INTEGRATED ACTIVITY FLAG: These activities also relate to EngenderHealth's activities in Condoms and Other Prevention (#7567) and CT (#7983). EngenderHealth also provides technical assistance to the Hope WorldWide (#7607) MAP program.

SUMMARY: EngenderHealth's Men as Partners (MAP) program aims to challenge the gender-related beliefs and attitudes that encourage men to equate masculinity with dominance over women, the pursuit of multiple partners and other risk-taking behaviors. To do this, MAP uses a range of strategies, including workshops, community education, media advocacy and public policy, to encourage young and adult men to remain abstinent, to be faithful and to decrease their number of sexual partners. This reduces the risk-taking behavior that puts them and their partners at risk. The primary emphasis area is training, with additional emphasis on community mobilization/participation and Information, Education and Communication (IEC). Populations to be targeted include children and youth, adults, PLHIV, community and religious leaders, program managers, health care providers, out of school and street youth, refugees, CBOs, FBOs, and NGOs.

BACKGROUND: EngenderHealth has received USG funding since 1998 to support FBOs, NGOs and the South African Government (SAG) to implement MAP programs in South Africa. EngenderHealth has used workshops, community education, IEC materials, media advocacy and policy development to promote abstinence, faithfulness, reduction of sexual partners and to increase men's use of HIV services. With FY 2007 PEPFAR funding, EngenderHealth will work with government and civil society partners to assist them to incorporate MAP programs and activities into their existing programs and strategies. EngenderHealth is currently collaborating with the Department of Social Development in the Western Cape and will be extending its working relationship in the Gauteng Province.

EngenderHealth has provided focused training and technical assistance to over 30 public sector and civil society organizations over the last 24 months, each of which has in turn trained other organizations. Building on these successes, EngenderHealth has assisted national and provincial governments to develop male involvement policies and programs, including the development of a National Task Force on Men and Gender Equality housed within the Presidency. Through its workshops, community education, IEC materials and frequent visibility in national print and television media, the MAP program has reached men across the country with messages that encourage them to reduce risk-taking behavior and to promote the use of health services. Featured regularly in international media, MAP has been singled out in Ambassador Tobias's speeches as an innovative and effective program. In addition, PEPFAR funding has been key in leveraging other donor funds, including UNAIDS, Ford Foundation, Canadian CIDA and Swedish SIDA. The MAP program was recently selected as a finalist for the Red Ribbon Award at the XVI International AIDS Conference in the category of "Addressing Gender Inequalities."

With FY 2007 funding, EngenderHealth will focus on two semi-urban areas and one rural area to establish a baseline to monitor the impact over time of the MAP program. To this effect, EngenderHealth will hire monitoring and evaluation (M&E) staff to look at establishing baseline information at the three sites, develop and test tools for the purpose of evaluation, and prepare for replication and rapid scale-up of the MAP program.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Training and Capacity Building in MAP Methodology EngenderHealth will continue to provide in-depth training and technical assistance on the implementation of MAP to three sets of partner organizations: PEPFAR grantees; Western Cape Department of Education; and the Western Cape Department of Social Development's HIV and AIDS Family Strengthening Initiative in collaboration with its NGO partners -- the Western Cape Network Against Violence Against Women, Resources for the Prevention of Child Abuse and Neglect, the Parent Centre and the South African Media and Gender Institute.

Using the MAP and Gender Equality Community Manual created by EngenderHealth and Planned Parenthood Association of South Africa in 1998, EngenderHealth will continue to

build the skills and commitment of these partner organizations to implement MAP workshops at the community level that focus on abstinence, faithfulness, the reduction of sexual partners, the need for men to respect women's right to negotiate sex, and the need for men to play a more engaged role in meeting the needs of orphans and vulnerable children (key legislative issue). The manual is currently being reviewed to add some activities which were not part of the original development. Using MAP workshops for community mobilization, EngenderHealth will utilize the MAP Community Action Team Manual to train partner organizations to use community mobilization strategies to reach greater numbers of young and adult men with risk reduction messages that promote AB and that challenge gender-based violence and promote gender equality.

EngenderHealth will further mobilize the community by partnering with JHU/Mindset to screen existing MAP video materials in clinics and in schools to ensure that Mindset materials include AB messages directed to men. EngenderHealth will also work with local media like South African Broadcasting Corporation to promote the AB messages directed to various target groups.

