This activity complements activities in 8305-AB, 8306-Other Preventions, 8311-OVC, 8310-TB/HIV, 8309-Basic Health Care & Support, 8308-CT.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006 with additional PEPFAR funding. Program areas include AB and Other prevention activities, VCT, PMTCT, Basic care and support, HIV/TB Palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, facilitating cross-sectoral linkages key to HIV/AIDS programming. The 2004-2005 Uganda HIV Sero Behavioral Survey (UHSBS) revealed a national HIV prevalence of 6.4% among the adult population, increased from 6 % in 2000. (In Yumbe district, the HIV prevalence is 2.3% according to the UHSBS, and in Masindi district, the prevalence is 6.9 %.) The increase in national HIV prevalence has raised concerns that successes to date in controlling the AIDS epidemic in Uganda could be threatened. In response, the GOU has renewed the emphasis on HIV prevention in Uganda and has declared 2006 the Year of HIV Prevention.

PMTCT services were introduced in Kiryandongo and Ikafe PEPFAR program in April 2005 and will be expanded in 2006. To date, IRC has offered pre-test counseling to 785 pregnant mothers, and has tested and provided results to 393 pregnant mothers (of whom 28 where found positive); 6 mothers and their babies have received a complete course of ARVs. In 2007, IRC will continue supporting one PMTCT site per camp, with an estimated 2,000 antenatal attendances per year. IRC has already trained 26 health care workers in the provision of PMTCT services. IRC will follow the Phase II (2006-2010) revised national PMTCT policy, which focuses on supporting the holistic implementation of the four-pronged PMTCT strategy: primary prevention; family planning; provision of ARV prophylaxis; and care and support.

IRC will ensure the consolidation of services to increase uptake, male involvement, strengthening of family planning services, improvement of comprehensive care for HIV positive women, their spouses and their exposed children through early HIV diagnosis and linkages to care. With the current move toward repatriation of Sudanese refugees, IRC will begin to shift the responsibility for providing PMTCT services to the District Directorates of Health Services. Districts will support PMTCT service provision at these sites by providing technical support, seconding health personnel, and providing some of the necessary commodities. IRC will provide refresher training of staff on counseling and testing and infant feeding options, procure PMTCT commodities for mothers and infants, adapt or develop BCC materials, and support referral for those clients who require specialized treatment either at district or regional hospitals. The PMTCT program will be closely linked with VCT, with pregnant women and their partners being asked to attend counseling and testing routinely, while emphasizing voluntarism. Linkages will be made with ART services provided at Arua, Kiryandongo and Yumbe Hospitals by the Ministry of Health, with mothers who qualify being referred accordingly.

IRC will aim to achieve the following: (1) increase access to quality PMTCT services; (2) increase awareness and demand for PMTCT services among beneficiary population (both refugee and national); (3) maintain a sufficient number of skilled staff who are trained, motivated, and productive; and (4) integrate quality PMTCT services into routine maternal and child health services.

Expected outcomes in this program area include: (1) increased use of complete course of ARV prophylaxis by HIV+ pregnant women and their newborns; (2) full supply of diagnostics and related medical supplies achieved and maintained; (3) improved logistics

system for the rollout of PMTCT services.

This activity complements activities in 8307PMTCT, 8305-AB, 8306-Other Preventions, 8311-OVC, 8310-TB/HIV, 8309-Basic Health Care & Support, 8308-CT.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006 with additional PEPFAR funding. Program areas include AB and Other prevention activities, VCT, PMTCT, Basic care and support, HIV/TB Palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, facilitating cross-sectoral linkages key to HIV/AIDS programming.

The 2004-2005 Uganda HIV Sero Behavioral Survey (UHSBS) revealed a national HIV prevalence of 6.4% among the adult population, increased from 6 % in 2000. (In Yumbe district, the HIV prevalence is 2.3% according to the UHSBS and in Masindi district, the prevalence is 6.9 %.) The increase in national HIV prevalence has raised concerns that successes to date in controlling the AIDS epidemic in Uganda could be threatened. In response, the GOU has renewed the emphasis on HIV prevention in Uganda and has declared 2006 the Year of HIV Prevention. According to the Ministry of Health, in their August 2006 package for Stepping up the Pace of HIV Prevention in Uganda, analysis of trends in the Ugandan HIV epidemic between 1995 and 2005 shows some positive behaviors, especially an increasing delay in age at 1st sex young women. The trend is not as clear among young men. Data also show abstinence among young people has increased.

