ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

Jhpiego's Siyazi project will continue to support workplace integrated HIV counseling and testing (CT) and

wellness screening services for workers, their partners and their families at 15 companies or work

associations. Jhpiego will provide counseling and testing services to 16,500 workers, their partners and

families by September 30, by 2010. Jhpiego will continue to provide technical assistance to 16 fixed road

site clinics and provide mobile testing outreach at additional workplaces. The primary geographic area of

work is Gauteng-based companies, their work associations and their provincial branches throughout South

Africa. The overarching goal of the project is to increase counseling and testing for hard-to-reach

populations and link them to prevention, care and support services. Jhpiego will continue to provide

technical assistance for policy development, review, dissemination and implementation through work with

management and peer educators. With the correct policy environment in place, Jhpiego will support

counseling and testing within an overall wellness screening package designed to decrease stigma related to

HIV testing. In addition, motivational speaking by people living with HIV will remain a key strategy to

encourage people to get tested and eliminate stigma. Jhpiego will initiate and implement GIPA (Greater

Involvement of People Living with HIV/AIDS) principles as a means to involve people living with HIV and

AIDS (PLWHA) in HIV/AIDS workplace related issues, address stigma, encourage disclosure of HIV status,

disseminate information on positive living and human rights for individuals and their families.

The Jhpiego Siyazi project will train 500 peer educators to provide group education for prevention

messages and condom distribution. To encourage behavior change Jhpiego will utilize audio visual, other

educational materials and facilitate formal and informal workshops to disseminate prevention messages for

specific groups. Prevention messages will be developed to suit each target group. In collaboration with

other PEPFAR partners, Jhpiego will support the development of a national logo to assist in the

identification on quality CT services.

Jhpiego, in collaboration with EngenderHealth's Men as Partners project, will address gender related issues

including gender-based violence (GBV) through the training of workplace management as well as peer

educators in FY 2009. Peer educators will play a vital role in sensitizing and empowering employees on

gender equity and reducing GBV. The Siyazi project will increase counseling and testing access

predominately for employed men, their partners, families and female sex workers at the truck stops where

the road site clinics are based.

A team of nurses and lay counselors will provide pre-test counseling, tuberculosis (TB) screening using the

five TB screening questions, and other wellness and health risk assessments including diabetes,

cholesterol, and body mass index. Counselors and nurses will provide 1) pre-test counseling, 2) rapid HIV

testing using the parallel algorithm, 3) post test counseling including disclosure counseling, and (4) referral

to prevention and care and support services. For individuals testing positive for HIV, nurses will refer

employees to in house and to local clinics for on-going care. In FY 2009, the Jhpiego Siyazi project will

explore the feasibility of on-site clinical staging and/or CD4 count testing.

Based on approval of workplace partners, Jhpiego will extend couple counseling services to employees and

their partners in the workplace by using the national and international HIV/AIDS couple counseling training

materials and systems. Jhpiego will pilot a variety of approaches to expand couples CT including issuing

invitations to couples and families for CT and wellness services. Jhpiego will also promote couples and

family CT during health calendar days such as sexually transmitted infection (STI) week, TB week, World

AIDS Day and other CT campaigns throughout the year as well as at the road site clinics for sex workers

and truck drivers.

While CT services are widely available in South Africa, a need was identified for the development of a

quantifiable system to measure adherence to quality standards for counseling and testing service delivery.

In FY 2009, Jhpiego will assist in establishing quality assurance systems that use Standardized-Based

Management and Recognition and performance improvement methods for CT in five sites in Gauteng.

Jhpiego will also facilitate the incorporation of existing CT materials into an e-learning format to increase the

access of partners' staff to self-based individualized learning.

Jhpiego will work with the National Institute for Communicable Diseases (NICD) to ensure quality for testing

in the workplace. The programme officer with a nursing background will work directly with the NICD on

quality assurance related matters at the testing sites. This will include proficiency testing using panels from

NICD and on-site monitoring. NICD will provide training and ongoing support including site visits for testing

quality assurance.

The Siyazi project is aligned with the HIV & AIDS and STI National Strategic Plan, 2007-2011 (NSP) Priority

Area 2, Objective 5.1- Increase access to VCT services that recognize diversity needs. Jhpiego will institute

confidential counseling and testing services in the workforce in both private and public institutions. Jhpiego

will design workplace HIV/AIDS programs that respond to individual companies' needs and fulfill the goals

of this project thereby addressing the NSP goal for 2008 of 40%. Management, union members, individual

employees, and family members will be targeted. Jhpiego will work to ensure that confidential counseling

and rapid testing services focusing on risk reduction, will be accessible to all workers and their partners in

selected sites.

Jhpiego drafted and reviewed a memorandum of understanding (MOU) for approval with the Gauteng

Department of Health Employee Wellness programme. As the workplace program is predominantly with

companies rather than the government, Jhpiego does not have MOUs with the South African Government

(SAG) at the moment. However, MOUs have been fully executed with the National Bargaining Council for

the Road Freight Industry and Ford Motor Company of Southern Africa. For the remaining partners

[National Prosecution Authority, Department of Justice and & Constitutional Development, State Information

Technology Agency, Judicial Officers Association of South Africa], MOUs have been drafted and are being

reviewed and/or routed for approval among the leadership of each organization. Jhpiego has re-established

the relationship with the City of Johannesburg and will be drafting and MOU for review and approval by the

Activity Narrative: City of Johannesburg.

----------------------------

SUMMARY:

The focus of this project is the implementation of confidential counseling and testing (CT) in the workplace

and will link CT with other interventions such as prevention, treatment and support systems. Emphasis

areas will be CT service delivery, development of HIV policies in the workplace, training, prevention

messages, quality assurance and supportive supervision, and capacity building, Target groups will include

women and men of reproductive age, management and trade union members in the work environment.

BACKGROUND:

Under this project JHPIEGO will assist individual companies to create a conducive environment for

confidentialand voluntary counseling and testing. JHPIEGO will do this by addressing management, unions

and employees though the provision of basic but thourough HIV and AIDS information; providing assistance

in the reduction of stigma and discrimination and the impact of HIV and AIDS in the workplace; and

supporting VCT services.

ACTIVITIES AND EXPECTED RESULTS:

JHPIEGO will institute confidential counseling and testing services in the workforce in both private and

public institutions. JHPIEGO will design workplace HIV and AIDS programs that respond to individual

companies' needs and fulfill the goals of this project. Management, union members, individual employees,

and family members will be targeted. JHPIEGO will work to ensure that confidential counseling and rapid

testing services focusing on risk reduction, will be accessible to all workers and their partners in selected

sites. JHPIEGO will also incorporate stigma reduction strategies and issues of sexual violence and

prevention for positives. The expected results under this objective are: 1) Workplace HIV and AIDS policies

developed and disseminated; 2) Counseling and testing sites established and running; 3) Stigma

surrounding HIV and AIDS reduced in and out of the workplace; 4) Prevention message dissemination

strategies developed and sustained; 5) Peer education programs developed and sustained and;6) Establish

linkages to care, treatment and other interventions.

Throughout the life of this project, JHPIEGO will implement the GIPA( Greater Involvement of People living

with HIV and AIDS) principles as appropriate; the GIPA principle supports the substantive involvement and

inclusion of people living with HIV and AIDS in all aspects of project design, implementation and monitoring.

These activities will directly support PEPFAR 2-7-10 goals.

New/Continuing Activity: Continuing Activity

Continuing Activity: 19511

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

19511 19511.08 HHS/Centers for JHPIEGO SA 8708 8708.08 $722,000

Disease Control &

Prevention

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Workplace Programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $29,155

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14: