PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
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.
-----------------------------
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.
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.
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: