This is a new activity.

The new MARPs Indefinite Quantity Contract (IQC) is aimed primarily at Commercial Sex Workers (CSW)

and secondarily at Mobile and Bridge populations . The latter include groups such as clients of CSW;

miners; long distance drivers; uniformed services; migration/border officials; incarcerated populations;

'mukheristas', informal female traders at the border; and partners and families of these populations. This

IQC also receives CT funding for community or site based Counseling and testing. This activity is

geographically focused on the high prevalence provinces of Maputo city, Maputo and Gaza and in hot spots

and corridors identified by the 2008 Mozambique Data Triangulation (Beira, Nacala, Niassa corridors;

Pemba, Quelimane, Mabote). While a MARP size estimation and mapping has not yet taken place in

Mozambique, preliminary findings from the CSW and IDU I-RARE study, as well as analysis from the 2008

Data triangulation, have identified key hot spots. Activities under this IQC will target these areas and hot

spots. Key drivers to be targeted include low risk perception, low condom use, low knowledge of sero-

status/low uptake of CT, multiple and concurrent partnerships (MCP)/sexual networks, sero-discordancy,

low male circumcision in targeted geographic areas, alchohol abuse, and social and gender-based norms

that increase risk and vulnerability.

Components of the MARP IQC will work in a comprehensive and site-based approach to reach CSWs and

Mobile/Bridge at the individual, couple, family, institutional, community, social and political level. This

activity will build upon and replicate the successful Maputo port night clinic for CSWs and their clients, a

‘one-stop shop' site offering peer-based outreach, small group risk reduction BCC, condom distribution and

negotiation skills building, CT, STI screening and treatment and ART referrals. The new awardee will be

encouraged to establish other night clinics in key hot spots in urban centers and major corridor cross roads

Other C&OP funded activities under the new MARPs IQC will include behavioral (peer-based risk

reduction, targeted condom distribution); some bio-medical (STI screening and treatment) and structural

interventions. Additional services funded under other program areas such as CIRC for male circumcision

for mobile men, or Care for mobile CT. Behavioral activities will include peer-based IPC BCC, advocacy

and sub-population-appropriate IEC. All sub-population messages and campaigns will be vetted through

the Partners' MARP technical working group (TWG) and the USG Prevention TWG to ensure coordination

and reinforcement with USG and non-USG funded on-the-ground , interpersonal (IPC), peer-based, risk

reduction activities.

New activities aimed at Mobile and Bridge populations are split funded between AB, CT and C&OP funds

and are split funded between the IQC for Combination Prevention and the IQC for MARPs. Mobile/Bridge

population activities under both IQCs will be institution and peer-based interventions that include risk

reduction counseling (individuals and peer-based), venue based outreach, individual.peer-based

communication materials and will also address alcohol. In addition to the activities stated above, C&OP

funds for the MARP IQC will also promote linkages to clinical health services that are funded under other

program areas, such as counseling and testing, ART, family planning and reproductive health, and when

policy allows, surgical male circumcision. Mobile pop activities will receive AB funds to address partner

reduction components of a risk reduction program. When policy allows, CIRC funds will provide MC

services for mobile men. AB funds may also be used to create IEC about the limitations of CIRC to address

possible risk compensation, as part of a comprehensive CIRC program.

All peer based and small group BCC programs will go beyond building basic awareness and will strengthen

individual risk perception and locus of control. Alcohol abuse as a risky behavior among each of the sub-

pops will be addressed, for example, in work place based programs for migration officials or police recruits.

Awardee/s of this IQC will be required to have a strong technical and organizational capacity building

component and 'graduation' plan for Mozambican sub-partner organizations providing services to these

populations. Awardees will be strongly encouraged to take on CSW or mobile pop led community based

organizations as sub-partners for capacity building in advocacy and prevention implementation.

This funding will support Community/site-Based and Mobile Counseling and Testing (CBCT) in key hot

spots in urban centers and major corridor cross roads and supports existing and new prevention programs

for the General Population and MARPs in the targeted provinces and areas listed above. These CBCT

activities will be in line with PEPFAR/Mozambique's Couples-Focused CT approach. Counselors will be

trained and equipped with the skills and materials necessary to help them provide both quality sexual

prevention counseling as well as couple counseling to clients. Counseling will move beyond educational

messages to tailor counseling sessions specific to the individual or couples' sexual behaviors and risks and

help them identify their risk and discuss different options in minimizing their risk. The limited, existing CBCT

programs in Mozambique rely on facility-based CT sites for commodity planning and distribution, client

record storage, and assistance with referrals. CBCT sites will be linked to a clinical facility and will be fixed

or mobile sites. There are a range of CBCT approaches that include moblie/outreach, satellite and home-

based services. CBCT sites aimed at MARPs will be satellite or mobile sites with MARP-friendly hours of

operation to increase access and uptake. Examples are night sites near bars, aimed at CSWs and their

clients, or mobile sites at major rest stops to reach long distance truck drivers.

CBCT services under this activity will complement other partner programs and will be better placed to reach

rural populations and harder to reach groups, such as non-street CSWs, including males, clients of CSWs

and migrants. For example, CDC supports facility-based CT in Gaza and Maputo and USAID's Clinical

RFA will provide facility-based CT in Sofala, Manica, Tete and Niassa. CBCT services under this

Prevention Program will collaborate with and supplement existing and planned clinical CT services.

*Project and impact evaluation of this activity will be funded through a separate activity under SI.

Targets are for nine-months of implementation as start up is anticipated for quarter 2 of FY2010.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.14: