ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

ACTIVITY 1: Conducting Workshops

In FY 2009, The Kagiso Educational Television and Communications (Kagiso) will continue to train male

facilitators and provide refresher training periodically. The national accreditation board has accredited the

2008 training curriculum, and now Master Trainers and Community Facilitators have established one key

stepping-stone on the road to sustainability. Identifying community workers, volunteers or community health

workers that are already trained in PMTCT and offering them accredited community-based male

involvement training will continue capacity-building efforts of FY 2008. This will extend the partnership

between PEPFAR and the South African National Department of Health to a grassroots level. Using FY

2009 funding, Kagiso also seeks to deepen productive relationships with national and provincial department

of health initiatives such as Men in Partnership Against AIDS and Women in Partnership Against AIDS as

well as those relationships established at a district and regional level.

ACTIVITY 2: Media Campaign Rollout

FY 2009 funds will be used to support a campaign entitled "Real MenTalking to Real Men". This campaign

will draw on the successes of previous years' case studies documented for television, and will be

complemented by a community radio campaign driven by the real life stories of the men in the project. The

campaign will also leverage the Soccer World Cup in South Africa, 2010, to develop stories for a range of

media organizations focusing on South Africa's challenges and successes. The media campaign will

operate at two levels. Firstly, the mass media campaign will be opportunistic, securing airtime with the

South African public broadcaster, leveraging its commitment to public education and to a world alliance of

media organizations supporting the prevention of the spread of HIV. The second level is aimed at

deepening the relationship with community radio and newspapers with specific messages drawing on the

idea of Fathers-to-Fathers or Men-to-Men, thus encouraging men at a community level to support each

other and their HIV-infected partners. This campaign will be linked with community outreach through

community radio, newspapers and other civil society initiatives to ensure that communities, particularly men,

have a platform to discuss issues raised by the campaign. In addition, Kagiso will investigate digital

storytelling and website channels as platforms to provide skills and work opportunities for young men and

women. Master Trainers and Community Facilitators will be trained in media skills to create opportunities for

themselves, the campaign and the communities they support. Community radio supports indigenous

languages and the campaign will develop an innovative crossover between the traditionally English

mainstream commercial media and the hugely popular vernacular media.

ACTIVITY 3: Men's Clubs

Building on the findings of previous years, FY 2009 funding will be used to strengthen the male networks

and support structures identified in FY 2008. As the campaign has shown, men are interested in playing a

role in their community and are interested in the information and knowledge it brings for them. Men usually

do not attend support groups and so a different approach is used to reach men, driven by the Master

Trainers and Community Facilitators. Men's group meetings take place outside of the health facility, at

places in which they are comfortable, including sports grounds, faith-based organizations, and informal

stokvels (gatherings) or taverns. Master Trainers and Community Facilitators will take these messages to

the workplace in FY 2009. Community radio will be used to promote these monthly meetings under the

banner of, for example, a burial society or a soccer club.

Kagiso will continue to encourage men to attend antenatal care clinics with their partners and to accept

couple counseling and testing. Men who want to be tested but who do not want to visit the clinic are referred

to alternative sites. These sessions aim to encourage the development of support networks (however

informal) for men whose partners are enrolled in PMTCT programs, and to encourage improved support to

their partners, ensuring better uptake and adherence of PMTCT service delivery.

ACTIVITY 4: Consolidation

In FY 2009 Kagiso will consolidate the lessons learnt of all the training workshops and media campaign, to

address weaknesses highlighted in FY 2008 and to build on strengths to ensure the Master Trainers and

Community Facilitators continue to develop skills enabling them to function as trainers, entrepreneurs or

even media professionals, thus generating further income for themselves and their families.

This activity increases awareness of HIV and AIDS and uptake of PMTCT, by reducing vertical

transmission. Targeting men and ensuring men identify and implement community-based activities in

support of PMTCT will improve community-wide support for PMTCT services. Increased male involvement

and community support for PMTCT will improve uptake of PMTCT service delivery.