EngenderHealth will also continue to train partner organizations in the use of MAP IEC materials and strategies including videos, posters, murals and cartoons. In addition, drawing on EngenderHealth's past successes in working with the Presidency to establish a National Task Force on Men and Gender Equality, EngenderHealth will train partners in policy analysis and systems strengthening approaches that increase the capacity of government to promote constructive male involvement. This will include the review of specific policies such as human resources, black empowerment, inheritance, access to higher education.

ACTIVITY 2: Building Networks With FY 2007 funds, EngenderHealth will continue to coordinate the MAP Network, an alliance of FBOs, CBOs, NGOs, and government departments working together to create social change. The network allows organizations to share and leverage resources which in turn increase the number of men reached with MAP activities. Members of the network also work in strategic collaboration to optimize media coverage on issues including men's awareness and commitment to abstinence, being faithful and the reduction of sexual partners, and preventing violence against women. Both secondary schools and tertiary institutions will be targeted.

In collaboration with the Presidency, National Prosecution Authority and civil society organizations, EngenderHealth will continue to participate in the coordinating committee on the National Action Plan to End Gender-based Violence. EngenderHealth will also continue to play a major role in the National Task Force on Men and Gender Equality housed within the Presidency. The task force will continue to assist national and provincial governments departments to develop male involvement policies and programs.

EngenderHealth will contribute to the overall PEPFAR goals of 2-7-10 by increasing the number of men accessing HIV services including treatment; increasing the number of young and adult men choosing to abstain or be faithful/reduce their number of sexual partners; reducing women's vulnerability to HIV and AIDS by preventing gender-based violence; and increasing the number of men caring for the ill. EngenderHealth will contribute substantially towards meeting the vision outlined in the USG Five-Year Strategy for South Africa by increasing the effectiveness of NGO activities in the area of being faithful.

INTEGRATED ACTIVITY FLAG: This activity relates to EngenderHealth's activities in AB (#7566), and CT (#7983).

SUMMARY: EngenderHealth's Men as Partners (MAP) program challenges the gender-related beliefs and attitudes that encourage men to equate masculinity with dominance over women, the pursuit of multiple partners and other risk-taking behaviors. MAP uses a range of strategies, including workshops, community education, media advocacy and public policy, to encourage young and adult men to use condoms, decrease their number of sexual partners, and take an active stand on violence against women and children. This reduces the behavior that puts them and their partners at risk. The primary emphasis area is training, with additional emphasis on community mobilization/participation and information, education and communications (IEC). Specific target populations include out-of-school youth, university students, adults, HIV-infected women, community and religious leaders, program managers, public healthcare providers, people living with aids, caregivers, CBOs, FBOs and NGOs.

BACKGROUND: EngenderHealth has received USG funding since 1998 to support FBOs, NGOs and the South African Government (SAG) in implementing MAP programs in South Africa. EngenderHealth uses workshops, community education, IEC materials, media advocacy and policy development to promote a comprehensive, integrated ABC program. MAP aims to promote effective and appropriate use of condoms, reduction of sexual partners, behavior change, and to increase men's use of HIV services. Responding to the SAG's Stakeholders' Consultation on Social Mobilization, EngenderHealth has provided training and technical assistance (TA) to over 30 public sector and civil society organizations over the last 24 months, each of which has, in turn, trained other organizations.

EngenderHealth has assisted national and provincial governments to develop male involvement policies and programs, including the development of a National Task Force on Men and Gender Equality housed within the Presidency. EngenderHealth played an integral role in the preparation and hosting of the first 365 Days of Action to End Gender Violence Conference in May 2006, which resulted in a Task Team to take the resolutions forward. Through its training program, workshops, community education, IEC materials and frequent visibility in national print and television media, the MAP program has reached men across the country with messages encouraging condom use, reduction of risky behavior and concurrent partners, and active stands in their own lives and in the communities against Violence on Women and Children. The MAP program was recently selected as a finalist for the Red Ribbon Award at the XVI International AIDS Conference in the category of "Addressing Gender Inequalities."

With FY 2007 PEPFAR funding, EngenderHealth will focus on two semi-urban areas and one rural area to deliver a set of coordinated MAP activities. EngenderHealth will monitor the outcomes as implementation progresses. This will be a demonstration program to learn lessons and value of activities for replication and scale-up of MAP activities.

