Reprogramming 8/07: This activity will provide support to the Rwandan Ministry of Education. While the MINEDUC is heavily involved in PSI's school-based HIV/AIDS prevention activities, human resources at the Ministry are scarce. There is currently one person, the Coordinator of HIV/AIDS programs, who is responsible for planning, coordination, and monitoring of all HIV/AIDS activities in the education sector. The Ministry would greatly benefit from two additional positions in the HIV/AIDS department. These two locally-hired FTE positions will be hired by PSI and seconded to the MINEDUC under this activity.

This activity relates to HVOP (7232) and HVAB (7265).

The overall goal of PSI's Healthy Schools Initiative is to reduce HIV/AIDS incidence among youth aged 15-24 by promoting abstinence and safer sexual behaviors, changing social norms among men and women, as well as improving communication among secondary school youth. According to the 2005 RDHS-III, the median age for sexual debut among Rwandans is 20.3 years for women and 20.8 years for men. Given this relatively late age of sexual debut, both abstinence and be faithful messages are appropriate interventions for youth in secondary schools.

During FY 2006, PSI collaborated with the MINEDUC to strengthen the HIV/AIDS competencies of teachers and anti-AIDS clubs by identifying thirty target schools and assessing their needs for training and support materials. PSI also created a BCC peer education Life Skills module and trained members of anti-AIDS clubs as peer educators. One component of the Life Skills curriculum is a module on gender, which focuses on techniques to strengthen girls' empowerment. The Healthy Schools Initiative also included abstinence BCC campaigns targeting youth, which utilized interpersonal communication sessions and mobile video shows to promote abstinence messages. PSI also developed a parent-child curriculum aimed at improving communication about HIV/AIDS and sexuality which is being used to train community-based facilitators to work with parents and religious leaders.

In FY 2006, PSI's focused, high-intensity prevention interventions reached 12,000 students with AB messages. This accounts for approximately 4% of Rwandan secondary school youth. National scale-up of this program is not feasible due to a high program cost per student. This activity has thus been altered slightly for FY 2007 so that a greater percentage of Rwandan youth (30-50%) will be reached with prevention messages.

In FY 2007, PSI will target a larger portion of Rwandan school youth with prevention messages using midlevel media in at least 200 secondary schools. This effort will complement the newly GOR approved HIV/AIDS curriculum for secondary schools. Mobile video shows will present abstinence and be faithful messages that focus on improved communication between boys and girls to strengthen negotiation skills, increased ability to resist peer pressure, the risks of cross-generational and transactional sex, and better understanding of gender equality. Two teams will be deployed to present the mobile shows in all 30 districts of the country. The program will maximize coverage of these prevention activities and reach at least 144,000 youth during FY 2007.

As a second component of this program, PSI will continue production of the ABAJENE! youth call-in radio shows to reinforce the prevention messages communicated during mobile presentations. The ABAJENE! youth magazine will also be produced quarterly and disseminated to 75,000 youth in secondary schools. Assuming that each magazine will be read by at least four youth, the program intends to reach at least 300,000 students.

The Healthy Schools Initiative addresses the key legislative issues of gender, particularly male norms, and stigma reduction. This activity also reflects the ideas presented in the EP Five-Year HIV/AIDS Strategy in Rwanda, and the GOR National Prevention Plan by expanding abstinence programs at secondary schools.

This activity relates to HVAB (7226, 7265).

The overall goal of PSI's Healthy Schools Initiative is to reduce HIV/AIDS incidence among youth aged 15-24 by promoting abstinence and safer sexual behaviors, changing social norms among men and women, as well as improving communication among secondary school youth. According to the 2005 RDHS-III, the median age for sexual debut among Rwandans is 20.3 years for women and 20.8 years for men. Given this relatively late age of sexual debut, both abstinence and be faithful messages are appropriate interventions for youth in secondary schools.