----------------------------

SUMMARY: The Kagiso Educational Television (Kagiso) PMTCT activity focuses on male involvement in

the prevention of mother-to-child transmission (PMTCT) to increase uptake of PMTCT through the

expansion of a grassroots campaign targeting community-based men's groups. The campaign aims to

create male awareness of PMTCT ensuring that men understand the implications of mother-to-child

transmission (MTCT) and can support and encourage their pregnant partners to uptake PMTCT services.

BACKGROUND: Low uptake of PMTCT services remains a challenge to successful implementation.

Although coverage of PMTCT exceeds 80%, PMTCT uptake still hovers around 50%, indicating that the

majority of women who need PMTCT services are being missed. Reasons for low uptake vary from health

systems issues to social issues. Cultural and social values are prime factors, with fear of violence and

abandonment from male partners due to HIV disclosure often cited as the primary reason for choosing not

to be tested during antenatal care. Furthermore, many women assume that because they are faithful to their

male partners, they cannot be HIV-infected and choose not test for HIV during antenatal care. MTCT is

also affected by the cultural perceptions that breastfeeding is a practice adopted by model mothers and

wives. Many HIV-infected mothers report that they breastfeed in the presence of their husbands and

Activity Narrative: mothers-in-law, but formula feed when they are absent. These mothers are not aware that mixed feeding

practices increase the risk of vertical transmission. Anecdotal evidence suggests that many men are afraid

to undergo HIV testing and use their wives' HIV test results as a proxy for determining their negative status.

Conversely, when their wives test positive, they often do not assume they are infected. These

misconceptions contribute to vertical transmission of HIV, and led to a joint decision by the USG Inter-

Agency Task Force and the National Department of Health (NDOH) to target the partners of pregnant

women and to develop a PMTCT male involvement campaign targeting grassroots men's groups. Using FY

2006 PEPFAR funding, the grassroots male campaign was initiated. This campaign works directly with non-

governmental and community-based organizations, sports clubs, savings associations, faith-based

organizations and other men's groups at the community level to ensure HIV, AIDS and PMTCT information

transfer, and to address gender, stigma and masculinity in the context of South African culture and how it

relates to PMTCT. Partners of women attending antenatal care are targeted by the campaign. The

campaign aims to sensitize men to issues relating to PMTCT, to create a platform from which to address

cultural and gender issues that impede the uptake of PMTCT. FY 2008 funding will ensure expansion of the

campaign to rural communities and will continue to target male partners of women attending antenatal care

and family planning clinics to facilitate their understanding of HIV and AIDS and PMTCT issues, and to

encourage them to get tested, "know their HIV status" and to support their partners, even if their results are

discordant. Efforts will be made to hold support groups for men whose partners are in the PMTCT program,

with a specific focus on the development of skills to reduce stigma. In addition, Kagiso will link with the

SAFPU (South African Football Players Union) to expand its reach training the Union's HIV and AIDS

facilitators, where they exist, and supporting the Union to select and train facilitators where they do not

exist. This project has a particular focus on the year 2010 when South Africa hosts the Soccer World Cup.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Conducting workshops Using FY 2008 funding, Kagiso will train male facilitators. Refresher

training will be offered periodically. Trained facilitators/community activists will be responsible for conducting

ongoing workshops with different male groups in their community. In each workshop or identified community

activity, men will be taken through a number of activities aimed at increasing awareness and understanding

of PMTCT and then each group of men will identify a community-based action or activity illustrating male

support for PMTCT and build on its outcomes. These actions may range from wearing T-shirts with

emblems supporting PMTCT, holding community meetings to address myths around PMTCT or

encouraging men to go with their partners to antenatal care and to be tested. With monitoring and ongoing

support from the workshop facilitators, the men will implement the activity in their communities. These

activities will be developed and implemented by the communities and will focus on creating support and

awareness for PMTCT. Using FY 2008 funding, the training curriculum will be accredited by the national

accreditation board. This will ensure continued support and sustainability. Capacity in the provincial

departments of health will be built around health communication by identifying community workers,

volunteers or community health workers that are already trained in PMTCT by offering the accredited

community-based male involvement training as a way for these community workers to continue their work

and earn additional resources. This will extend the partnership between USG and SA NDOH to a grassroots

level. Using FY 2008 funding, Kagiso also seeks to deepen productive relationships with national and

provincial department of health initiatives such as MIPAA (Men in Partnership Against AIDS) and WIPAA

