Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4455
Country/Region: South Africa
Year: 2007
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: USAID
Total Funding: $12,025,000

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $4,000,000

INTEGRATED ACTIVITY FLAG:

Activities described are part of an integrated program related to the ARV Services (#7536), CT (#7535), OVC (#7534), SI (#7531), and Condoms and Other Prevention (#7533) program areas.

SUMMARY:

With funding through the Johns Hopkins University/Center for Communication Programs Health Communication Partnership (HCP), its South African affiliate, Johns Hopkins Health and Education coordinates the work of 15 South African partners, provides technical assistance and capacity building to prevent HIV and AIDS by promoting abstinence and fidelity (AB). FY 2007 funds will support a comprehensive, integrated ABC program that addresses risky behavior in the general population. The target populations are: youth, adults, people living with HIV (PLHIV), religious leaders, teachers, public health workers, and community, faith-based and non-governmental organizations. All 15 partners will contribute to changing male norms and behaviors, with an emphasis on reducing the practice of multiple, concurrent partners, violence and coercion, while diminishing alcohol use, stigma and discrimination (all key legislative areas). A special focus for girls and young women will be on cross-generational and transactional sex. Findings from the 2006 National HIV and AIDS Communication Survey will provide valuable information about community and individual perceptions of AB to help design programs. The survey found that 87% of all South Africans were reached with messages dedicated to AIDS prevention and living with HIV and AIDS by means of television and radio programs.

BACKGROUND:

The HCP prevention initiatives in the AB area are in their fourth year. The evidence-based strategic message design identifies key theoretical and practical factors that influence behavior, reinforcing the positive and minimizing the negative. Each activity below is designed to enhance critical and creative thinking, contribute to changes in social norms, create social networks that support individual change, build skills and improve decision-making in AB leading to safer sexual behavior. Ten of the fifteen South African partners will incorporate AB messages and theories into their community mobilization and mass media activities.

ACTVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Community Mobilization

Dance4Life's (D4L) initial programs in KwaZulu-Natal and the Western Cape will expand into the Free State and Eastern Cape. D4L works in secondary schools using a proven methodology of drumming, dancing and drama as an entree to young people to discuss postponing sexual debut and how to avoid sexual violence and coercion, with a special focus on girls and young women on cross-generational and transactional sex. D4L has funding from the Coca Cola Foundation and European-based foundations that contribute two thirds of their budget with another third from the USG.

DramAidE places HIV-infected Health Promoters (HPs) in all 28 of the country's higher learning institutions. The HPs will continue their work on campuses and in neighboring secondary schools to address gender equity, stigma, male norms and behaviors, sexual violence and coercion, cross-generational and transactional sex. They use individual meetings, workshops, group meetings, classroom instruction and live events to reach young men and women and also refer them for CT.

The Valley Trust (TVT) focuses on community mobilization activities with youth and older men and women in KwaZulu-Natal. With older men and women, it will utilize community leaders as entry points into the community and as advocates for changing male norms and behaviors and reducing violence and coercion. With youth it will utilize peer educators in- and out-of-school to reach as many individuals as possible with AB messages.

LifeLine South Africa will target men in FY 2007. LifeLine uses an innovative workplace approach, working with management and employees to develop a comprehensive program

that trains peer educators (PEs). The PEs also do community outreach using knowledge of their communities to seek out men at risk through appropriate venues. They work in partnership with the Small Business Association in the Alexandra informal settlement (Johannesburg) and with the Farm Owners Association in Limpopo.

A TBD faith-based organization (FBO) will use religious activities with men to reach them with appropriate messages on key AB issues. Religious leaders will be trained and provided with appropriate communication materials to guide them.

Lesedi and a TBD community-based organization (CBO) will work in mining communities targeting the mobile populations in Free State and Gauteng. They use PEs, nurses and lay counselors in and out of clinics to involve men and women in partner reduction.

