ROADS aims to increase access to HIV services and reduce transmission among bridge and most-at-risk populations (MARPs), along transport corridors and hot spot venues, by promoting a package of interventions and preventive services tailored to their lifestyle and risk situation, and promoting appropriate linkages to care and treatment. Transient lifestyles often encourage a preponderance of multiple partnerships, heavy alcohol consumption, widespread sexual and gender-based violence, all of which create an environment of elevated risk for HIV acquisition and transmission. Target groups include mobile populations, eg truckers and other migrant workers; female sex workers (FSWs) and their partners, girls and young women who engage in risky sex primarily for economic purposes. Communities at elevated risk, eg in mining towns or transit points along transport corridors and other hotspots are key foci for this project. ROADS will continue to expand and increase the uptake of non-traditional HIV CT targeted to hard-to-reach populations, and strengthen the linkages of CT to other HIV and health services. In line with priorities of the Partnership Framework, the project aims to strengthen government coordination and multisectoral programming for MARPs. ROADS has specific quantifiable performance measures, indicators and targets to help document, monitor and evaluate the programs performance and achievements. One car in 2011 for Maputo activities, 2 cars are being purchased in 2012 for Maputo and Beira; 2 more cars will be purchased in years 3 and 4 for new sites.Based on rigorous financial analysis of pipeline, burn rates, and implementation the FY 12 request for ROADS was decreased by $3.0 million.

ROADS will continue to provide voluntary CT services as part of a comprehensive package for MARPs and individuals residing in high-risk communities along the Maputo-South Africa and Beira-Zimbabwe transport corridors in the high prevalence provinces of Maputo City, Maputo and Sofala. HIV female/male prevalence rates are: is 29.9% / 16.8% Gaza; 20.5%/12.3% Maputo city and 20%/19.5% Maputo province. Reported HIV testing in the last 12 months for female/males was: 26%/10% in Gaza; 33%/23% in Maputo city and 24%/17% in Maputo province. Specific target populations include commercial sex workers, truckers, port and customs workers and their partners and families. Following the national testing algorithm, ROADS will increase uptake at non-traditional CT sites and continue to strengthen linkages to other HIV and health services (e.g. male circumcision for HIV- men) using the national referral documentation system to track and monitor HIV+ clients to ensure they are received at appropriate services. ROADS counselors will ensure successful referrals by introducing newly diagnosed HIV+ clients to ROADS peer educators who will escort clients to enroll or register for follow up services, including positive prevention or the new MOH pre-ART service delivery package and support groups. ROADS will contribute to MOH/CNCS capacity to plan, expand and sustain CT for MARPs and bridge populations by developing, testing and scaling-up innovative models for creating demand and increased uptake of CT. They will continue to engage with opinion leaders, public and private health providers and policy makers to publicly endorse CT as an essential service; to encourage risk reducing behaviors; and to address stigma, denial and discrimination (a key barrier to CT uptake). ROADS will continue to emphasize improved quality of testing by participating in the biannual EQA panels; use of standardized QA tools; and utilizing peer supervision, client exit interviews or provider self-reflection tools for monitoring and improving counseling quality. Planned trainings may include QA/QI, MARP-friendly counseling, supply planning, linkages/continuum of care, gender and gender-based violence and treatment as prevention. As capacity building is crucial for scale-up, ROADS plans to fully transfer CT service provision to GRM or local NGOs/CBOs by the end of project and will continue to seek more PPPs with the private sector. They will continue to advocate with government for an enabling policy environment to effectively reach these populations and ensure appropriate government leadership and coordination of programming for MARPs. The target for ROADS COP 12 HVCT funds ($210,000) is 16,000 individuals. CT activities began in FY12; so they did not report results in the SAPR 11.

ROADS will build on progress achieved to date to further demonstrate outputs and results in reaching high risk mobile and community populations along transport corridors with HIV, health and related services through various entry points community clusters, SafeTStop Resource Centers, community-based counseling and testing services, night clinic services and addressing determinants and barriers to HIV prevention, treatment, and care, including risk factors such as alcohol, gender-based violence and economic vulnerability. Target populations include mobile populations, such as truckers and other migrant workers who engage in risky behavior, commercial, transactional or casual sex, and place their regular partners at increased risk as well; female sex workers (FSWs) and their partners, and girls and young women who engage in risky sex primarily for economic purposes. This will entail further accelerating project implementation in existing sites to achieve comprehensive HIV prevention programming that creates Paragem Segura (Safe T Stop) communities, and using lessons, tools and resources developed to facilitate an efficient expansion to new project sites. Program priorities for FY12 inlcudeStrategically expand the geographic footprint of the project to three additional sites, for a total of seven Paragem Seguras ,SafeTStop, sites;Extend the reach of community clusters to at-risk individuals through expansion of the immediate social network to connectors, individuals who have frequent contact with truckers, sex workers and other high risk groups;Develop innovative approaches for reaching and engaging truck drivers as they move from one point to another along the corridors;Strengthen outreach to sex workers through a combined set of interventions that includes involvement in the women clusters, targeted peer education, night clinics, and other services;Introduce various options for providing support at the community level to address alcohol abuse and gender-based violence, inter-linked risk factors that contribute to HIV transmission;Introduce economic strengthening activities within the community such as Group Savings and Loans Associations in order to promote economic empowerment as a means to strengthen HIV and AIDS interventions;Continue to explore opportunities to leverage support from the private sector for the delivery of HIV and health information and services to target populations;Establish and define the project baseline through the Behavioral Monitoring Survey (BMS), mapping and population size estimations to prepare for future evaluations and special studies to measure the impact of the project and support evidence-based programming.