Johns Hopkins Health and Education in South Africa (JHHESA) and its 20 partners support USAID and the SAG at national, provincial, district and local level to implement evidence-based strategic advocacy, communication and social mobilization (ACSM) programs to address HIV issues. Initiatives are aligned to the NSP and USAID Prevention Guidance and Partnership Framework.JHHESA addresses HIV prevention and TB through comprehensive communication programming that address the social, structural, behavioral and biomedical drivers of the epidemic. Activities impact upon attitudes, norms, and risk perception. They also promote the uptake of services to reduce new HIV infections, increase HIV counseling and testing, drive demand for VMMC, and improve HIV/TB treatment adherence. Activities target key populations: youth, sex workers, people living with HIV, high risk women, and adult men.Activities are geographically targeted in high transmission areas including mining, farming, and informal settlements; they are tailored to each target group. Interventions combine community engagement, mass media, interpersonal, and communication approaches. Such approaches are enhanced through toolkits and social media, and link people to prevention, treatment, and social services. JHHESA also focuses on gender dynamics addressing male norms and womens empowerment.JHHESA partners strengthen the social mobilization skills of community health care workers and NGOs. A post-graduate program focuses on health communication and workshops for provincial and district and local leaders to build capacity to design, implement, monitor, and evaluate ACSM strategies.As this is the final project year, JHHESA will document and disseminate challenges, successes and lessons learnt.

Johns Hopkins Health and Education in South Africa (JHHESA) is an affiliate to the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP) based in Baltimore, USA. JHHESA works through partners at a national, provincial and district and sub-district level to implement evidence based strategic communication interventions.The types of HIV care provided include the provision of psychological, social support and prevention interventions for people living with HIV. This is done by working with HIV positive peer educators based at previously disadvantaged tertiary institutions and establishing and maintaining support groups to provide psychological care for people living with HIV. These support activities occur in communities and at health facilities ensuring strong linkages to other essential care and treatment services. In addition, prevention with positives programs are conducted within these contexts. Support includes provision of treatment literacy and adherence counseling using current SAG treatment guidelines.Capacity-building activities underpin and support the delivery of home-based care activities. This includes the training of community health care workers, NGOs and CBOs to provide support to people living with HIV and facilitate prevention with positives discussions, treatment literacy and adherence counseling using current SAG treatment guidelines, training of post-graduate students in development- and HIV communication and strategic communication capacity-building (ACSM workshops) for provincial and district level officials to strengthen their capacity to develop ACSM strategies incorporating home-based care.Media advocacy activities targeting policy and decision makers and the general public are undertaken to improve programming for prevention with positives and to enhance the skills of NGOs and community health workers to ensure better quality prevention, treatment and care support.Monitoring- All JHHESA partners provide monthly reports including quantitative and qualitative data of their activities. The quantitative data is collected manually and collated electronically on-line. This ensures high data quality and timely reporting.

Johns Hopkins Health and Education in South Africa (JHHESA) is an affiliate to the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP).JHHESA works with 20 partners at national, provincial, district and sub-district level to implement advocacy, communication and social mobilization (ACSM) activities that support the SAG.Activities promote infection control, increase knowledge and referral to IPT, intensified case finding (ICF) and early treatment initiation with referral to local HIV/TB services.ACSM activities target in school youth in 450 schools in 5 provinces; out of school youth, 21 previously disadvantaged tertiary institutions, mining communities, rural, informal, peri-urban traditional and farming communities (10 districts in 6 provinces)Seven partners do community based activities including peer education, community dialogues, door-to-door and in-clinic facilitation.Brothers for Life targets adult men with radio talk shows and ACSM activities that focus on mines and the surrounding communities, workplaces, taverns, prisons, informal, peri-urban, rural, traditional and farming communities (nationally and in 10 districts)Five partners (10 districts in 6 provinces) conduct HCT and TB screening in communities. Activities support ICF with referral to local health facilities. HIV positive individuals who do not have active TB disease are referred for IPT and early treatment initiation.Capacity-building activities support the SAG to plan, implement, monitor and evaluate strategic ACSM activities to generate demand for TB/HIV services. Lay counselors are trained using the HCT Toolkit to provide client-appropriate counseling and testing. NGOs, CBOs and FBOs are capacitated in undertaking ACSM activities supporting the three Is (infection control, ICF and IPT), TB/HIV integration and early treatment initiation through the use of Siyayinqoba Prevention and Treatment Literacy guide and the discussion guide based on the 4Play TV drama series.Media advocacy targets policy, decision-makers and the general public to encourage screening and testing for HIV/TB, people living with HIV to test for TB and to access IPT. Activities support events, e.g. World TB Day, conferences, etc.All JHHESA partners provide monthly electronic reports of their activities.

