The USG Gender Initiative on Girls' Vulnerability to HIV aims to understand the causes of and mitigate the effects of HIV vulnerability among girls and young women in Mozambique, Malawi and Botswana. Girls and young women in Mozambique are 3 to 4 times more likely to contract HIV than males their age. The multifaceted and complex factors that fuel the epidemic among adolescent girls in sub-Saharan Africa include economic vulnerability; lack of social cohesion; pervasive gender inequalities, including fewer legal rights; the social acceptability—even expectation—of multiple concurrent sexual partnerships; and the tacit acceptance of cross-generational sex between older men and younger women. Those at highest risk need to be reached with a package of comprehensive services, including economic strengthening activities, to meet their unique needs.

Through comprehensive programming, the Initiative seeks to address the structural, social and individual risk factors of adolescent girls. The USG Gender Initiative on Girls' Vulnerability to HIV was developed as part of a set of USG special gender initiatives. The Initiative targets communities in 4 districts in each of the two provinces, Zambezia and Nampula through two partner NGOs, World Vision and SNV, and the local CBOs with whom they work. Beneficiaries include in-school youth, out-of-school girls, community members, school administrators and teachers. The program aims to prevent HIV infection among 10- to 17-year-old girls by developing innovative program interventions to successfully modify contextual factors associated with increased sexual risk behavior and rates of HIV infection. The feasibility and effectiveness of these interventions and their potential for sustainability, scale-up, and transferability to other settings will be assessed.

A multi-component approach with a focus on the most vulnerable girls was undertaken to address the antecedents of risk. A literature review was conducted that looked at vulnerable girls and HIV in southern Africa as was a rapid analysis of economic empowerment opportunities for older girls and women in the two provinces. Consultative meetings have been held and consensus building continues with stakeholders, NGO partners, district authorities and local leaders in both provinces. Formative research was conducted including focus group discussions with youth, adults and other key community members. The research clearly pointed to awareness among research participants that the current behavior of adolescent girls is markedly different from adolescent girls of a previous generation. These new behaviors are evident in two of the main proximal factors to girls' vulnerability to HIV: early sexual debut and transactional/intergenerational sex. The research also contributed to the creation of a vulnerability index for girls as well as an ideation index regarding individuals' perceptions of girls' vulnerability and a community support index. These indices will be used to survey the causes and community response to girls' vulnerability.

Program tools have been developed including a guide on mobilizing communities around girls' vulnerability to HIV; an adult-child communication guide; a life-skills manual for in-school youth, to complement the Ministry of Education and Culture's materials; and a life skills manual for out-of-school girls, as well as accompanying teacher-training materials. A radio design workshop was held with VGI staff, NGO partner representatives and radio producers from 2 radio stations (Catholic and Muslim) that broadcast in both provinces to develop programming to stimulate a collective response to address girls' vulnerability to HIV. The VGI has brought members of the community together, regardless of their religious affiliation, to work collectively and respond to this issue.

Data collectors from the local Ernst and Young office received an intensive, two-week training; data collection is underway for the process evaluation. This training also serves as institutional capacity building as the pool of qualified, experienced Mozambican data collectors is limited. Community mobilization activities are in progress; the teacher training and implementation of the life skills program will begin in early 2010.

This program links with the Partnership Framework through its overarching goal of the reduction of new HIV infections in Mozambique as well as the engagement of partners at the district and provincial level and increases participation of civil society. VGI has engaged members at all levels of the community

(district education staff, school staff, religious leader, parents, etc.) to work together to address girls' vulnerabilities to HIV.

VGI has cross-cutting linkages with gender, including mitigation of gender-based violence. Specifically, this program seeks to address the key issues of increasing gender equity in HIV activities and addressing male norms and behaviors through community mobilization efforts and with young boys as they participate in the in-school life skills interventions. The life-skills program for out-of-school girls is aimed toward increasing older girls' access to income and productive resources.

New activities FY 2010 include analysis and dissemination of results from both the process monitoring and evaluation as well as survey results from the vulnerable girls' index, the ideation index and the community support index. Deliverables include the survey indices as well as training materials. Researchers from JHU intend to present preliminary results back to the communities as well as regionally with VGI staff and participants to compare and contrast the results from Botswana, Malawi and

Mozambique. In addition, meetings will be held in Maputo and the two provinces with representatives from USG, GOM and non-governmental organizations to share findings and programmatic successes and obstacles to inform future interventions aimed at vulnerable girls in Mozambique. As such, these activities correspond to the Key Issue of End-of-Program Evaluation.