Samaritan's Purse has been implementing community-based interventions targeting adults, youth, and adolescents through local institutions including schools and churches to respond to HIV in the southern region of Mozambique over the past seven years. Ongoing knowledge, attitude and practice (KAP) and lot quality assurance sampling (LQAS) data collected since 2003 have demonstrated programmatic success in significantly increasing knowledge of HIV, testing rates, care of PLHIV, and stigma reduction.

Samaritan's Purse's goal through this proposed program is to reduce the risk of HIV infection and STIs among youth along the Maputo and Zambezia corridors. Activities will support USG's Partnership Framework goal 1, to reduce new HIV infections; and goal 2, to strengthen the multisectoral HIV response, through engaging civil society. Furthermore, it is in direct alignment with objective 10.3 stated in MOH's Strategy for Accelerated Prevention of HIV Infection, which is to improve the education of adolescents regarding sex. The main objectives and outputs of the proposed program are designed to assist the USG and the MOH with the achievement of the results they seek under these goals.

The organizational objectives for this activity are to: 1) Provide skills based training of parents and guardians; 2) Develop and disseminate information, education and communication on HIV and reproductive health issues; 3) Implement interventions targeting primary behavior change among adolescents and youth; 4) Enhance the capacity building of local institutions (schools, churches and clinics); 5) Increase linkages and community access to health and social services; 6) Cultivate strategic partnerships and coordination; and 7) Develop quality information systems, utilization of monitoring and evaluation data to inform program implementation and adoption of evidenced-based strategies.

In FY 2010 Samaritan's Purse will also support community / home-based HIV counseling and testing in Inhambane province. The main emphasis of this activity is community mobilization and access to counseling and testing services. Target populations include students, families, community and religious leaders, traditional birth attendants, and traditional healers. Training activities under the supervision of provincial and district health authorities will contribute to strengthening integrated health networks, and activities will be aligned with partnership framework objectives to expand access to HIV counseling and testing.

This activity will directly contribute to the following goals of the Partnership Framework: -Goal 1: Reduce new HIV infections in Mozambique by getting to know the HIV status and expanding access to confidential HIV counseling and testing; -Goal 3: Strengthen the Mozambican health system, including human resources for health and social welfare in key areas to support HIV prevention, care and treatment goals.

During FY 2009 Samaritan's Purse (SP) was trained by Jhpiego on the implementation of home-based HIV counseling and testing as a complementary intervention to the existing implemented activities related to prevention and home-based care. This funding will provide resources to continue community based counseling and testing in Massinga and Zavala districts of Inhambane Province. This service will reinforce SP's current Family Matters program and will help to further achieve PEPFAR's five year strategic prevention objective of "Strengthening Access to the Ministry of Health's Integrated Health Networks".

The main emphasis area of this new activity is community mobilization/participation and increased access to counseling and testing. Through networks and relationships built through SP's existing

interventions, individuals will be easily identified for participation in community-based CT. Target populations include Secondary School students, Adults, HIV affected families, community and religious leaders, traditional birth attendants, and traditional healers. Training of counselors and integration of CT activities under the supervision of both Provincial and District level health services contributes to strengthening access to MOH's "Integrated Health Networks." The training of counselors and partnership with health facilities at the district level in monitoring quality assurance of testing activities and defining referral mechanisms between community and clinic activities enhances the capacity of both health systems and health care workers.

The Families Matter! Program (FMP) is an evidence-based intervention designed to promote positive parenting and effective communication for parents of 9-12 year olds. This family prevention program strives to foster enhanced protective parenting practices that support the reduction of sexual risk behaviors among adolescents, including delayed onset of sexual debut, by giving parents tools to deliver primary prevention to their children. A preliminary analysis of an assessment conducted in Kenya 15 months post-intervention, found sustained positive effect in terms of parenting and communication skills reported by participants and their children separately.

FY 2010 funds will be used to implement FMP in Gaza and Zambézia Provinces, along high density, high HIV prevalence transport corridors. Samaritan's Purse will train FMP facilitators to deliver the five consecutive, three-hour sessions for parents and caregivers. The intervention curriculum, adapted specifically for Mozambique, focuses on: raising awareness about the sexual risks many teens face; encouraging parenting practices that decrease the likelihood that children will engage in risky sexual behaviors; and improving parents' ability to effectively communicate about abstinence, sexuality and sexual risk reduction. An additional emphasis will be placed on training parents to address the role of gender-based norms in adolescent sexual decision-making and risks associated with transgenerational sex for girls. FMP activities will be linked with other youth-focused interventions implemented in and out of schools by Samaritan's Purse and others. In addition, Samaritan's Purse will use the opportunity to reach adults during the FMP training and will include messages about fidelity, multiple concurrent partnerships and substance use. Community-based activities with provincial leaders will be initiated to foster changes in social norms that support protective behaviors for adolescents.