The Mindset Health Channel (MHC) will reach 300 clinics during FY 2007. It will produce and disseminate 23 hours of new video material for both the Health Care Worker (HCW) and patient channels, emphasizing the need to reduce partners and change male norms. Expanded information will be made available on demand to the HCWs via the web.

Community Health Media Trust will provide HIV-infected facilitators (24 in total, 16 funded by PEPFAR and 8 funded by the National Department of Health (NDOH)) to MHC clinics to discuss AB themes with patients. The facilitators will also work with CBOs, FBOs and NGOs in each province with an emphasis on older men in settings where they are more accessible: workplace, religious meetings, social clubs, etc.

The Department of Correctional Services, a PEPFAR partner, will receive AB materials and training of their PEs to expand their prison programs to other provinces.

The Center for AIDS Development, Research and Evaluation supports all partners in evidence-based program planning through research and identification of best practices. It also provides DVDs/VHS tapes and facilitators guides, using episodes from the popular Tsha Tsha TV drama series previously funded by PEPFAR, for use in community and small group meetings.

ACTIVITY 2: Mass Media Support for Community Mobilization

ABC Ulwazi will produce a radio talk show tailored to 60 different communities with community radio stations. Emphasis will be placed on male norms and behaviors, partner reduction and on stimulating local input. Listeners Associations formed by local citizens will have facilitator's guides and conduct community outreach interventions related to the radio series themes.

The South African Broadcasting Corporation plays a key support role by co-funding two TV programs with radio (nine local language stations) and web support. Trailblazers, a community health show, will air 13 episodes highlighting individuals and CBOs that are outstanding leaders in behavior change for others to emulate. A new 26-episode TV drama will deal with contextual issues about social and cultural norms that inhibit and/or support positive male norms and behaviors. It will also demonstrate positive role models that address male norms, violence and coercion. Radio talk shows will follow both programs and provide additional information and community participation.

The Wits Journalism School and the Perinatal HIV and AIDS Research Unit project works with journalists and their editors to develop articles and op-ed pieces about these issues. The focus in FY 2007 will be on AB. The articles will be published in prominent newspapers and through public forums.

HCP will contribute towards meeting the USG Five-Year strategy for South Africa by building the capacity of individuals and the social networks around them to abstain from sexual activities and remain faithful to their partners. The results expected include: 1) redefine social and cultural norms, especially for men; 2) address cross-generational and transactional sex; 3) decrease multiple concurrent partnerships; and 4) increase the age of sexual debut.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $2,975,000

INTEGRATED ACTIVITY FLAG: Activities described are part of an integrated program related to the ARV Services (#7536), CT (#7535), OVC (#7534), SI (#7531) and AB (#7532) program areas.

SUMMARY: With funding through the Health Communication Partnership (HCP), Johns Hopkins University (JHU) coordinates the work of 15 South African partners and provides technical assistance and capacity building to prevent HIV and AIDS by promoting correct and consistent condom use and other interventions. PEPFAR funds support a comprehensive, integrated ABC program that addresses risky behavior in the general population. Major emphasis includes community mobilization/participation with minor emphasis on IEC. The target populations include youth, adults, people living with HIV, HIV-infected pregnant women, discordant couples, community and religious leaders, nurses, factory workers and public health workers, and community-based, faith-based and non-governmental organizations. All 15 partners will contribute to changing male norms and behaviors, with an emphasis on reducing the practice of multiple, concurrent partners and reducing violence and coercion, while diminishing alcohol use, stigma and discrimination (key legislative issues). Findings from the 2006 National HIV and AIDS Communication Survey will provide valuable information about community and individual perceptions of AB to help design the partners' programs. The survey found that 87% of all South Africans were reached with messages dedicated to AIDS prevention and living with HIV and AIDS by means of television and radio programs. The JHU/HCP partners utilize the media to reinforce community mobilization interventions.