ACTIVITIES AND EXPECTED RESULTS: ACTIVITY 1: Capacity Building EngenderHealth will continue to provide training and TA on the implementation of MAP to three sets of partner organizations: PEPFAR grantees; Western Cape Department of Education; and the Western Cape Department of Social Development's HIV and AIDS Family Strengthening Initiative in collaboration with its NGO partners -- the Western Cape Network Against Violence Against Women, Resources for the Prevention of Child Abuse and Neglect (RAPCAN), the Parent Centre and the South African Media and Gender Institute.

Using the Gender Equality Community Manual created by EngenderHealth and Planned Parenthood Association of South Africa in 1998, EngenderHealth will continue to build skills and commitment of these partner organizations to implement MAP workshops at the community level that focus on condom usage, reduction of sexual partners, respecting women's rights to negotiate sex and the need for men to play a more engaged role in caring for OVC. MAP workshops will use the MAP Community Action Team Manual to train partner organizations in community mobilization strategies to reach greater numbers of

young and adult men with risk reduction messages that promote OP, challenge gender-based violence and promote gender equality. These activities will be delivered in coordination with at least 10 organizations.

EngenderHealth will also continue to train partners in the use of MAP's IEC materials and strategies including videos, posters, murals and cartoons. In addition, drawing on EngenderHealth's past successes in the Presidency's National Task Force, EngenderHealth will train partners in policy analysis and systems strengthening approaches that increase the government's capacity to promote male involvement.

ACTIVITY 2: Building Networks EngenderHealth will continue to coordinate the MAP Network, an alliance of about 40 FBOs, CBOs, NGOs and SAG departments working together to create social change. The Network allows organizations to share and leverage resources which in turn increase the number of men reached with MAP activities. Members of the network also work in strategic collaboration to optimize media coverage on issues including men's awareness and commitment to OP. In collaboration with the Presidency, National Prosecution Authority and civil society organizations, EngenderHealth will continue to participate in the coordinating committee on the National Action Plan to End Gender-based Violence.

ACTIVITY 3: Condom Promotion The MAP program has been carrying out peer education and counseling with condom distribution in Johannesburg since 2004. With FY 2007 funds, additional full-time Peer Educators (PEs) will be hired to counsel older youth and adults, encourage healthy behaviors, and promote correct and consistent use of condoms. Time will be spent on delivering risk reduction messages as part of the standard counseling session during CT. Comprehensive counseling on ABC strategies will be discussed and promoted to avoid HIV. PEs will continue to provide government-issued condoms to men through establishing distributions sites and one-on-one community distribution channels.

ACTIVITY 4: Behavior Change This activity will address gender norms that increase vulnerability to and impact of HIV and AIDS. Communities will be mobilized to fight forced sex, unequal status of women, and the sexual coercion and exploitation of young people. PEs will be trained and monitored as they conduct workshops to challenge male behaviors and norms relating to masculinity, and encourage condom use, partner reduction and risk aversion. With Let Us Grow, a local NGO, EngenderHealth will organize campaigns and events to educate communities about sexual violence against women and children, thus strengthening community sanctions against such behaviors. Through involvement in the 365 Days of Action to End Violence Against Women and Children, in collaboration with SAG and civil society, EngenderHealth will support activities and policies to strengthen sanctions against sexual and physical violence.

ACTIVITY 5: Partner Reduction Community-based messaging, in the form of posters, brochures, and workshop manuals, will advocate for reduction of concurrent sexual partners and low sexual partner turnover as methods for decreasing HIV transmission. This activity is integrated with the increased condom use activity explained above.

These activities contribute to the PEPFAR 2-7-10 goal by increasing the number of men accessing HIV services including treatment; increasing the number of men using condoms and reducing their number of sexual partners; reducing women's vulnerability to HIV by preventing gender-based violence; and increasing the number of men caring for the ill.

EngenderHealth will use plus up funds to provide HIV related palliative care through the men as partners networks to HIV infected individuals and their families. They will utilize both static and mobile models that are in place for men as partner activities and counseling and testing activities to expand services for care. EngenderHealth will focus on keeping those who test positive in wellness programs and will link these people to CD4 staging services and ART. Tracer systems developed by other PEPFAR partners will be used to ensure that those testing positive will initiate ART when they become eligible.

