Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 8707
Country/Region: South Africa
Year: 2009
Main Partner: Salesian Missions
Main Partner Program: NA
Organizational Type: FBO
Funding Agency: HHS/CDC
Total Funding: $506,812

Funding for Testing: HIV Testing and Counseling (HVCT): $506,812

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

SUMMARY:

Salesian Missions will conduct a voluntary counseling and testing (VCT) Life Choices project serving youth

and adults in the Western Cape.

BACKGROUND:

In 2004, the Salesians were granted support from the U.S. Government to start an HIV/AIDS outreach

project - Life Choices.

In the end of 2005, Life Choices South Africa began its work with children and youth in the Western Cape.

The vision of this project is to contribute to a South Africa with empowered and passionate youth equipped

to make informed and healthy life choices. Life Choices achieves this by partnering with the Western Cape

Department of Education and Health in order to deliver holistic approach to public schools. Life Choices

bases its methodology in the fact that schools present the perfect opportunity for accessing young people

from all walks of life as well as sustained and positive behaviour change requires significant investment of

time, one-on-one support and resources. For these reasons, Life Choices runs different programs in each of

the target schools that complement each other in order to create a supportive environment for healthy

behaviours. This model calls for working on the same school for a period no shorter than four years.

Running programs directly targeting young people (life skills, peer-education, VCT, welfare, career

guidance, behaviour change communication and health promotion programs) as well as running programs

targeting stakeholders in the lives of youth (parents and teachers programs).

As part of the successful education and peer training programs, the belief of normalization and importance

of testing has been made a norm with all the youth, thereby creating an unprecedented demand. For this

reason, Life Choices approached the U.S. Government once again to get support to expand the VCT

component. In 2007, Life Choices was granted that support in order that VCT activities can be expanded in

order to meet the demand created within youth to know their status. Life Choices also intends to take

advantage of Life Choices' vast network within the Western Cape area and implement VCT with youth in the

Western Cape area (rural and urban) via a mobile VCT unit going in this way beyond their initial targeted

schools.

Outcome Objectives (5 Years):

1)100 different sites provided with mobile flexi-hour VCT services;

2)30,000 Youth & Adults know their HIV status;

3)30,000 Youth & Adults are screened for TB;

4)30,000 clients have access to care, treatment and prevention interventions;

5)90,000 people are reached with HIV/AIDS awareness and VCT mobilization campaigns;

6)300 clinic staff are trained and mentored in how their services can become friendlier to different targeted

groups (youth, males, couples, etc).

ACTIVITIES AND EXPECTED RESULTS:

Life Choices will carry out eight separate activities in this program area.

ACTIVITY 1: Mobile youth friendly VCT in high schools

In FY 2009, 8,000 youth in high schools will be tested using youth friendly VCT services through a mobile

unit. All youth will be invited to participate in group information sessions (30 - 40 minutes) where HIV/AIDS

basic facts are discussed and after they are invited to the pre-counseling session. During this session, youth

explores risk factors in their lives, support structures and they are also screened for tuberculosis (TB) and

sexually transmitted infections (STIs), following the SA Government guidelines. After the pre-counseling

session, a Life Choices lab technician conducts the test using a serial algorithm (First Response, Sensa and

SD Bioline, as a tiebreaker). Results are given during a post-counseling session where a plan is made with

the individual about how to maintain their negative status or how to manage his/her positive diagnosed.

During all the procedure, all youth will receive strong messages about the benefits of abstaining, being

faithful to one negative partner and information about the consistent use as well as the limitations of

condoms. In the end of the procedure, all youth is referred to prevention, care and treatment programs in

accordance with their particular situation. Clients who are diagnosed as HIV-infected will also be offered on-

going psychosocial support given by a professional psychologist.

ACTIVITY 2 - Mobile VCT services in churches, community groups and workplaces

In FY 2009, 2,000 adults, couples and young people in churches, workplaces and community structures will

be tested using VCT services through a mobile unit. The VCT services in church settings and community

groups will be provided mainly after regular work hours and during the weekends. VCT services at the

workplace will be provided during business hours. With this activity, Life Choices intends to continue

reaching and testing people during school holidays and school exam time. In this activity, different

methodologies will be used in accordance with the specificity of the campaign. In some campaigns, Life

Choices uses the same methodology like in high schools (campaigns with colleges, community youth

groups, church youth groups among others) and in other campaigns (church general population, shopping

centres, workplaces among others) Life Choices does not conduct information sessions but pre-counseling

Activity Narrative: sessions touch briefly in the basics in order to minimize the time that the client goes through the procedure.

ACTIVITY 3 - Awareness and VCT mobilization campaigns

During FY 2009, the project will organize awareness and mobilization campaigns prior to the roll-out of the

mobile VCT services. The project will also seek to promote sexual and reproductive health (SRH) discourse

among in school youth and religious leaders to address cultural practices that discourage abstinence and

faithfulness. These campaigns will incorporate culturally and age-appropriate HIV/AIDS prevention

communication and will reach 35,000 people.

ACTIVITY 4 - Enhance youth's life skills

The adoption of healthy behaviors is not a simple process of providing information to people and then

watching them change. Years of research have proven that knowledge alone will not assist young people in

adopting the behaviors needed to prevent the spread of HIV/AIDS and that many more factors play a role.