BACKGROUND: The JHU prevention initiatives in the condoms and other prevention area are in their fourth year. The evidence-based strategic message design identifies key theoretical and practical factors that influence behavior, reinforcing the positive and minimizing the negative. Each activity below is designed to enhance critical and creative thinking, contribute to changes in social norms, create social networks that support individual change, build skills, and improve decision making leading to safer sexual behavior.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Community Mobilization Lesedi and Mothusumpilo will work in the mining districts of Free State and Gauteng provinces, especially with young women, including sex workers, at risk to inform them about PEP, GBV, stigma and discrimination, condom negotiation, male norms and behaviors and risks associated with alcohol consumption and sexual behavior. They will utilize Peer Educators (PEs) and healthcare workers (HCWs) to meet with women in clinics, schools, in their communities and homes. Their programs will be linked to the local mining companies who generally focus on male employees especially for sexually transmitted infection (STI) services.

LifeLine will work in the Alexandra informal settlement in Gauteng, and with mobile agricultural workers in Limpopo. Their strategy of working with both employers and employees has proven successful in previous, non-PEPFAR-funded interventions. They will train 30 PEs to provide education on correct and consistent condom use, prevention with positives, PEP, GBV, stigma and discrimination, male norms and behaviors and risks associated with alcohol consumption and sexual behavior. They will also carry out community-based interventions in combination with other CBOs and faith-based organizations. LifeLine will work in partnership with the Small Business Association in Alexandra, an informal settlement in Gauteng, and the Farm Owners' and Farm Workers' associations in Limpopo.

ACTIVITY 2: Mass Media Support for Community Mobilization The South African Broadcasting Corporation will play a key support role by co-funding two TV programs with radio (nine local language stations) components and by providing web support. Trailblazers, a community health show, will air 13 episodes highlighting individuals that provide models of positive behaviors for others to emulate. A new 26 episode TV drama will deal with contextual issues relating to social and cultural norms that inhibit and/or support positive male norms and behaviors, including positive examples that counter violence and coercion. Radio talk shows will follow both programs, providing

additional information and stimulating community participation.

Funding for Care: Adult Care and Support (HBHC): $500,000

JHU partners providing a variety of different PEPFAR services, particularly on care and support, will further integrate these activities with CT and Prevention. Activity 1: Community mobilization--- Sub-grantees including the Lighthouse Foundation, Lesedi and Mutusimphilo would expand their care programmes to include additional support of prevention with positivies, stigma and discrimination issues and gender related concerns. Activity 2: Mass media support for community mobilization---South African Broadcasting Corperation through its television and radio programming, would include up to 6 hours a week of programming about the need to address the concerns of those people who are living with HIV/AIDS, their families and the need for communities to develop mechanisms to help support them. Particular emphasis will be given on citing local, community level, examples that can be replicated with a minimum of external resources by individuals within small communities.

Funding for Care: Orphans and Vulnerable Children (HKID): $500,000

INTEGRATED ACTIVITY FLAG: The OVC activities described here are part of an integrated program also described in the AB (#7532), CT (#7535), ARV Services (#7536), and Other Prevention (#7533) program areas.

SUMMARY: The Johns Hopkins University/Center for Communication Programs Health Communication Partnership (HCP) working through its South African affiliate, Johns Hopkins Health and Education in South Africa, will implement an Orphan and Vulnerable Children (OVC) intervention that builds networks of support around OVC, their caregivers and educators. OVC will be assisted in accessing basic needs and psychosocial support. Proven psycho-social models for supporting OVC will be used to build the capacity of organizations working with OVC. The target populations for this program are OVC, HIV-infected children, caregivers, out-of school youth, community and religious leaders, volunteers, teachers, nurses, and community and faith-based organizations. The major emphasis area for the activity is community mobilization and participation, with additional emphasis placed on IEC, training, and linkages with other sectors/initiatives. Capacity building with all sub-partners and their intended audiences is a critical part of HCP's support in the area of OVC. Findings from the National HIV and AIDS Communication Survey, carried out in early 2006, will help focus on community perceptions of OVC, their perceived needs and the amount of social capital invested in providing assistance for them.