Johns Hopkins Health and Education in South Africa (JHHESA) is an affiliate to the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP). JHHESA works with 20 partners to implement strategic advocacy, communication and social mobilization (ACSM) interventions.ACSM activities promote a comprehensive HIV prevention approach - behavioral prevention (partner reduction, correct and consistent condom usage, alcohol and substance abuse, male norms, contraception and gender based violence), STI prevention and the uptake of biomedical HIV prevention services HCT and VMMC with youth, men and women.The National HIV Communication Survey (NCS), conducted every three years, evaluates the combined impact of communication interventions on the ideational factors that impact on the social and behavioral outcomes. SI activities focus on the dissemination of the findings of the NCS through three road shows and the strengthening provincial and district responses through 9 provincial strategic ACSM planning workshops.JHHESA will finalize and disseminate the evaluation of the USAID supported strategic communication interventions including Brothers for Life, Scrutinize, 4Play Sex Tips for Girls, Intersexions and Siyayinqoba-Beat It. The evaluation will examine the cost effectiveness of these interventions.Community Media Trust, with funding from USAID, implemented a research project to evaluate the impact of community health care workers on PMTCT access, utilization and outcomes for mothers and babies in the Motheo district in the Free State province. This evaluation is to inform government policy relating to the integration of community health care workers.USAID/PEPFAR supports community based ACSM activities of partners in six sub-districts. Baseline surveys undertaken at the inception of the project were repeated in FY 11. FY 12 funding will be used to disseminate the findings of these studies to inform the design of future interventions and support the sub-districts in developing strategic ACSM strategies.Qualitative evaluations are undertaken for two mass media interventions and for one of the interpersonal communication/social mobilization activities of partners.

The Africa Centre for HIV and AIDS Management at Stellenbosch University offers an the accredited post- graduate Diploma (PDM) aimed at strengthening the capacity of individuals in the prevention and mitigation of the impact of HIV and AIDS in the workplace. Each year an average of 350 students from South Africa and abroad participate in the PDM program. The course has several modules, facilitated by SUN and other organizations. This includes the facilitation the HIV and AIDS Policy Development, Stigma and Discrimination (S&D) and Gender modules during the annual implementation of the course.JHU will provide technical support to the program and review modules and facilitate training sessions. As a follow-up to the work previously done by Futures Group, JHU will also assess the impact of the overall diploma course. JHU will identify a sample of 50 graduates to explore the extent to which they are engaged in HIV workplace policies, dialogue, advocacy, and program implementation.

Johns Hopkins Health and Education in South Africa (JHHESA) is an affiliate to the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP). JHHESA supports the Department of Health to implement demand creation activities for VMMC, including rapid expansion and scale-up associated with the one-time VMMC funding that South Africa will receive to conduct an additional 260,000 VMMCs.Technical support is provided to the SAG at national, provincial and district level to develop strategic demand creation strategies and implementation plans. Capacity-building is provided for government and civil society partners to undertake demand creation activities.Men are reached in mining workplaces, stokvels (community savings and burial societies), taverns, schools, tertiary institutions, prisons, rural, traditional and farming communities (nationally and in 10 districts) and through the religious sector. Women are reached through mobilization activities.Demand creation activities promote a comprehensive HIV prevention approach including behavioral prevention (partner reduction and condoms), promoting positive male norms, STI prevention, HCT (including encouraging couples counseling), and VMMC including post-operative care and reducing behavioral disinhibition. VMMC also is an opportunity to promote positive male norms such as stopping GBV and supporting partners.Community dialogues and social mobilization activities are undertaken by community action teams in communities where VMMC services are provided. Activities are supported through information, education and communication (IEC) materials including flipcharts to facilitate small group discussions and counseling sessions and brochures on demand creation and post-operative care and support.Social mobilization activities are supported through a mass media campaign comprising television adverts, radio talk shows and outdoor media that draw upon men who have been circumcised to promote the uptake of VMMC. Mass media activities are linked to a SMS location based service.A post-operative SMS service disseminates regular post-operative care and support to some PEPFAR partners and SAG clients.Media advocacy targeting policy and decision-makers and the general public is undertaken to promote demand creation for VMMC.JHHESA partners provide monthly electronic monitoring reports.

