PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The overall goal of this activity is to reduce HIV incidence among youth aged 15-24 by promoting
abstinence and safer sexual behaviors, changing behaviors and social norms among men and women, and
improving and building life skills among secondary school and out-of-school youth. Prevention programs for
youth remain a high priority for both the GOR and PEPFAR. With an overall national prevalence of 3.1%,
there is a critical need for evidence-based prevention efforts in the largely HIV-negative population and an
opportunity to affect the progression of the epidemic by reaching the youth population. Averting new
infections in this age group, is not only cost effective, but is also the most sustainable way to turn the tide
against HIV/AIDS.
Although 2005 DHS data reflect a very low HIV prevalence among nearly all youth groups, recent testing
data from some youth centers suggest that HIV prevalence among out-of-school youth is as high as 7%.
Data from the three PEPFAR supported studies: DHS 2005, PLACE and the recently concluded data
triangulation exercise all indicate areas where programs need to improve prevention programming in
Rwanda. The 2005 DHS indicates that 2.5% of young girls 20-24 are HIV positive, whereas only 0.5% of
boys in the same age bracket are HIV positive. Substantially higher prevalence rates are present among
older males; e.g., for men aged 40-44, the prevalence rate is 7.1%. Considered together, this data
suggests that older men and younger women engage in trans-generational sex.
PEPFAR through the Healthy Schools Initiative has collaborated with the GOR to implement health
communication interventions in 60 secondary schools and has scaled up comprehensive prevention and
testing services for high risk youth at four youth centers in Rwanda. This strategy has provided an
integrated prevention program for youth in Rwanda, targeting a diverse mix of in- and out-of-school youth.
In the activities proposed under this new mechanism, the partner (TBD) will develop and test a
comprehensive prevention package tailored for particular population segments (in school, out-of-school, all
the high risk groups) and develop and implement evidence-based behavioral interventions to these groups.
The interventions will focus on personal skills building, self efficacy, and improving parent-child
communication about HIV/AIDS and general sexual and reproductive health. The partner will also develop
training for youth groups and implement gender and HIV/AIDS training for youth using interactive drama,
peer education, interpersonal communication, and life skills techniques. Through these trainings and
ongoing supportive supervision, PEPFAR will contribute to strengthening the capacity of youth to conduct
outreach IPC interventions at their schools and in the communities.
Effective prevention interventions, just as ART, are not a "start-it-and-forget-it treatment", and require a
sufficient ‘dose', reinforcement to promote and sustain risk reduction, addressing factors that may contribute
to prevention lapses, and ongoing monitoring to promote optimal outcomes. The partner will be required to
use a multi-pronged approach focusing on combining both behavioral and biomedical prevention
interventions.
During FY 2009 PEPFAR will support the scale-up of the youth centers to a total of six. These centers will
be instrumental in providing prevention interventions for most-at-risk out of school youth and in school
youth. Priority target groups reached by youth centers will include higher-risk youth living in urban areas and
high HIV transmission zones (as defined by the PLACE study), girls working in vulnerable employment
places (such as bars, hotels), their employers, girls engaging in transactional sex, youth with multiple sex
partners and street youth.
The partner will identify proven behavioral and best practices and tailor them to deliver high quality
prevention messaging and TC to most at-risk youth. The partner will work with CNLS to balance and
synergize in and out of school activities.
Funding will also support the national HIV/AIDS hotline, which is managed by the CNLS. The objective of
the hotline is to respond to client calls with information about behavior change to prevent HIV, provide
psychosocial counseling for PLHIV, and refer clients to testing centers. Program outcomes and
effectiveness will be monitored through a rigorous M&E system to manifest trends and demonstrate
program impact. In addition, the partner will also carry out periodic behavioral evaluations to assess
program impact.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Health-related Wraparound Programs
* Child Survival Activities
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Estimated amount of funding that is planned for Education
Water
Table 3.3.02:
improving communication among secondary school and out-of-school youth. Prevention programs for youth
remain a high priority for both the GOR and the PEPFAR. With an overall national prevalence of 3.1%, there
is a critical need for prevention programming in the largely HIV-negative population and an opportunity to
affect the progression of the epidemic by reaching the youth population. Averting new infections in this age
group, is not only cost effective, but is also the most sustainable way to turn the tide against HIV/AIDS.