(Women in Partnership Against AIDS) identified in the previous year. Having established public-private

partnerships (PPPs) with appropriate companies as well as training existing facilitators in fundraising,

Kagiso will concentrate on establishing sustainability of these organizations with FY 2008 funds. These

activities will be done in collaboration with Soul City training and outreach and the Soul Buddyz clubs

throughout the country. Soul City is also a recipient of PEPFAR funds.

ACTIVITY 2: Media campaign rollout Building on the project's success stories profiled in FY 2007, FY

2008 funding will be used to ensure scale up and rollout of a media campaign entitled "Real Men Talking to

Real Men." This campaign will draw on successes of FY 2007 and will aim to reach a wider audience

through broadcasting on both television and radio. It will also leverage the hosting of the Soccer World Cup

in South Africa in 2010 drawing on the relationship with the South African Football Players Union. The

media campaign will operate at two levels with the mass media campaign being a targeted media burst. For

example, in August, which is traditionally "women's month," the messages could be differentiated by running

a series of smart campaign commercials on SABC radio stations and for one week on SABC TV; the

second level could be community radio and newspapers with a more specific messages drawing on the idea

of Fathers to Fathers encouraging men at a community level to support each other and their HIV-infected

partners. This campaign will be linked with community outreach through community radio, newspapers and

other civil society initiatives to ensure that communities, particularly men, have a platform to discuss issues

raised by the campaign. In addition, Kagiso will investigate digital storytelling and website channels and

opportunities to provide skills and work opportunities for young men and women.

ACTIVITY 3: Support groups In FY 2007, Kagiso targeted women attending antenatal care and pregnant

HIV-infected women attending support groups and encouraged them to bring their male partners to a

discussion group. At the outset of the partner discussion groups, all aspects of pregnancy, not just HIV and

PMTCT, are discussed. Groups meet regularly. Men are encouraged to attend antenatal care clinics with

their partners and accept couple counseling and testing. Men who want to be tested but who do not want to

go to the clinic are referred to alternative sites. The aim of the group sessions is to ensure the development

of support networks for men whose partners are enrolled in PMTCT programs, and to encourage improved

support to their partners, ensuring better uptake and adherence of PMTCT service delivery. Using FY 2008

funding, these groups will be expanded geographically. The groups will be modeled on the highly successful

mothers2mothers initiative, although a different approach is being used to reach men. Men's groups will

take place outside of the health facility, at places where they are comfortable hanging out. These include

sporting grounds, churches, (through faith-based organizations) and informal stokvels (gatherings) or tavern

associations.

ACTIVITY 4: Expansion Funding will be used to expand the workshops and media campaign by linking the

campaign with the South African Football Players Association Union (SAFPU). By linking the male

involvement in PMTCT campaign to SAFPU, Kagiso will be able to reach at least 80,000 men and create

greater awareness around HIV, AIDS and PMTCT. In addition, this linkage will enable SAFPU the

opportunity to strengthen the HIV prevention campaign and to incorporate messages around PMTCT,

thereby creating greater awareness among their members.

This activity contributes to PEPFAR 2-7-10 goals by increasing awareness of HIV and AIDS, increasing

Activity Narrative: uptake of PMTCT, and reducing vertical transmission. Targeting men and ensuring men identify and

implement community-based activities in support of PMTCT will improve community-wide support for

PMTCT services. This activity will begin a process by which men begin to understand PMTCT.