Targets

Target Target Value Not Applicable Indirect number of service outlets/programs providing general
HIV-related palliative care Indirect number of individuals provided with general HIV-related
palliative care Indirect number of individuals trained to provide general
HIV-related palliative care Indirect number of service outlets/programs providing malaria care
and/or referral for malaria care as part of general HIV-related palliative care Total number of service outlets providing HIV-related palliative care
(excluding TB/HIV) Total number of individuals provided with HIV-related palliative care 3,000  (excluding TB/HIV) Total number of individuals trained to provide HIV-related palliative 90  care (excluding TB/HIV)

Table 3.3.07: Program Planning Overview Program Area: Palliative Care: TB/HIV Budget Code: HVTB Program Area Code: 07 Total Planned Funding for Program Area: $ 24,272,000.00

Program Area Context:

The scale of the HIV-related TB epidemic in South Africa is staggering. TB is the leading cause of death in HIV-infected individuals and HIV accelerates the TB epidemic. South Africa has one of the highest estimated TB rates in the world, ranking 5th among high burden countries. According to provisional data, in 2005 there were more than 285,000 reported cases of TB, a rate of 608 per 100,000 population. The real prevalence is unknown but is estimated to be much higher. 58% of TB patients in South Africa are co-infected with HIV. According to provisional results for the 2004 cohort, treatment outcomes showed little progress; the cure rate for new smear positive cases was 56.4% and the overall successful completion rate was 72.2%. Rates of default from treatment were still high at 11.6%.

South Africa adopted the DOTS Strategy in 1996 and most districts have now implemented the core DOTS components. In 2006 the South African Government (SAG) developed the TB Crisis Plan. This plan focuses on social mobilization and multi-sectoral engagement and initially targets three provinces and four districts with high caseloads and unsatisfactory performance.

Government investment in TB control is significant; however, due to the decentralized nature of funding channeled through the provincial treasuries, the National TB Control Program (NTCP) is unable to quantify the amount of resources that are committed to TB control.

In acknowledgement of the burden of TB/HIV, the SAG Comprehensive Plan for HIV and AIDS Care, Management and Treatment espouses the integration of TB and HIV services as essential to ensuring that patients co-infected receive appropriate care and treatment. USG efforts in mitigating the impact of TB/HIV are consistent with the National Department of Health (NDOH) as well as the WHO Framework which highlights the need for integrated programming, decreasing the burden of TB among people living with HIV (PLHIV) and decreasing the burden of HIV among TB patients.

In FY 2006, the USG strategy to expand TB/HIV services was two-pronged: 1) line item TB/HIV funding for specific TB/HIV interventions and 2) embedding TB-related activities within PEPFAR partners' core activities. For example, screening for TB signs and symptoms in treatment sites is now standard of care.

A joint monitoring review of the NTCP took place in October 2005. Among the key findings was that there was insufficient planning and coordination in the development and implementation of joint action plans across TB and HIV program staff and that technical guidelines are often poorly implemented. USG efforts bolster the SAG capacity to address challenges related to TB/HIV coordination. USG partners work in all provinces to strengthen mechanisms of collaboration.

South Africa was awarded Round 2 funding by the Global Fund. The agreement was signed and the project started in January 2006 after having been delayed by administrative processes. Implementation has been slow and barriers remain in recruiting a project manager and for the tender process for the training component. In the interim, Belgian Technical Cooperation (BTC) has appointed a temporary project manager to facilitate the implementation process. Other major donors supporting TB/HIV activities in South Africa include The Bill and Melinda Gates Foundation, which is funding community-based trials of new strategies to combat TB in high HIV prevalence settings, and BTC (as above), which provides infrastructure and personnel support for expansion of the TB/HIV training.

The USG resources and technical assistance complemented SAG efforts in a broad range of TB/HIV activities. A best practice model of increasing access to HIV services (including routine counseling and testing, HIV care, wellness and ART) among TB patients was implemented in several sites in KwaZulu-Natal and this model is being replicated in additional provinces.

TB/HIV surveillance efforts included enhancements in the electronic TB register (ETR.Net) software to

include the ability to measure TB treatment outcomes by HIV status. An assessment of TB/HIV data collection tools took place and it is hoped that these results will help reduce barriers to more widespread TB/HIV surveillance. Efforts to bolster TB screening among clients of HIV services are less advanced and hampered by a lack of consensus on appropriate screening tools and deficiencies in the national health information systems which make these data unreliable.

