Populations Services International (PSI) and its local affiliate Society for Family Health (SFH) will implement a comprehensive HIV prevention project in the Free State and Mpumalanga Province. The goal of this program is to contribute to the efforts of PEPFAR and the objectives of the HIV & AIDS and STI Strategic Plan for South Africa (NSP) to reduce the number of new HIV infections in Free State and Mpumalanga. Specifically, the objectives include: Increase knowledge of HIV sero-status through greater access to HCT; Promote safer sexual behaviors and sexual norms; Reduce multiple concurrent sexual partnerships;

Increase correct and consistent condom use; Increase safer sexual behaviors and promote prevention with positives to people living with HIV and AIDS and sero-discordant couples; and, Increase uptake of referrals to related services. Target populations for mobile HCT will be men and couples and for home-based HCT will be families and couples. Target populations for community- and school-based prevention interventions will be schoolchildren aged 15-19 and their parents as well as young adults 20-24. The focus for condom distribution will be bars, small late night shops, and other high risk outlets. Lubricant will be distributed primarily through organizations working with men who have sex with men. SFH will conduct rigorous internal and external quality assurance of testing. A monitoring and evaluation plan for the project will be developed. No vehicles will be purchased with the proposed COP 2012 funding. No new vehicles will be purchased with this funding. PSI will propose to transfer all vehicles purchased through the old agreement with PSI to be used with this current agreement.

Laboratory funding will be used to support the incidence testing in the MMC program evaluation as well as other tests that are not routinely offered by the program.

SFHs school-based YouthAIDS curriculum targets children aged 15-19 and takes place twice weekly during the school year. The program will take place in 10 schools in each of the four program areas. The Safe from Harm program reaches children aged 15-17 and their parents over a two week period through four sessions aimed at improving parent-child communication around sexuality and related prevention issues. Messaging for both YouthAIDS and Safe from Harm is focused on abstinence, delay of sexual activity, secondary abstinence, and related adolescent risk behaviors such as alcohol and drug abuse, intergenerational sex, and transactional sex. On the ground SFH YouthAIDS coordinators train and supervise peer educators operating in schools. All activities are conducted using standardized curricula and materials developed to address the key drivers of the epidemic among youth. A monitoring and evaluation plan will be developed. The YouthAIDS project has been approved by DOE provincial and district offices together with the participating schools.

Population Services International (PSI) and its local affiliate Society for Family Health (SFH) will provide mobile and home-based HCT through SFHs New Start HCT network, South Africas largest NGO HCT network. The target population for mobile HCT services will be males aged 25-35 and couples. Testing rates among men remain lower than those among women. The target population for home-based HCT will be couples and families living in townships. Overall, approximately 50% of all South Africans have ever been tested. New Start uses a parallel testing algorithm. New Start develops a referral guide for all project areas that allows counselors to refer clients appropriately to follow on services. Referred clients are requested to give New Start their cell phone number and New Start referral coordinators follow up on all clients telephonically to ensure clients reach their referral point and to provide follow up counseling. This also allows New Start to evaluate the quality of services listed in the New Start referral directory. SFH has rigorous internal and external quality assurance procedures. SFHs external quality assurance partner is the South African national reference laboratory, the National Institute for Communicable Diseases. SFH will conduct campaigns to promote both New Start and testing in general. SFHs YouthAIDS, Safe from Harm, and MMC programs are also closely linked to New Start. Monitoring and evaluation allows for the gathering of all data needed to manage the program, report to government, and report to donors. SFH will test 100,716 individuals. 52% of clients will be male and 5% will test as a couple. New Start is a non-profit franchise network and HCT services will be provided by SFH and by two to-be-determined subaward franchisees. Franchisees are provided with financial, technical, M&E, marketing, and quality assurance support by SFH.

SFHs YouthAIDS program targets children aged 15-19 in school but also provides community outreach activities aimed at reaching youth aged 20-25 with appropriate messaging that includes condom use, testing, MMC, concurrent sexual partnerships, abstinence, secondary abstinence, drug and alcohol abuse, intergenerational sex and transactional sex. YouthAIDS community activities are closely linked to SFHs HCT and MMC programs. Community activities include community outreach events and community radio call in shows. All activities are conducted using standardized curricula and materials developed to address the key drivers of the epidemic among youth. A monitoring and evaluation plan will be developed in the first months of the project. SFH also will distribute the Government of South Africas free-issue Choice brand condom, responsible for distributing Choice condoms into high risk and non-medical outlets such as bars, taverns, and late night shops. These condom distribution activities will be carried out province-wide and SFH will distribute 21M condoms. SFH also will distribute 15,336 sachets of lubricants, primarily through organizations working with men who have sex with men.