New/Continuing Activity: Continuing Activity

Continuing Activity: 13980

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

13980 7944.08 HHS/Centers for Kagiso Media, 6673 4640.08 $1,599,320

Disease Control & South Africa

Prevention

7944 7944.07 HHS/Centers for Kagiso Media, 4640 4640.07 $900,000

Disease Control & South Africa

Prevention

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Reducing violence and coercion

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.01:

SUMMARY:

The Kagiso Educational Television (Kagiso) prevention of mother-to-child transmission (PMTCT) activity

focuses on male involvement in HIV prevention within the context of PMTCT to reduce the number of new

HIV infections among men, and promote behavior change. This activity is being implemented through the

expansion of a grassroots campaign targeting community-based men's groups. The campaign aims to raise

male awareness of HIV and PMTCT and ensure that men understand the implications of HIV and HIV-

acquisition on their female partners. This activity is linked to an activity in the PMTCT that is being

implemented by Kagiso. In addition Kagiso is also implementing a public-private-partnership with South

African Breweries, targeting men but focusing on HIV prevention and alcohol.

BACKGROUND:

Using FY 2006 PEPFAR funding, the grassroots male campaign aimed at targeting men around PMTCT

was initiated. This campaign works directly with non-governmental and community-based organizations,

sports clubs, savings associations, faith-based organizations and other men's groups at the community level

to ensure HIV, AIDS and PMTCT information transfers, and to address gender, stigma and masculinity in

the context of South African culture and how it relates to PMTCT. During the PEPFAR South Africa Partner

Evaluation, the review team determined that the PMTCT activity should be split to ensure that the

prevention aspects of the male awareness campaign were not lost. For this reason, FY 2009 funding for this

activity is split between PMTCT and other prevention.

The "You Can Count on Me" campaign aims to sensitize men to issues relating to HIV, to create a platform

from which to address cultural and gender issues that impede safer sexual practices. In addition the

campaign aims to ensure that men take action as fathers, husbands, partners and that their partners, and

children can count on them to remain HIV negative through behavior change.

FY 2009 funding will ensure expansion of the campaign to rural communities and will continue to target

male partners of women attending antenatal care and family planning clinics to facilitate their understanding

of HIV/AIDS and PMTCT issues, and to encourage them to get tested, "know their HIV status," and to

support their partners, even if their results are discordant. Efforts will be made to hold support groups for

men whose partners are in the PMTCT program, with a specific focus on the development of skills to reduce

stigma. In addition, Kagiso will link with the South African Football Players Union (SAFPU) to expand its

reach training the Union's HIV/AIDS facilitators, where they exist, and supporting the Union to select and

train facilitators where they do not exist. This project has a particular focus on the year 2010 when South

Africa hosts the Soccer World Cup.

ACTIVITIES AND EXPECTED RESULTS:

Kagiso will carry out the following five separate activities in this program area.

ACTIVITY 1: Conducting Workshops

Using FY 2009 funding, Kagiso will continue to train male facilitators. Refresher training will be offered

periodically. Trained facilitators/community activists will be responsible for conducting ongoing workshops

with different male groups in their community. In each workshop or identified community activity, men will be

taken through a number of activities aimed at increasing awareness and understanding of HIV prevention

and then each group of men will identify a community-based action or activity illustrating male support for

HIV prevention and build on its outcomes. These actions may range from wearing t-shirts with emblems

supporting prevention of HIV, holding community meetings to address myths around HIV or encouraging

men to go with their partners to be tested. With monitoring and ongoing support from the workshop

facilitators, the men will implement the activity in their communities. These activities will focus on HIV

prevention. With the training curriculum accredited by the national accreditation board, master trainers and

community facilitators will have established one key stepping stone on the road to sustainability. Capacity in

the provincial departments of health will be built around health communication by identifying community

workers, volunteers or community health workers that are already trained in PMTCT by offering the

accredited community-based male involvement training as a way for these community workers to continue

their work and earn additional resources. This will extend the partnership between the U.S Government

(USG) and the South Africa National Department of Health (NDOH) to a grassroots level. Using FY 2009

funding, KTV & C also seeks to deepen productive relationships with national and provincial department of

health initiatives such as MIPAA (Men in Partnership Against AIDS) and WIPAA (Women in Partnership

Against AIDS) as well as those relationships established at a district and regional level.