BACKGROUND: This program, now entering its third year, focuses on using tools developed in past years to work with communities, caregivers and OVC to implement appropriate responses which address a range of OVC needs, including physical, social and emotional issues. Through the Caring Communities Project (CCP), DramAidE and The Valley Trust will work with schools, FBOs and CBOs to identify OVC, who will receive needed services. These services include access to food, proper household sanitation, adult supervision, and assistance in obtaining proper documentation for social security grant applications and school fees exemption.

ACTIVITIES AND EXPECTED RESULTS: ACTIVITY 1: Psychosocial Support to OVC The Valley Trust (TVT) and DramAidE will work in KwaZulu-Natal to identify and provide training and assistance to OVC by working with children in and out of the classroom on bereavement assistance with memory boxes as well as other psychosocial support interventions. Children affected by HIV and AIDS are often subjected to physical, sexual and emotional abuse. Particular emphasis will therefore be placed on protection from abuse and exploitation of OVC. Community facilitators (CFs) will be trained to work in communities to assist OVC to gain access to basic material needs and ongoing psychosocial support activities. In addition to providing direct assistance to OVC, CFs will also work with the communities, FBOs, NGOs, educators and caregivers to lay the foundation for community action in support of these OVC. DramAidE and TVT will work to strengthen the capacity of the communities to be able to respond to the needs of and to develop a culture of care, nurture and support for OVC. Communities need to be able to sustain OVC until they are able to look after themselves. Thus, they are working with and mobilizing sustainable community institutions, such as churches and schools which can continue with programs over a long time frame.

ACTIVITY 2: Technical Assistance (TA) for PEPFAR OVC Partners DramAidE will also provide training and technical assistance to other PEPFAR OVC partners. Creative, interactive and culturally appropriate activities to reach OVC, such as drama, storytelling and workshops, will be used to equip and enhance existing PEPFAR OVC programs in responding to the psychosocial needs of OVC and will include HIV prevention messages for OVC which are age appropriate. Educators and caregivers will be trained and provided with on-going support in implementing these programs. The meaningful participation of affected children, OVC and youth is critical to the success and sustainability of any effective intervention targeting OVC. To this end, OVC will be consulted regarding their needs and will be involved in developing local support networks

ACTIVITY 3: Communication Training HCP and PEPFAR partner Soul City will work together to provide communication training to

assist care givers in developing tools and skills which will enhance their ability to provide more effective and efficient services. The CDC caregivers tool kit which focuses on prevention for positives, will be adapted to South Africa for use in various communities throughout the country. Interpersonal communication skills training will be conducted, and a core set of materials adapted from media programs, along with facilitator guides, will also be produced and distributed as part of this activity. HCP's OVC program aims at bolstering other existing OVC initiatives so that that they can effectively respond to the needs of OVC in a sustainable manner.

Using FY 2007 plus-up funds, JHU will add additional activities targeting older OVC. Particular attention will be on psycho-social support needs, prevention interventions and identifying risk factors in their behaviors. Activity 1: JHU sub-partner DramAidE will work in the Eastern Cape and the Western Cape to identify and provide training and assistance to OVC by working with children in and out of the classroom on bereavement assistance with memory boxes as well as other psychosocial support interventions. Children affected by HIV and AIDS are often subjected to physical, sexual and emotional abuse. Particular emphasis will therefore be placed on protection from abuse and exploitation of OVC. Community facilitators (CFs) will be trained to work in communities to assist OVC to gain access to basic material needs and ongoing psychosocial support activities. In addition to providing direct assistance to OVC, CFs will also work with the communities, FBOs, NGOs, educators and caregivers to lay the foundation for community action in support of these OVC. DramAidE will work to strengthen the capacity of the communities to be able to respond to the needs of and to develop a culture of care, nurture and support for OVC. Communities need to be able to sustain OVC for the long term using institutions such as churches and schools. Activity 2: DramAidE will also provide training and technical assistance to other PEPFAR OVC partners. Creative, interactive and culturally appropriate activities to reach OVC, such as drama, storytelling and workshops, will be used to equip and enhance existing PEPFAR OVC programs in responding to the psychosocial needs of OVC and will include HIV prevention messages for OVC which are age appropriate. Educators and caregivers will be trained and provided with on-going support in implementing these programs. The meaningful participation of affected children, OVC and youth is critical to the success and sustainability of any effective intervention targeting OVC. To this end, OVC will be consulted regarding their needs and will be involved in developing local support networks.