Resources were provided to adapt and replicate a successful stand-alone counseling and testing model to services where TB patients are diagnosed and treated. Ongoing activities also aim to provide additional technical and financial resources for provincial and district health management teams to increase the effectiveness of referral networks between TB and HIV services and to improve the mechanisms of TB and HIV program collaboration. USG continues to support the development of a National TB Reference Lab as a key activity aimed at improving diagnosis of TB among PLHIV. Public-private partnerships will continue to expand access to TB/HIV services, including cotrimoxazole preventive therapy (CPT), expansion of access to ART and, on a limited basis, isoniazid preventive therapy (IPT) among PLHIV, all critical interventions in the integration of patient care.

Emerging concerns about the interaction between TB, HIV and drug resistance came to the fore in 2006. Efforts to better understand the extent of these threats and to control them have already begun and will be accelerated in 2007.

The USG is also supporting several targeted evaluations to identify improved methods to diagnose TB in HIV co-infected patients, enhance screening for TB in HIV CT and care settings, and improve referral networks between HIV and TB services.

In FY 2006, $6 million was invested in TB/HIV-related activities; approximately 6% of the country USG budget. In keeping with OGAC guidance to expand TB/HIV programming, close to $14,000,000 is requested in FY 2007. This excludes funds allocated to other TB-related line items (e.g. TB lab support, ART in TB settings, etc). Twenty-two partners are anticipated to be active in TB/HIV services.

Key constraints to effective TB/HIV collaboration are linked to both broad institutional factors as well as SAG-specific policy. These include: 1. Human resource constraints at district and facility levels; 2. Seperation of the TB and HIV and AIDS programs in the NDOH; 3. TB services are provided at the primary health care level and HIV and AIDS care services are usually hospital-based; 4. Emerging threat of multi-drug resistant TB (MDR-TB), extreme drug resistant TB (XDR-TB), with evidence of facility and community transmission; 5. The MDR-HIV interaction threat in the context of large-scale HIV care and treatment program; 6. Program approaches and cultures of TB and HIV programs inhibit effective collaboration.

The USG attempts to ameliorate these challenges via ongoing efforts to ensure that barriers to TB and HIV program collaboration are reduced and through frequent and persistent communication with the NDOH. Also, to ensure sustainability, USG works closely with the Department of Health at all levels to develop policies and build the capacity of service providers. Training of trainers and on-the-job training is also implemented. Because of staff rotation at service provider level, USG has embarked on training all service providers to ensure skill retention. TB/HIV programming will continue to receive priority attention in FY 2007.

Program Area Target: Number of service outlets providing treatment for tuberculosis (TB) to 1,538 HIV-infected individuals (diagnosed or presumed) in a palliative care setting Number of HIV-infected clients attending HIV care/treatment services that are 114,743 receiving treatment for TB disease Number of HIV-infected clients given TB preventive therapy 2,525 Number of individuals trained to provide treatment for TB to HIV-infected 10,321 individuals (diagnosed or presumed)

Table 3.3.07:

INTEGRATED ACTIVITY FLAG:

This activity also relates to EngenderHealth's activities in AB (#7566), as well as Condoms and Other Prevention (#7567).

SUMMARY:

EngenderHealth's Men as Partners (MAP) program aims to challenge the gender-related beliefs and attitudes that encourage men to equate masculinity with dominance over women, the pursuit of multiple partners and other risk-taking behaviors. To do this, MAP uses a range of strategies, including workshops, community education, media advocacy and public policy, to encourage young and adult men to follow a comprehensive ABC strategy, and to be counseled and tested for HIV. The primary emphasis area is Information, Education and Communication (IEC), with additional emphasis on Development of Network/Linkages/Referral Systems, Community Mobilization and Participation, and Training. Target populations include men, women, university students, discordant couples, people living with HIV (PLHIV), healthcare providers, and community leaders.

BACKGROUND:

EngenderHealth has received USG funding since 1998 to support faith-based organizations (FBOs), non-governmental organizations (NGOs) and the South African Government (SAG) to implement Men As Partners programs in South Africa. EngenderHealth has used workshops, community education, IEC materials, media advocacy and policy development to promote abstinence, faithfulness, correct and consistent condom usage, reduction of sexual partners and to increase men's use of HIV services, including VCT. Responding to the SAG's Stakeholders' Consultation on Social Mobilization, EngenderHealth has provided focused training and technical assistance to over 30 public sector and civil society organizations over the last 24 months, each of which has in turn trained other organizations.

