Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 13767
Country/Region: South Africa
Year: 2012
Main Partner: Re-Action!
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $720,000

The Re-Action project aims to reduce number of new HIV infections among commercial sex workers (CSWs) in Nkangala District, Mpumalanga Province, South Africa. The project will draw on Re-Actions successful Public-Private Mix (PPM) approach to health systems strengthening and extensive institutional partnerships and community outreach infrastructure in Mpumalanga, as well as RTI Internationals technical expertise in working with female sex workers and the implementation of the women-focused evidence-based Womens Health CoOp (WHC) intervention package. Drawing on these strategies and capacities, the project will: (a) produce an accurate, thorough situational assessment of CSWs throughout Mpumalanga through the use of community mapping strategies; (b) strengthen local networks and other support structures, and increasing availability of condoms and water-based lubricants; (c) reach a minimum of 80% of identified CSWs in the target area with comprehensive prevention interventions, link them to relevant, care and treatment resources and services, including HIV testing, substance abuse support, and life skills mentoring. The project will initially be implemented in Nkangala District, expanding to Ehlanzeni district in subsequent years in order to reach CSWs throughout the province. Re-Action will work with other partners working with CSWs and their clients in Mpumalanga (such as Health and Development Africa and Careworks) to ensure activities are coordinated and collaborative. By localizing the evidence-based capacity to reach, test, treat and retain CSWs, this project has tremendous promise for sustainability. Through this cooperative agreement, Re-Action will purchase two vehicles to conduct mobile HCT, and STI services.

Funding for Testing: HIV Testing and Counseling (HVCT): $180,000

Reliable data does not exist for the HIV prevalence, current HCT coverage, nor the size of the sex worker population in this geographic area. Through this award Re-Action will establish and strengthen the provision of comprehensive HIV prevention services including the provision of mobile HCT services to sex workers at brothels, truck stops, and other venues where sex workers can be found with the goal of reaching 80% of identified CSWs in Nkangala district with HCT services. To ensure accuracy of mobile HCT, Re-Action will enroll in an external quality assurance program for rapid HIV testing and all test kits will be procured and stored following the NDOH HIV testing algorithm. Sex workers found to be HIV positive will be offered prevention with positives interventions tailored to the unique HIV risk profile of sex workers. Through the utilization of peer educators and outreach workers, Re-Action will improve referral to HIV care, treatment and support services. All HVCT funding provided through this cooperative agreement will support provision of HCT for CSWs, a most at-risk population.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $540,000

Re-Actions HCT program is complemented by the implementation of the Womens Health Co-operative (WHC) intervention, a women-focused evidence-based group-level behavioral intervention that addresses substance abuse, gender-based violence and mental health as a component of HIV prevention. The aim of the project is to reach a minimum of 80% of the identified CSWs with the WHC intervention package, provide referrals relevant prevention, care and treatment resources and services, including referrals to substance abuse counseling and life-skills mentoring. The needs assessment and mapping of service providers conducted in FY2011-2012 will determine the best mix of capacity for delivering WHC interventions. To ensure community participation and ownership, Re-Action has established Community Advisory Boards to strengthen local institutional relationships that will implement the WHC intervention. Mobile units conducting HCT will also be equipped to conduct syndromic STI screening and treatment for CSWs and offer condoms, lubricants and IEC material related to substance abuse, gender-based violence and provide individualized risk assessment and risk reduction counseling and support. Local networks will be strengthened to increase the availability of condoms (including female condoms) and water-based lubricants. To ensure sustainability and local ownership, Re-Action will conduct training for maser trainers, peer education/ outreach workers, NGO staff and department of health personnel, sensitize healthcare workers to the health needs of CSWs and promote community dialogues on sexuality, gender and beliefs/expectations/stigma regarding CSWs. Technical assistance will be provided to assistance local partners adapt new or existing evidence-based PwP intervention for CSWs based on the theoretical model of the WHC. Additionally, Re-Action will monitor technology and policy developments relevant to HIV prevention, care and treatment for CSWs such as vaginal microbicides, PrEP, PEP, etc.), and will integrate new technologies as approved and when available.

Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Increasing women's access to income and productive resources
Increasing women's legal rights and protection
Mobile Populations
Workplace Programs