Summary

This activity narrative refers to field support which will augment the central Gender Initiative, "PEPFAR

Gender Initiative on Girls' Vulnerability to HIV".

Johns Hopkins University (JHU/CCP) has won this award.

The PEPFAR Gender Initiative on Girls' Vulnerability to HIV has been developed as part of a set of

PEPFAR special gender initiatives. The program aims to prevent HIV infection among 13-19 year old girls

by developing innovative program interventions to 1) modify contextual factors associated with increased

sexual risk behavior and rates of HIV infection; and 2) assess the feasibility and effectiveness of these

interventions and their potential for sustainability, scale-up, and transferability to other settings. Botswana,

Malawi and Mozambique are the three countries selected for this Initiative.

Background

Many PEPFAR programs reach adolescent girls through broad-reaching AB prevention activities that focus

on HIV education in church and school settings. However, these programs often do not reach those at

highest risk, who commonly are found outside of these settings. Those at highest risk need to be reached

with a package of comprehensive services, including economic strengthening activities, to meet their unique

needs. In addition, many OVC programs focus on younger children and overlook the needs of adolescent

orphans, even though this latter group represents a significant proportion of all orphans. This Initiative

seeks to address these programming gaps by implementing and evaluating promising integrated models to

reach highly vulnerable adolescent girls with comprehensive services tailored to their particular needs.

The goal of the Initiative is to prevent HIV infection in the most vulnerable adolescent girls. The objectives

are: 1) To identify and expand promising new and existing program approaches for addressing the

contextual factors which place some adolescent girls at especially high risk of HIV; and 2) To evaluate the

feasibility, sustainability, and effectiveness of these interventions and their potential for adaptation and scale

-up to other settings. Initiative activities will be closely linked with other prevention and OVC activities, as

well as relevant wrap-around programming.

A multi-component approach with a focus on the most vulnerable girls will be undertaken to address the

antecedents of risk. Age-segmentation and targeting based on different types of risks girls face will be

utilized to prevent girls from adopting risky behaviors as well as addressing the needs of girls already

engaged in risky behaviors. Program components may include the following:

-HIV prevention education focused on the "ABC" approach;

-Non-material support for girls' continuation in, or return to, school;

-Outreach and linkages with HIV-related health services as well as RH services such as pregnancy

prevention;

-Wrap-around or direct support for training in sustainable livelihoods and/or improved access to economic

resources such as development of appropriate age- and gender-specific financial literacy, development of

savings products and related social support mechanisms, sustainable livelihoods and/or improved access to

economic resources, including government-provided entitlements and health services;

-Parenting skills among parents and guardians of adolescents;

-Peer influence by promoting positive group norms and behaviors; and

-Community social norms that help to reduce sexual coercion and exploitation and other harmful practices

contributing to girls' vulnerability.

For those adolescents without parents, this activity will include specialized subjects such as developing

mentoring programs to ensure all adolescents have support on a continuing basis from a caring

mentor/community member and providing lessons on empowerment and interpersonal skills to enable girls

to adopt and/or maintain healthy sexual behaviors, including making decisions within relationships, families,

and communities.

Specific activities are TBD, pending selection of the Task Order contractor and development of the workplan

(anticipated to begin Oct 2008).

Summary

This activity narrative refers to field support which will augment the central Gender Initiative, "PEPFAR

Gender Initiative on Girls' Vulnerability to HIV".

The PEPFAR Gender Initiative on Girls' Vulnerability to HIV has been developed as part of a set of

PEPFAR special gender initiatives. The program aims to prevent HIV infection among 13-19 year old girls

by developing innovative program interventions to 1) modify contextual factors associated with increased

sexual risk behavior and rates of HIV infection; and 2) assess the feasibility and effectiveness of these

interventions and their potential for sustainability, scale-up, and transferability to other settings. Botswana,

Malawi and Mozambique are the three countries selected for this Initiative.

Background

Many PEPFAR programs reach adolescent girls through broad-reaching AB prevention activities that focus

on HIV education in church and school settings. However, these programs often do not reach those at

highest risk, who commonly are found outside of these settings. Those at highest risk need to be reached

with a package of comprehensive services, including economic strengthening activities, to meet their unique

needs. In addition, many OVC programs focus on younger children and overlook the needs of adolescent

orphans, even though this latter group represents a significant proportion of all orphans. This Initiative

seeks to address these programming gaps by implementing and evaluating promising integrated models to

reach highly vulnerable adolescent girls with comprehensive services tailored to their particular needs.

The goal of the Initiative is to prevent HIV infection in the most vulnerable adolescent girls. The objectives

are: 1) To identify and expand promising new and existing program approaches for addressing the

contextual factors which place some adolescent girls at especially high risk of HIV; and 2) To evaluate the

feasibility, sustainability, and effectiveness of these interventions and their potential for adaptation and scale

-up to other settings. Initiative activities will be closely linked with other prevention and OVC activities, as

well as relevant wrap-around programming.

A multi-component approach with a focus on the most vulnerable girls will be undertaken to address the

antecedents of risk. Age-segmentation and targeting based on different types of risks girls face will be

utilized to prevent girls from adopting risky behaviors as well as addressing the needs of girls already

engaged in risky behaviors. Program components may include the following:

-HIV prevention education focused on the "ABC" approach;

-Non-material support for girls' continuation in, or return to, school;

-Outreach and linkages with HIV-related health services as well as RH services such as pregnancy

prevention;

-Wrap-around or direct support for training in sustainable livelihoods and/or improved access to economic

resources such as development of appropriate age- and gender-specific financial literacy, development of

savings products and related social support mechanisms, sustainable livelihoods and/or improved access to

economic resources, including government-provided entitlements and health services;

-Parenting skills among parents and guardians of adolescents;

-Peer influence by promoting positive group norms and behaviors; and

-Community social norms that help to reduce sexual coercion and exploitation and other harmful practices

contributing to girls' vulnerability.

For those adolescents without parents, this activity will include specialized subjects such as developing

mentoring programs to ensure all adolescents have support on a continuing basis from a caring

mentor/community member and providing lessons on empowerment and interpersonal skills to enable girls

to adopt and/or maintain healthy sexual behaviors, including making decisions within relationships, families,

and communities.

Specific activities are TBD, pending selection of the Task Order contractor and development of the workplan

(anticipated to begin Oct 2008).