Building on these successes, EngenderHealth has assisted national and provincial governments to develop male involvement policies and programs, including the development of a National Task Force on Men and Gender Equality housed within the Presidency. EngenderHealth was integral in the preparation and hosting of the first 365 Days of Action to End Gender Violence Conference in May 2006, which resulted in a Task Team to take the resolutions forward. Through its training program, workshops, community education, IEC materials and frequent visibility in national print and television media, the MAP program has reached men across the country with messages that encourage them to abstain from sex, reduce sexual partners, reduce risk-taking behavior, and take an active stand in their own lives and in the communities against Violence on Women and Children. The MAP program was recently selected as a finalist for the Red Ribbon Award at the XVI International AIDS Conference in the category of "Addressing Gender Inequalities."

With FY 2007 funding, EngenderHealth will focus on two semi-urban areas and one rural area to establish baseline to monitor over time the impact of the MAP program. EngenderHealth will also hire Monitoring and Evaluation staff to look at establishing baseline information at the three sites, develop and test tools for the purpose of evaluation, replication and rapid scale up of the MAP program.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: University-Based Counseling and Testing

With PEPFAR funding, EngenderHealth will continue to support VCT work that has been done on five government-supported university campuses, to increase access of young men and women to VCT services. Peer Educators will be trained according to SAG guidelines, to promote VCT through workshops and community mobilization on campus. Educational materials, which will also follow SAG policies, will be designed, developed and tested to further spread the message. A monitoring and evaluation system will be designed and utilized to track the effectiveness of the activities on campuses. Referrals for TB screening

will be conducted, as well as referrals for CD4 count and ARV services for those who test positive for HIV. A follow-up system will be established to ensure that those referred do get the necessary services. Activities will be carried out through three components: support for VCT activities at five universities through sub-agreements; developing a referral system to VCT sites; and promotion of VCT among students. Activities will also include training for counselors, which will focus on gender-specific counseling, couple counseling, and stigma reduction.

Additionally, VCT outreach days will be arranged to take the services to the wider campus population, reaching those who do not use university health clinics. During these outreach days, testing booths will be set up at strategic points throughout the campus and VCT services offered to all. These booths will be designed to ensure confidentiality. Students will be mobilized to come forward for testing through posters, campus radio and other media. Referral systems for HIV-infected students to existing support groups and medical services will be established, and those students testing negative will receive re-enforced prevention messages. These activities will continue to be conducted in concert with the work at tertiary institutions supported by Johns Hopkins University and its sub-partner, DramAidE (activity flag #7532).

ACTIVITY 2: Community-Based Counseling and Testing

With FY 2007 PEPFAR funding, EngenderHealth will expand their reach of VCT services through the establishment of several new testing sites, each of which will be staffed by trained counselors and nurses. Special community VCT drives will also be arranged to promote VCT services specifically for men in the community. Funding will also support the acquisition of a mobile VCT van, staffed with a nurse and counselors, to increase men's access to VCT services in Gauteng Province. The mobile clinic will be designed to ensure confidentiality. Experience has shown that mobile testing will result in reaching a large proportion of the population that would not visit clinics. This activity will improve and expand on the work already being done in the inner-city area of Johannesburg in conjunction with the Reproductive Health Research Unit (RHRU). Trained Peer Educators will be an integral part of promoting VCT and mobilizing the community for VCT service uptake.

As with the university-based VCT activity, community-based VCT will also include SAG-approved training for counselors, which will focus on gender-specific counseling, couple counseling, and stigma reduction. Referral systems for HIV-infected people to existing support groups and medical services will be established, and those testing negative will receive re-enforced prevention messages. A follow-up system will be established to ensure that those referred do get the necessary services.

ACTIVITY 3: Training

EngenderHealth will train healthcare providers, according to SAG policies, to improve VCT services, taking into account male-specific needs. This improvement of services will in turn increase men's utilization of HIV services, especially VCT, TB Screening, ARV uptake, ARV adherence, and their support for their partners' participation in these services, especially prevention of mother to child transmission (PMTCT). EngenderHealth's programs will also improve the quality and availability of male-friendly HIV services.

These activities contribute to the PEPFAR goal of providing care to 10 million HIV-affected individuals through an increased number of people being tested and knowing their status, resulting in fewer infections; higher gender equality through counseling (individuals/couples); increased lifespan due to timely treatment of opportunistic infections, and strengthened linkages between services offered by government and other organizations.