ACTIVITY 2: Media Campaign Rollout

FY 2009 funding will be used to support a media campaign working on the theme of "Real Men Talking to

Real Men." This campaign will draw on the successes of previous year's case studies being documented for

television in FY 2007 and FY 2008 and being complemented by a community radio campaign driven by the

real life stories of the men in the project. The media campaign will also leverage the hosting of the Soccer

World Cup in South Africa in 2010 to develop story angles for a range of media organizations focusing on

the country and its challenges and successes. The media campaign will operate at two levels with the mass

media campaign being an opportunistic one leveraging partnerships or securing airtime with the public

broadcaster under its commitment to public education as well as it being a signatory to a world alliance of

media organizations committed to curbing the spread of HIV. The second level is deepening the relationship

with community radio and possibly newspapers with more specific messages drawing on the idea of

"Fathers to Fathers" or "Men to Men," encouraging men at a community level to support each other and

their HIV-infected partners. This campaign will be linked with community outreach through community radio,

newspapers and other civil society initiatives to ensure that communities, particularly men, have a platform

to discuss issues raised by the campaign. In addition, Kagiso will investigate digital storytelling and website

channels and opportunities to provide skills and work opportunities for young men and women. Master

Activity Narrative: trainers and community facilitators will be trained in media skills and presenting and using the media to

create opportunities for themselves, the campaign and the communities they support. Community radio

supports indigenous languages and the campaign will develop an innovative crossover between the

traditionally English-speaking mainstream commercial media and the hugely popular vernacular media.

ACTIVITY 3: Men's Clubs

Building on the findings of previous years, FY 2009 funding will be used to strengthen the male networks

and support structures identified in FY 2008. As the campaign has shown since inception, men are

interested in playing a role in their community and they are interested in the information and the knowledge

it brings for them. Men do not attend support groups and so a different approach is being used to reach

men. This is driven by the project's master trainers and community facilitators. Men's groups take place

outside of the health facility, at places where they are comfortable hanging out. These include sporting

grounds, churches, (through faith-based organizations) and informal stokvels (gatherings) or tavern

associations. FY 2009 funding will help equip some master trainers and community facilitators to take these

messages to the workplace. Where possible the community radio will link these initiatives encouraging men

who already gather monthly under the banner of - for example - a burial society or a soccer club to get

involved in the campaign.

Men will continue to be encouraged to attend antenatal care clinics with their partners and accept couple

counseling and testing. Men who want to be tested but who do not want to go to the clinic are referred to

alternative sites. The aim of these sessions is to encourage the development of support networks (however

informal) for men whose partners are enrolled in PMTCT programs, and to encourage improved support to

their partners, ensuring better uptake and adherence of PMTCT service delivery.

ACTIVITY 4: Consolidation

FY 2009 funding will be used to consolidate the learning of all the training workshops and media campaign.

FY 2009 funds will address weaknesses highlighted in FY 2008 and build on the strengths to ensure the

master frainers and community facilitators will continue to develop a set of skills enabling them to function

as trainers, entrepreneurs or even media professionals, generating further income for themselves and their

families.

ACTIVITY 5: Public Private Partnership with South African Breweries

Using the premise of the male involvement work in both prevention and PMTCT, Kagiso will collaborate with

South African Breweries to develop and implement activities focused around men, alcohol and HIV

prevention. FY 2009 funding will be used to develop the scope of work, design the activities and pilot the

initial phases of the activity.

This activity contributes to PEPFAR 2-7-10 goals by increasing awareness of HIV/AIDS, reducing the

number of new infections, and getting men to take responsibility as husbands, partners and fathers to

protect themselves and their partners against contracting HIV/AIDS. Targeting men and ensuring men

identify and implement community-based activities in support of HIV prevention will improve community-

wide support for prevention services. A focus on alcohol will also address risk behaviors and behavior

change in the context of HIV. This activity contributes to PEPFAR 2-7-10 goals by increasing awareness of

HIV and AIDS, reducing the number of new infections.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03: