental monitoring and effective parent-child communication on sexual topics and sexual risk reduction. The goal of FMP is to reduce sexual risk behavior among adolescents, including delaying onset of sexual debut, by training parents to deliver primary prevention messages to their children. More effective parental communication can help to delay their childrens sexual behavior and increase protective behaviors as their children get older. The intervention also links parents to other critical evidence-based interventions including HTC and VMMCQuality AssuranceTo promote quality assurance, IRDO will provide On Job Trainings (OJTs), mentorships, Continuous Medical Education (CMEs) and refresher courses where knowledge and/or skill gaps are identified. The trainings will target all individuals who are involved in the AB programs including health care workers, peer educators and facilitators. Quality assurance of FMP is promoted through rigorous training and certification of facilitators, ongoing process monitoring with standardized tools, and quality assurance site visits by a capacity building agency. All data generated by the facilitators and other service providers will be entered into standard data base and periodically analyzed to improve programming. IRDO will seek to share experiences, lessons learnt and best practices with other PEPFAR partners and other stakeholders. With the technical assistance from NASCOP and CDC, IRDO will enhance field site supervision to provide technical support to the service providers and ensure adherence to the guidelines and ethics

The goal of the country as reflected in Kenya National Aids strategic plan (KNASP III) is to reach 80% knowledge of HIV status in the country by 2013. Nyanza Province, which has a population of about 5.1 million people, carries the highest HIV burden in Kenya. With an estimated adult HIV prevalence of 14.9% compared to the national 7.1%, ~500,000 people are living with HIVIRDO The Pembe Tatu Project supports the Provision of Integrated HIV Prevention Interventions, including Voluntary Medical Male Circumcision (VMMC) in Nyanza Province. This mechanism covers several program areas and activities that include HIV testing and Counseling in outreaches/mobiles and national Rapid Response Initiative (RRI) campaigns. Many of these activities build synergies between HIV testing and counseling, male circumcision and HIV care and treatment services in a sustainable way. The overall goal of HTC program is to increase the proportion of individuals who know their correct HIV status in Kisumu East, Nyando, Rongo, and Bondo/Rarieda DistrictsIn FY10, IRDO supported HTC in the two counties using various approaches including national RRI campaigns, mobile/outreach and moonlight HTC. Between October 2010 and March 2011, a total of 51,443 people were offered comprehensive HTC services. Individuals identified as HIV infected were linked to care and treatment services.Guided by gaps identified in KAIS, KDHS 2009 and program data, IRDO will continue to support HTC service implementation in the two counties with specific area of focus being outreach/mobile and targeted HTC approaches to most-at-risk populations. This mechanism will work with the Ministry of Health (MOH) at the county, District and community levels to jointly plan, coordinate and implement HTC services for both adults and children in support of the KNASP III, the Partnership framework and the District and Provincial level MOH annual operation plansIRDO will target couples, sexually active youth, youth out of school and general population amongst others with intent to enhancing diagnosis of HIV status among individuals with unknown HIV status, enhanced knowledge of HIV status with emphasis of identifying HIV infected individuals and HIV sero-discordant couples and strengthened linkage to appropriate HIV prevention, care and treatment services and ensuring disclosure as a key strategy of strengthening HIV prevention among sero-discordant couples. The program will target a total of 146,000 individuals with HBTC of whom 10% will be pediatricsEffort will be directed towards building capacity of MOH staff to provide safe and quality services, as well as minor renovations in MOH facilities to ensure ownership for sustainabilityWorking with other relevant stakeholders, the program will strengthen appropriate referral and linkages between Community HTC and other HIV/AIDS prevention, care and treatment services in the selected districts. The program will also work with the GoK system and in particular NASCOP to support the following activities at district level: Commodity management, Training of HIV service providers, Implementation of the WHO recommended multistep approach to Quality Assurance and National Quality Assurance Strategy on HIV Testing, Supervision and Implementation of the community PwP strategy. The program will continue to strengthen data collection, analysis, utilization and reporting at all levels to increase and improve performance and reporting to NASCOP and PEPFAR

IRDO will continue to expand access to a high quality comprehensive package of HIV prevention services for the general population (36,783) and MARPS (13,450) in Nyanza Province specifically in Kisumu East, Nyando and Bondo/Rarieda Districts. This program will continue to target high risk sexual behavior prevalent among these populations including incorrect and inconsistent condom use particularly with regular sex partners.IRDO will work with the beach management units to select, recruit and train fisher folk peer leaders on peer education and facilitation skills of peer sessions of the stepping stones EBI. Small groups of 20 individuals are identified by the peer educators based on age and gender to enhance discussion. During the peer sessions, demand creation and referrals for other services like HTC VMMC, STI treatment, HIV care and treatment services will be offered. Each group undergoes 5 sessions on various SRH topical issues to for a person to qualify. Follow up sessions will be conducted after 6 months for each group. Other behavioral risk factors that will be addressed include excessive alcohol and substance abuse, gender based violence and low adherence to treatment among fisher folk.This mechanism will support implementation of the Combination Prevention Interventions for FSWs as defined in the National Guidelines for the package of services for SWs. These comprise evidence-informed behavioral, biomedical and structural interventions. Behavioral interventions include peer education and outreach, condom and lubricant demonstration and distribution and risk assessment, risk reduction counseling and skills building. Specific EBIs for this group will be RESPECT, Sister-to-Sister and Safe in the City. Biomedical interventions include HTC, VMMC, STI screening and treatment, TB screening and referral to treatment, HIV care and treatment, RH services, Emergency contraception and Pre-exposure prophylaxis.IRDO is considering initiating Treatment as Prevention for MARPS and initiating Pre-exposure prophylaxis where feasible, malaria treatment all within its drop in and service centres. Among the discordant couples IRDO will implement an EBI EBAN with an objective of lowering the rate of risky behavior among HIV-discordant couples and promoting the safe sex through increased condom uptake in this sub population. This shall be offered in an integrated setup with other services also availableYouth aged 13 17 years both in and out of school will be reached with Healthy Choices II (HCII) that aims to delay sexual debut, promote secondary abstinence or have protected sexual intercourse, by providing knowledge and skills on correct and consistent condom use, handling peer pressure, and learning ones HIV status.To promote quality assurance, IRDO will provide On Job Trainings (OJTs), mentorships, Continuous Medical Education (CMEs) and refresher courses where knowledge and/or skill gaps are identified and addressed through mentorship, trainings and exchange visits for bench marking. All data generated by the facilitators and other service providers will be entered into standard data based and periodically analyzed for programming purposes. IRDO will seek to share experiences, lessons learnt and best practices with other PEPFAR partners and other stakeholders. Quarterly support supervision with NASCOP, ministry if fisheries and DHMTs will ensure quality of services delivered is of the expected standard