Johns Hopkins Health and Education in South Africa (JHHESA) is an affiliate of the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP). JHHESA works with 20 partners to implement strategic advocacy, communication and social mobilization (ACSM) interventions.ACSM activities promote a comprehensive HIV prevention approach - behavioral prevention (delaying sexual debut, partner reduction, correct and consistent condom usage, alcohol and substance abuse, male norms, contraception and gender based violence), STI prevention and the uptake of biomedical HIV prevention services HCT and VMMC.JHHESA partners undertake social mobilization activities in 450 schools, with out of school youth, youth in 21 previously disadvantaged tertiary education institutions, mining, rural, traditional and farming communities (10 districts in 7 provinces).Youth are reached through the popular Scrutinize campaign that includes television advertising and participatory social mobilization methods to promote AB and HIV prevention services, HCT and VMMC.Brothers for Life reaches adult men through mass media activities combined with interpersonal communication and advocacy. Mass media activities include television adverts, radio talk shows and outdoor media. Interpersonal communication includes community dialogues, facilitated peer education and small group discussions. Advocacy targets policy, decision makers and the general public to address social norms that perpetuate multiple partners and other behaviors that place men at risk.Vulnerable women (young women, women in lower socio-economic contexts) are reached through peer education programs, group and individual sessions and community dialogues using 4Play television drama series.Community health care workers and NGOs are capacitated to conduct social mobilization activities using Siyayinqoba prevention and treatment literacy manual. A post-graduate degree program in health communication is presented by the University of KwaZulu-Natal. Capacity-building is provided for provincial and district level officials to develop, implement, monitor and evaluate ACSM strategies.JHHESA partners provide monthly monitoring reports collected manually and collated electronically on-line.

Johns Hopkins Health and Education in South Africa (JHHESA), an affiliate to the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP), works through 20 national, provincial, district and sub-district level partners to implement strategic advocacy, communication and social mobilization (ACSM) interventions.JHHESA partners use participatory approaches using tools and manuals to promote communication between partners, risk identification and reduction, information on acute infectious period and HIV transmission, TB screening, correct and consistent condom use, partner reduction, reduction of alcohol and substance use and male norms. Activities encourage regular testing, testing before and during pregnancy, referrals to HIV prevention and treatment services.Community based HCT services are provided by JHHESA partners in 4 provinces that include pre- and post-test counseling, TB screening and referral to local prevention, treatment and care services.Youth ACSM activities are undertaken in 450 schools in 5 provinces, 21 previously disadvantaged tertiary education institutions, mining communities, informal, peri-urban, rural, traditional and farming communities (10 districts in 7 provinces) to create demand for HCT.Brothers for Life targets adult men through mass media, community dialogues, and interpersonal methods, in mines and surrounding communities, prisons, informal, peri-urban, rural and traditional communities (nationally and in 10 districts) to create demand for HCT, VMMC and early initiation of treatment.Peer education programs, group and individual sessions and community dialogues reach vulnerable women using 4Play television drama series.Community health care workers and NGOs are capacitated to conduct ACSM activities using Siyayinqoba prevention and Treatment Literacy Manual to promote HCT uptake. HCT counselors are capacitated through a toolkit to support individual pre- and post-test counseling. A post-graduate degree program is undertaken in health communication. Capacity-building is provided for provincial, district and sub-district officials to develop, implement, monitor and evaluate ACSM strategies for the uptake of HCT.JHHESA partners provide monthly activity reports collated electronically.

Johns Hopkins Health and Education in South Africa (JHHESA) is an affiliate of the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHU/CCP). JHHESA works with 20 partners to implement strategic advocacy, communication and social mobilization (ACSM) interventions.ACSM activities promote a comprehensive HIV prevention approach - behavioral prevention (partner reduction, correct and consistent condom usage, alcohol and substance abuse, male norms, contraception and gender based violence), STI prevention and the uptake of biomedical HIV prevention services HCT and VMMC.JHHESA partners support youth in 450 schools, out of school youth, youth in 21 previously disadvantaged tertiary education institutions, mining communities, rural, traditional and farming communities (10 districts in 7 provinces) using the popular Scrutinize campaign that includes television advertising and participatory social mobilization methods to promote OSP and HIV prevention services, HCT and VMMC.Brothers for Life reaches adult men through mass media activities combined with interpersonal communication and advocacy. Mass media activities include television adverts, radio talk shows and outdoor media. Interpersonal communication includes community dialogues, facilitated peer education and small group discussions. Advocacy programs target policymakers, decision makers, and the general public to increase male and female condom supply, services for survivors and perpetrators of GBV, shifting cultural and political practices/laws that perpetuate patriarchy and impact on risk behaviors.Vulnerable women (sex workers, young women, women in lower socio-economic contexts) are reached through peer education programs, group and individual sessions and community dialogues using 4Play.Community health care workers and NGOs are capacitated to conduct social mobilization activities using Siyayinqoba. A post-graduate degree program is undertaken in health communication. Capacity-building is provided for provincial and district level officials to develop, implement, monitor and evaluate ACSM strategies.JHHESA partners provide monthly monitoring reports collected manually and collated electronically on-line.