These activities will contribute towards meeting the vision outlined in the USG Five Year Strategy for South Africa, by providing care for children made vulnerable by HIV and AIDS through the expansion of community capacity to deliver good quality care. In addition, HCP will increase OVC access to government support systems, and strengthen linkages and referral systems to other social services such as health, education and social welfare.

Funding for Prevention: HIV Testing and Counseling (HVCT): $1,200,000

INTEGRATED ACTIVITY FLAG:

The activities described here are part of an integrated program also described in the AB (#7532), OVC (#7534), SI (#7531), ARV Services (#7536), and Condoms and Other Prevention (#7533) program areas.

SUMMARY:

The Health Communication Partnership (HCP) of Johns Hopkins University/Center for Communication Programs will provide voluntary counseling and testing (VCT) using both mobile and fixed services through local NGOs and tertiary institutions. These services will be promoted through the Mindset Health channel to both healthcare workers and patients. Key legislative areas of male norms and behaviors, and reducing violence and coercion along with stigma and discrimination, form an integral part of the VCT interventions. The target populations for this activity are secondary school learners, university students, people living with HIV (PLHIV), out-of-school youth, community leaders and healthcare providers. The major emphasis areas are community mobilization and participation, and information, education and communication, with additional emphasis on local capacity building across all activities. Findings from the National HIV and AIDS Communication Survey, carried out in early 2006, will help focus on community perceptions of VCT and will help to determine perceived needs in respect to VCT communication interventions.

BACKGROUND:

These activities are implemented through ongoing and successful partnerships with organizations including DramAidE, Dance4Life, The Valley Trust, Mindset Health channel, Community Health and Media Trust (CHMT) and the South African Broadcasting Corporation (SABC). Dance4life will add a VCT component to their existing prevention programs and LifeLine South Africa will be a new partner in this area. HCP has partnered for several years with DramAidE to help promote and assist in providing VCT to tertiary students as part of DramAidE's Health Promoters Project. The Valley Trust (TVT) has operated a mobile clinic and a static VCT site and is currently promoting HIV testing in communities in rural KwaZulu-Natal (KZN) province. In total, HCP will support 38 VCT sites (28 of which are university campuses throughout South Africa and 5 TVT sites in KZN; additional mobile sites will be introduced through Lifeline and Dance4Life). Mindset Health channel will produce video, web-based and print materials for healthcare workers (HCW) on VCT as a distance education/learning tool, as well as broadcast video content to patients in clinic waiting rooms at 300 testing sites.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Youth Counseling and Testing Through its partnerships with DramAidE and The Valley Trust, HCP will support and promote services at 33 testing sites. Both projects target youth for VCT, but also provide services to the community at large. The health promoters work with tertiary students, faculty and staff in 28 tertiary institutions across the country while The Valley Trust focuses on youth in- and out-of-school in KZN. With FY 2007 funding, these two partners will provide direct VCT and ongoing support to those who test positive.

HCP will provide assistance to organizations in developing interventions that emphasize prevention for positives. For those that test negative, the project provides a safe forum to discuss safe sex and other HIV prevention issues. The Valley Trust has also started post-test clubs, facilitated by community members, who are trained to provide information to encourage the uptake of VCT.

