The objective of Men Taking Action (MTA) is to increase access & acceptability of HCT services to adult men (15-49), couples & children using Home Based HCT model in rural areas of Eastern Cape Province in Amathole, Cacadu & NMM districts. The program uses 1) Community & household mapping in preparation for the door-to-door HCT strategy to reach out to men and their families using available resources. 2) Campaign style community CT where tents are set up in the community such as bus stop, taxi ranks, malls & other public places using non-HIV labeled tents or private areas for CT to reduce the associated stigma. 3) Parish-based CT of men by making HCT available during regular programs. The parish group pre-testing events are carried out by trained male educators, incorporating the benefits of HIV-testing into general health topics, mens responsibilities & faith. Men are encouraged to form support groups & are invited to actively participate in long-term programs that engage them as household leaders linking families to care & prevention services. There will be an increase in the field workers for community mobilization & expansion. Mobilisers will recruit clients, offer information on HCT & on availability of home testing. Counselors offer the individual pre-test counseling and facilitate testing in the homes. MTA nurses draw blood for CD4-count testing from all clients that test HIV positive to ensure prompt access to treatment. The samples are then sent to the nearest health facility for regular laboratory collection of samples for testing. The clients are then referred for the results of CD4 count, further management, HAART, treatment for STI and OIs.A mid-term evaluation of the program will be carried out before the end of the year & no vehicles will be purchased.

In this fourth year of the program, CMMB will maintain the same category of staff. There will be an increase in the field workers staff profile and expansion into other districts in the Eastern Cape. The target group will still be men between the ages of 15yrs to 49yrs, and their families, not excluding any outside the bracket. The targeted districts have the following HIV prevalence rates (2008): Amathole: 26, 7%; Cacadu: 14, 5%; NMM: 27, 9%. In MTAs counseling and testing model men are approached in their homes or area of comfort, including workplaces, churches, shebeens & taxi ranks, and offered CT. Mobilisers will recruit clients and offer them information on HIV testing and inform them of availability of CMMB home testing, counselors offer the individual pre-test counseling and facilitate testing in the home. Where testing is offered in a public area, a non-HIV labeled tent or a private area is secured for CT to reduce the associated stigma. MTA nurses will draw blood for CD4-count testing from all clients that test HIV positive in order to ensure prompt access to treatment and care. We refer clients for further management including CD4 count testing, HIV treatment and treatment of opportunistic infections. Confidentiality and informed consent will still be maintained in line with national guidelines. In these past 3 years, CMMBs CT activities have extended reached 9 005 individuals. In the 4th year we will be extending the activities into NMM, looking at a total target of 17 688. We will place teams in different communities, close their residences. Aside from the quality assurance of test kits, the MTA Project Manager and Project Supervisor will randomly select previously visited households to interview members on the services they received. These interviews will include client satisfaction surveys, and will be carried out on a regular basis. Training of the counselors and nurses will continue throughout the period of the program. The training will be provided by certified qualified trainers recommended by the department of health and PEPFAR. A mid-term evaluation of the program will be carried out before the end of the year.