According to the United Nations Children's Fund (UNICEF) some of the components that young people

need to adopt healthy behaviors are information about the need to be healthy, motivation to be healthy skills

to initiate and sustain behavior, belief that the change is possible and positive, community norms that

support the behavior, supportive environment to enable behavior and policy structures that support

behavior. Life Choices South Africa aims, with the Life Skills Program, to address the first five of these

components. This activity will aim to support youth by mobilising youth to know their HIV status as well as to

give youth skills to initiate and sustain healthy behaviors. With this activity, Life Choices will reach 2,500

youth with life skills sessions (seven sessions per class) given during Life Orientation (LO) periods. These

sessions are designed in order to be interactive, experimental, and to learn while having fun. At the same

time, 60 youth will be trained as peer-educators in order to work as health promoting agents among their

group of peers. These groups of peer-educators will run awareness campaigns, one-on-one conversations

as well as they will serve as a support structure to their peers in case they have been diagnosed as

infected or they have any other problem.

ACTIVITY 5 - Referral and Support of mobile VCT clinic clients

Life Choices South Africa will develop referral networks for the mobile VCT clients. Project counselors and

health professionals will be trained to refer all clients (7,250 people) to additional prevention, care and

treatment programs. Life Choices will also provide each client diagnosed as HIV with five psychological

support sessions (one-on-one). In addition to these sessions, youth needing further support will be linked

with the Life Choices social worker to obtain further support and to access additional services.

ACTIVITY 6 - Life Choices Staff Training

Life Choices South Africa will engage in a full range of capacity building activities focused on organizational

management, resources, and monitoring and evaluation. In FY 2009, the Life Choices-VCT Project will

provide two main trainings to the 20 staff members.

ACTIVITY 7- TB Screening

In FY 2009, 10,000 youth and adults in schools, churches and workplaces will be screened for TB during

the pre-counseling sessions. Clients presenting with two or more TB symptoms will be referred to TB

diagnose in their nearest health clinic. All clients reached through the mobile unit will receive information

about TB.

ACTIVITY 8- Quality Assurance

In FY 2009, Life Choices will continue with activities to ensure that processes are adequate in order to

achieve quality services. Standards procedures (protocols & quality control) will continue being followed

during each of the steps of the procedure (information session, clients intake, pre-counseling, testing and

post-counseling). On-going direct observation of each of the steps will take place by the Life Choices VCT

coordinator and HIV/AIDS government coordinator in order to secure that good standards are followed. This

direct observation will also guide the development of the on-going training of staff. Clients' feedback

(survey) will also be considered in guiding further changes. Data for each activity will be collected, records

will be kept (paper and electronic) and they will inform the monthly reports submitted to the government, as

well as the semi-annual reports submitted to the Centers for Disease Control and Prevention.

Expanding CT services contribute towards the PEPFAR 2-7-10 goals.

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

SUMMARY:

Salesian Missions will conduct a voluntary counseling and testing (VCT) Life Choices project serving youth

and adults in the Western Cape.

BACKGROUND:

The vision of Life Choices is to reach youth with a culturally accepted abstinence and be faithful (AB)

message early in their lives and to support the maintenance of positive behavior changes during

adolescence and adulthood through the involvement of community mentors, informed parents, and

organized peer groups. Life Choices has also networked with an established organization in order to use

their mobile VCT in the project's targeted High Schools. However, Life Choices' capacity to carry out VCT

services is much higher than the numbers its' partner organization has been able to meet. As a part of the

successful education and peer training programs, the belief of normalization and importance of testing has

Activity Narrative: been made a norm with all the youth, thereby creating an unprecedented demand. This program hopes to

meet the demand created within youth to know their status, and to take advantage of Life Choices' vast

network within the Western Cape area and implement VCT with youth in the Western Cape area (rural and

urban) via a mobile VCT unit.

ACTIVITIES AND EXPECTED RESULTS:

The main goals of this project are to: 1) increase access to youth friendly VCT by youths and young couples

15-24 years in high schools; 2) increase access to mobile VCT during the weekend in churches and; 3)

build an indigenous, sustainable response to the national HIV epidemic in South Africa through a rapid

expansion of innovative, culturally appropriate, high-quality, youth friendly HIV/AIDS VCT services.

Salesian Missions will expand VCT services to youth by: 1) integrating VCT into Life Choices; 2) offering

high schools and churches in the Western Cape Province with access to mobile VCT services; 3) improving

the quality of youth friendly VCT services at existing VCT sites through training and mentoring of service

providers and other clinic staff; 4) increase community mobilization within schools and churches via peer

educators, educators, parents and community leaders; and 5) offering psychological support and counseling

for onward care and support services to clients diagnosed as HIV infected.

Expanding CT services contribute towards the PEPFAR 2-7-10 goals.

New/Continuing Activity: Continuing Activity

Continuing Activity: 19510

Continued Associated Activity Information

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

System ID System ID

19510 19510.08 HHS/Centers for Salesian Mission 8707 8707.08 $722,000

Disease Control &

Prevention

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Reducing violence and coercion

Health-related Wraparound Programs

* TB

Workplace Programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $15,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14:

Cross Cutting Budget Categories and Known Amounts Total: $15,000
Human Resources for Health $15,000