Dance4life, as part of its ongoing work with youth older than 14, will provide VCT services and promotion (using dance, drama and drumming) as part of their prevention activities covering schools in the Eastern Cape, Western Cape, KZN and Free State provinces. LifeLine, working with the Small Business Association in Alexandra informal settlement in Gauteng, and with farm owners and workers' associations in Limpopo province, will develop workplace interventions that provide VCT for workers. Counseling will specifically cover male norms and behaviors (key legislative issue), violence and coercion (key legislative issue) and stigma and discrimination (key legislative issue). All organizations will

carry out prevention with positive living activities as part of their post-test counseling with HIV-infected individuals.

ACTIVITY 2: Mindset Broadcasts

The Mindset Health channels (MHC) provides direct broadcast information to health clinics, targeting both patient populations in waiting rooms with general information and healthcare workers with technical and training information. MHC will create 10 hours of video material that provides HCW with current VCT guidelines (including strong linkages to HIV care and services). The video material will be supplemented supporting material in print and computer-based multimedia. This capacity building activity will reach HCWs in the 300 clinic sites via video material, on-demand web-based and printed material, and will be followed by questionnaires to test their knowledge and skills.

In addition, information explaining and promoting VCT services will be broadcast to patients at the 300 clinic sites. CHMT will work in Mindset clinics as well as with CBOs using treatment literacy facilitators (TLFs) to promote VCT. Using packaged (material sourced from other media) and produced (material developed in-house) video material these HIV advocates will encourage testing as an entry point into treatment as well as an opportunity to build on prevention. An area of key concern for TLFs would be prevention with positives, and they will specifically focus on providing education and support to discordant couples.

ACTIVITY 3: Community Outreach

Media will support community outreach activities through several partners. The hit TV drama Tsha Tsha, co-produced in 2004-2005 with SABC Education and PEPFAR funds will be edited into six compilation digital video discs (DVDs) that highlight appropriate themes, i.e. VCT, gender-based violence, older men/younger women, stigma and discrimination, risk perception etc. These DVDs will be accompanied by facilitators' guides. Both DVDs and guides will be distributed to each of the organizations listed earlier, and their staff will be trained in their utilization. ABC Ulwazi will produce a radio reality series to be broadcast on 60 community radio stations. Special emphasis will be placed on providing community-specific programming in support of National HIV communication priorities. Listeners' associations formed by community radio stations will host community discussions and community mobilization activities related to radio reality series aired on the respective community radio stations.

SABC will produce two TV programs with radio and web support. Trailblazers, a new 26 episode TV drama co-funded and produced by SABC Education and PEPFAR will deal with issues relating to social and cultural norms that inhibit and/or support male norms and behavior and demonstrate positive examples of healthy life styles that address male norms, VCT and violence and coercion. Trailblazers will highlight the lives of individuals and of CBOs that provide positive examples for others to emulate.

HCP's work to improve NGO capacity to promote and deliver good quality VCT services supports the vision outlined in the USG Five-Year Strategy for South Africa for expanding CT services. CT is seen as a critical entry point into an entire range of HIV services, including identifying HIV-infected individuals for ART. These activities will substantially contribute to the PEPFAR goal of providing 2 million people on treatment.

Funding for Treatment: Adult Treatment (HTXS): $2,450,000

INTEGRATED ACTIVITY FLAG:

The ARV Services activities described here are part of an integrated program also described in the AB (#7532), Counseling and Testing (#7535), OVC (#7534), and Other Prevention (#7533) program areas.

SUMMARY:

With funding through the Health Communication Partnership (HCP), Johns Hopkins Health and Education in South Africa (JHHESA) coordinates the work of 15 South African partners and provides technical assistance and capacity building to mobilize and educate communities and clinicians about ARV treatment. The focus is on treatment literacy, adherence activities, and training clinicians through distance learning. The target populations for this activity are adult men and women, HIV-infected pregnant women, other people living with HIV (PLHIV), discordant couples, volunteers, public health workers, and community-based, faith-based and non-governmental organizations. The major emphasis areas for this activity are community mobilization, but IEC, training and policy and guidelines development are also important aspects of this work. Findings from the National HIV and AIDS Communication Survey, carried out in early 2006, will help HCP focus on community perceptions of treatment-related messages, their perceived needs for treatment literacy and the amount of social capital invested in providing assistance in better understanding treatment and its uptake. The survey is providing a valuable baseline to further develop present communication interventions on treatment.