Although 2005 DHSdata reflect a very low HIV prevalence among nearly all youth groups, recent testing
In the activities proposed under this new mechanism, the partner (TBD) will develop and implement
evidence based behavioral interventions focusing on personal skills building, self efficacy, and improving
parent-child communication about HIV/AIDS and general sexual and reproductive health. The partner will
also develop training for youth groups and implement gender and HIV/AIDS training for youth using
interactive drama, peer education, interpersonal communication, and life skills techniques. Through these
trainings and ongoing formative supervision, PEPFAR will contribute to strengthening the capacity of youth
to conduct outreach IPC interventions at their schools and in the communities.
During FY 2009, PEPFAR will support the scale-up of the youth centers to a total of 6. These centers will
be instrumental in providing comprehensive HIV prevention interventions including counseling and testing,
STI services (screening, diagnosis, and treatment) and referrals and linkages to care & treatment to most-at
-risk out of school youth. Specifically, the partner will develop an STI/HIV integration model that screens
high risk youth with STI for HIV, and those with HIV for STIs (including male clients of SWs & their sexual
partners). Activities will promote "repeat testing" for high risk groups and develop innovative approaches to
provide condoms. Additionally, the partner will deploy an STI/HIV integration model that screens high risk
youth with STI for HIV, and those with HIV for STIs (including male clients of SWs & their sexual partners).
All these interventions will be instrumental in reducing the incidence of HIV in these Most at Risk
Populations (MARPs).
Priority target groups reached by youth centers will include higher- risk youth living in urban areas and high
HIV transmission zones (as defined by the PLACE study), girls working in vulnerable employment places
(such as bars, hotels), their employers, girls engaging in transactional sex, and street youth. The partner
will use proven interventions and tailor them to deliver high quality prevention messaging and TC to most at-
risk youth. The partner will work with CNLS to synergize in and out of school activities.
program impact. In addition, the partner will carry out periodic behavioral evaluations to assess program
impact.
Estimated amount of funding that is planned for Human Capacity Development
Table 3.3.03:
This is a new activity and mechanism in FY 2009.
In FY 2009, through a TBD partner the EP will extend support from four youth centers to at least six where
the TBD partner will offer comprehensive HIV prevention and testing services. In addition, STI services
(including screening, diagnosis, and treatment) and family planning counseling will be provided, thereby
ensuring that youth who access the centers receive an integrated package of prevention services.
The TBD partner will deliver counseling and testing to high risk youth who visit the Reproductive Health
Youth Centers. HIV testing and counseling (HTC) is an important component of HIV prevention, care, and
treatment programs worldwide. Despite widespread promotion and implementation of counseling and
services, there is inadequate knowledge about the behavioral impact of counseling and testing and how to
maximize the prevention benefit of these services, especially for youth who receive a negative test result. A
focus of this funding will be to develop prevention messages, follow-up, etc. that deals with those who have
negative results. Messages will be adapted for counseling these youth to maximize the effectiveness of
counseling and testing as a prevention intervention. In addition, HIV positive youth will be refereed to Care
and Treatment facilities and a referral system will developed to track the effectiveness of the program.
Specifically, the TBD partner will develop STI/HIV integration model that screens high risk groups with STI
for HIV, and those with HIV for STIs (including sexual partners), promote "repeat testing" for high risk
groups and develop innovative approaches to provide condoms and STI services to High Risk group and
ensure linkages of these services to Care & Treatment. All these interventions will be instrumental in
reducing the incidence of HIV in these Most At Risk Populations (MARPS)
Priority target groups reached by youth centers will include youth living in urban areas and high HIV
transmission zones (as defined by the PLACE study), youth frequenting hotspots, girls working in
workplaces that make them vulnerable (bars, hotels..), girls engaging in transactional sex, and street
children.
This activity directly supports the Rwanda EP five-year strategy by expanding abstinence programs at
secondary schools and among the youth population in general.
Gender
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Table 3.3.14:
