The goal of the Letlama project is to improve the health of the people of Lesotho by reducing HIV incidence. The Letlama project will focus on supporting Basotho youth and adults in three main behavioral areas: 1) Increased correct and consistent condom use with all sexual partners; 2) Reduction of multiple and concurrent sexual partnering; and, 3) Increased knowledge of ones own HIV status and ones partners status. The project will implement evidence-based behavior change communication activities and strategies to improve linkages and referrals between communication activities and existing programs that provide HIV counseling and testing, PMTCT, and VMMC services, as well as male and female condoms. No service delivery or condom distribution activities will be directly supported by the Letlama project, beyond technical support to public sector partners to implement post-exposure prophylaxis services. The Letlama team will work closely with the public sector, community partners, and the private sector to strengthen the capacity of Basotho institutions to lead, sustain and harmonize the HIV prevention response and deliver high-quality HIV prevention services to scale, measurably contribute to the adoption of social and cultural norms, attitudes, and values that reduce vulnerability to HIV, and measurably improve the ability and motivation of Basotho youth and adults to change their behaviors through increased knowledge, risk perception, skills, and linkages to key services. Although project activities reach youth and adults of all ages, the Letlama team works specifically with young people aged 15-24 and adults 25-35.

The Letlama project will build the capacity of partners to design and deliver age-appropriate HIV prevention interventions to youth 15-24, including delay of sexual debut. Capacity building strategies include: formal trainings; engagement with real-world programs; and, engagement with networks of highly capable individuals and institutions. The project will also build the capacity of local coordinating authorities to play a more active role in the coordination of community-level HIV prevention programs that include abstinence and partner reduction messages. Capacity building efforts will be complemented by a multi-channel integrated campaign, designed and implemented by the Letlama team, to address the underlying social and cultural norms and practices that drive HIV and will include age-appropriate messaging to encourage the delay of sexual debut among youth and partner reduction among sexually active youth and young adults. Interactive individual and small group interpersonal communication activities will promote partner reduction amongst those who are sexually active and delay of sexual debut among youth who are not yet sexually active.

The Letlama project will build the capacity of partners to design and deliver comprehensive HIV prevention interventions to youth 15-24 and young adults 25-34. Capacity building strategies include: formal trainings; engagement with real-world programs; and, engagement with networks of highly capable individuals and institutions. The project will also build the capacity of local coordinating authorities to play a more active role in the coordination community-level HIV prevention programs. Capacity building efforts will be complemented by a multi-channel integrated campaign, designed and implemented by the Letlama team, to address the underlying social and cultural norms and practices that drive HIV. Through a coordinated social mobilization effort designed to maximize local partners coverage, and based on sound theory-based interventions, the Letlama team will increase community action and repeated exposure to key behavior change messages. Interactive individual and small group interpersonal communication activities will be implemented by Letlama partners to promote condom use, partner reduction and uptake of HIV counselling and testing services. These individual level activities will also strengthen referrals to community and health system products and services, including biomedical interventions implemented by other projects and Letlama partners. The project will also support the expansion of programs that provide post-exposure prophylaxis (PEP) to respond to cases of sexual assault, accidental needle prick, accidental surgical cut and other exposure. The project will work with the MoHSW to conduct an initial assessment of the implementation of PEP guidelines in 10 districts and identify gaps; develop of job aides; provide onsite training; develop and disseminate a register; advocate for more a confidential system for health professionals; and, ensure the availability of specific ARV components of PEP. District-level symposia will also be implemented in each district throughout the year to revitalize local commitments to HIV prevention and to galvanize local leaders to play a leading role in advocating for effective HIV prevention programming.