BACKGROUND:

The HCP treatment initiatives are in their second year, following successful programming and ongoing partnerships in treatment literacy, adherence and clinician training with the South African Broadcasting Corporation (SABC), Mindset Health Channel (MHC), Community Health and Media Trust (CHMT), LifeLine and The Valley Trust (TVT).

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Community Mobilization

CHMT, with PEPFAR funding, has developed a series of video and print materials for people affected by and infected with HIV, including PLHIV, their caregivers and communities. PEPFAR funding will assist CHMT in the community rollout of these materials through group sessions and workshops. CHMT, using 24 treatment literacy practitioners, will train community-based organizations to use their treatment literacy materials and mentor them throughout the year on treatment-related issues. This intervention has received National Department of Health (NDOH) accreditation and eight additional treatment literacy practitioners' salaries will be supported by the government. Treatment literacy practitioners will also work with HIV-infected clients on treatment literacy issues that will be broadcast through Mindset's patient channel at 300 health facilities.

The seven hours of treatment literacy videos materials, developed by CHMT and Mindset for the public channel, will be a major part of the support materials for the treatment literacy practitioners (in addition to the materials developed previously by CHMT). The materials also cover prevention with positives, male norms and behavior, and stigma and discrimination.

The Valley Trust, as part of their rollout of antiretroviral treatment (ART) will build a treatment literacy program with the assistance of CHMT and their treatment literacy practitioners. LifeLine will work with small business associations in Alexandra Township in Gauteng, as well as farmers and farm workers associations in the Limpopo province, to develop workplace programs, which include ART. These programs will focus on treatment preparedness and adherence for HIV-infected persons and their treatment supporters (treatment buddies). Both of these populations are at high risk.

The Mindset Health Channel (MHC) provides direct information in health clinics, targeting patients in waiting rooms with general information, and healthcare providers with technical and training information. To broadcast current and accurate information on ARV

treatment, HCP will continue its collaboration with MHC which, at the beginning of FY 2007, will be in more than 300 health facilities. Existing material will be revised and updated, including treatment videos, web content and print materials in up to five languages for healthcare workers at these sites. Materials developed through previous PEPFAR funding will be updated as national guidelines and protocols change. CHMT treatment literacy practitioners will spend half their time with patients in ARV rollout and down referral sites that have the MHC.

Both Mindset and CHMT material have been developed through public-private partnerships including; business (MTN, Liberty Foundation and Sunday Times) as well as assistance from government and parastatals (e.g. NDOH, SABC).

This intervention will mobilize communities around treatment literacy and build community preparedness by reaching several million people, while Mindset will use its onsite access to clinicians to build their capacity to deliver ART services in line with national protocols. Treatment literacy will include adherence messages for persons on treatment, treatment support education for families and individuals supporting those on treatment, and ART preparedness education for communities and individuals who anticipate initiating treatment. Other issues that will be covered include prevention with positives with emphasis on discordant couples.

ACTIVITY 2: Media support for community mobilization

SABC will continue the theme of treatment through two programs: Trailblazers, a 13 episode TV series highlighting success stories including best practices in this area; and a new 26 episode adult TV drama series. Both TV programs will be accompanied by radio talk shows (on 9 local language stations) as well as web-based content. The storylines will include a focus on treatment and prevention for positives.