During FY 2006, PSI collaborated with the MINEDUC to strengthen the HIV/AIDS competencies of teachers and anti-AIDS clubs by identifying thirty target schools and assessing their needs for training and support materials. PSI also created a BCC peer education Life Skills module and trained members of anti-AIDS clubs as peer educators. One component of the Life Skills curriculum is a module on gender, which focuses on techniques to strengthen girls' empowerment. The Healthy Schools Initiative also included abstinence BCC campaigns targeting youth, which utilized interpersonal communication sessions and mobile video shows to promote abstinence messages. PSI also developed a parent-child curriculum aimed at improving communication about HIV/AIDS and sexuality which is being used to train community-based facilitators to work with parents and religious leaders.

In FY 2006, PSI's focused, high-intensity prevention interventions reached 12,000 students with AB messages. This accounts for approximately 4% of Rwandan secondary school youth. National scale-up of this program is not feasible due to a high program cost per student. This activity has thus been altered slightly for FY 2007 so that a greater percentage of Rwandan youth (30-50%) will be reached with prevention messages.

In FY 2007, PSI will target a larger portion of Rwandan school youth with prevention messages, using mid-level media in at least 200 secondary schools. Mobile video shows will be presented at schools in two parts. The first part of the presentation will target all the secondary school youth and will focus on abstinence and be faithful messages. The second part of the show will target the older students in the school and will incorporate messages about consistent and safe condom use to protect against HIV transmission. Additionally, the emphasis will be on improving communication between boys and girls to strengthen girls' negotiation skills, increase their ability to resist peer pressure, and emphasize the risks of cross-generational and transactional sex. Two teams will be deployed to present the mobile shows in all five provinces of the country. The program will maximize coverage of these prevention activities and reach at least 100,000 youth during FY 2007.

As a second component of this program, PSI will continue production of the ABAJENE! youth call-in radio shows to reinforce the prevention messages communicated during mobile presentations. The ABAJENE! youth magazine will also be produced quarterly and disseminated to 75,000 youth in secondary schools. Assuming that each magazine will be read by at least four youth, the program intends to reach at least 300,000 school students.

The Healthy Schools Initiative addresses the key legislative issues of gender, particularly male norms, and stigma reduction. This activity also reflects the ideas presented in the EP Five-Year HIV/AIDS Strategy in Rwanda, and the GOR National Prevention Plan by expanding abstinence programs at secondary schools

In FY 2007, PSI will field a mobile VCT team to provide HIV testing and counseling to high risk groups. This funding will cover salaries of counselors, laboratory supplies, transportation costs, and partial salaries for VCT Coodinator and Director of HIV Programs at PSI. The GOR's overall strategy continues to be prioritizing support for facility-based CT and expansion of new sites. However, GOR endorses selective use of mobile CT to reach mobile populations such as the uniformed services, CSWs and their clients, prisoners, men who have sex with men, truck drivers, and itinerant workers (fishermen, tea plantation workers, etc) - high-risk populations that are likely to have higher than average seroprevalence rates. PSI will work with the GOR and other key partners to field an MVCT team to provide high quality, client-initiated CT services that ensure confidentiality, minimize stigma and discrimination, and reach those individuals most likely to be infected.Counseling messages will emphasize prevention, including abstinence and reduction of partners, alcohol reduction, GBV sensitization, disclosure of test results, and follow-up care.

PSI's mobile team will coordinate schedules, target populations, and locations of testing with other EP partners conducting MVCT. In order to ensure proper referral to care, PSI will identify ARV sites in proximity of each MVCT testing location and provide this information and actively refer each HIV-positive client, and a follow-up system will be used to determine what percentage of clients actually accessed care. This will be implemented in accordance with GOR standards and guidelines. PSI will work with PFSCM and district pharmacies to ensure inventory monitoring and tracking systems for the test kits. This MVCT activity reflects the ideas presented in the Rwanda EP five-year strategy and the National Prevention Plan by scaling-up CT services, increasing the availability of CT services outside of health facilities, and providing prevention messages to high-risk groups.