HCP will contribute substantially towards meeting the vision outlined in the USG PEPFAR Task Force Five-Year Strategy for South Africa by providing quality treatment literacy education to health providers, their patients and communities through Mindset Health channels. In addition HCP will build capacity of other organizations to utilize treatment literacy materials so that they in turn work with HIV-infected people on treatment literacy issues. By training individuals to deliver quality ARV services and reaching South Africans with correct treatment literacy messages, this activity contributes to the PEPFAR goal of putting two million HIV-infected people on treatment.

Funding for Strategic Information (HVSI): $400,000

INTEGRATED ACTIVITY FLAG:

Activities described are part of an integrated program implemented by the Health Communications Partnership including AB (#7532), ARV Services (#7536), CT (#7535), OVC (#7534) and Other Prevention (#7533) program areas.

SUMMARY:

With funding through the Health Communication Partnership (HCP), Johns Hopkins Health and Education in South Africa (JHHESA) coordinates the work of 15 South African partners and provides technical assistance and capacity building in communications activities to prevent HIV, provide care and support, and increase treatment adherence and support. Key legislative areas are male norms and behaviors, and reducing violence and coercion, along with alcohol use and stigma and discrimination. The National HIV and AIDS Communication Survey, carried out in early 2006, serves as a baseline for comparing overall PEPFAR and South African Government (SAG) communications goals and objectives with a follow-up survey planned for 2008.

BACKGROUND:

HCP will lead the implementation of the National HIV and AIDS Communication Survey 2008, which will be a follow-on to the baseline survey carried out in 2006. This survey will build on the continued partnership with the National Department of Health (NDOH) through Khomanani, Soul City and the Centre for AIDS Research and Evaluation (CADRE). This survey measures the effectiveness of the three large mass media activities in South Africa, of which two are PEPFAR-funded. The key objectives of this survey are to develop an understanding of the overall HIV and AIDS communication environment; understand communication gaps that can inform future communication interventions; and determine the reach and complementarities of national communication campaigns and their contribution to individual level responses. The results of the 2006 Survey will be used to develop the first National HIV and AIDS Communication Strategy.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: National HIV and AIDS Communication Survey

The National HIV and AIDS Communication Survey 2008 will provide in-depth information about the communication environment in South Africa as well as estimates of the separate and joint impact of various communication interventions. No other survey captures as much information about the SAG's communication programs and other communication interventions of NGOs, community-based organizations and faith-based organizations. The results of the study will be used to measure progress on program goals and to inform future strategic planning for communications activities.

A nationally representative sample of 8,000 individuals aged 15 to 65 will be interviewed in the quantitative part of the survey. Additional qualitative studies of specific issues such as primary abstinence, partner reduction, sexual violence and coercion, and male norms will also be conducted to provide valuable information for communication strategies and message design. PEPFAR partner, Soul City, will contribute to the survey with non-PEPFAR funds, while the NDOH will contribute SAG funds.

ACTIVITY 2: Dissemination Workshops

The findings will be disseminated through a series of workshops to more than 500 key stakeholders throughout the country. The purpose of these workshops is to build national and local consensus on what has been achieved through communication interventions and in what program areas interventions need to be strengthened. In addition, the findings from the 2008 survey will be compared to those from the 2006 survey to assess changes in norms and behavior and the impact of various communication interventions.

This activity will assist in making communication interventions across the different program areas more effective by providing key data for decision making. This will contribute to the PEPFAR goals of averting 7 million new infections.

Subpartners Total: $4,727,500
Applied Broadcasting Centre : $350,000
Anglican Church of Southern Africa: NA
Center for AIDS Development, Research, & Evaluation: $750,000
Community Health Media Trust: $750,000
Department of Justice and Correctional Services - South Africa: $150,000
DramAidE: $650,000
Mindset Health: NA
South African Broadcasting Corporation: NA
The Valley Trust: $562,500
University of the Witwatersrand: $150,000
University of KwaZulu-Natal: $40,000
Pollution Environmental Community Development Energy and Resource Africa: NA
Dance4Life: $550,000
Lifeline: $475,000
Lutheran Church Lighthouse Foundation: $300,000