On the other hand, the analysis shows that risky behaviors are on the increase from the late 1980s. In particular, there is an increase in casual sex, an increase in multiple partners, and a decrease in condom use with casual partners. (Prof. Wabwire Mangeni, IPH August 2006). In May 2006, IRC conducted an HIV/AIDS Knowledge, Attitudes, and Practices survey among the youth in Kiryandongo and Ikafe refugee settlements, which indicated that the vast majority of youth have heard of HIV/AIDS (96.4%) but that knowledge on ways to prevent HIV/AIDS is low, particularly amongst female youth. 55.9% of the youth surveyed reported using condoms; 52.3 % reported that they abstained from sex; and 44.6% reported that they were faithful to one partner. Although this was an improvement from a previous KAP survey done in 2003, the results demonstrate a need to strengthen knowledge about HIV prevention and to increase HIV/AIDS-related behavior change activities among the refugee population. These factors, along with the move toward repatriation of Sudanese refugees, have contributed to IRC's decision to increase the focus on promotion of prevention (AB and Other prevention) in 2007, in an effort to minimize the risk of HIV transmission during the repatriation process and upon return to communities of origin. Interventions promoting abstinence and faithfulness will strengthen the existing prevention initiatives in Kiryandongo and Ikafe refugee settlements. From October 2005 through March 2006, IRC reached 8,532 individuals in the two refugee settlements with AB messages and 14,376 with other prevention messages. This was achieved with support of network of 337 trained community condom distributors and youth mobilizers. In 2007, these activities will continue and IRC shall identify and train more community-based mobilisers in preparation for repatriation, ensuring that at least one mobilizer accompanies returnees as they travel to Sudan. BCC materials with AB prevention messages for refugee and host populations in the two beneficiary camps and surrounding areas will be developed or adapted, as appropriate, with particular emphasis being placed on prevention of HIV during the return process. IRC will support community outreach, mobilization, and training of community-based health workers in AB. The AB activities will be closely linked to BCC and two community mobilizers in each camp will be

responsible for the distribution of BCC materials within their communities. AB prevention messages in faith-based and community networks will be strengthened in an effort to decrease high-risk behaviors among youth and reduce HIV/AIDS stigma and discrimination. Community HIV/AIDS Assistants will work in each camp, providing training and support supervision for volunteer community mobilizers, whose responsibilities will include the mobilization of community members for all HIV/AIDS-related activities, including AB activities. Community Assistants will also train community leaders (youth in secondary schools, out-of-school adolescents, community health workers, and adults) to multiply messages and become change agents within their camps of residence and will coordinate with community members and other IRC staff in the development of appropriate BCC materials to be distributed among the beneficiary populations. AB messages will be conveyed during all VCT and PMTCT sessions carried out by IRC staff, and community health workers in both camps will promote AB in community health education sessions on HIV/AIDS to be given at least twice during the year.

This activity complements activities in 8307-PMTCT, 8305-AB, 8311-OVC, 8310-TB/HIV, 8309-Basic Health Care & Support, 8308-CT.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. Refugees and other conflict-affected populations have a heightened vulnerability to HIV/AIDS infection. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006 with additional PEPFAR funding. Program areas include AB and Other prevention activities, VCT, PMTCT, Basic care and support, HIV/TB Palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, facilitating cross-sectoral linkages key to HIV/AIDS programming. The 2004-2005 Uganda HIV Sero Behavioral Survey (UHSBS) revealed a national HIV prevalence of 6.4% among the adult population, increased from 6 % in 2000. (In Yumbe district, the HIV prevalence is 2.3% according to the UHSBS and in Masindi district, the prevalence is 6.9%.) The increase in national HIV prevalence has raised concerns that successes to date in controlling the AIDS epidemic in Uganda could be threatened. In response, the GOU has renewed the emphasis on HIV prevention in Uganda and has declared 2006 the Year of HIV Prevention. According to the Ministry of health, in their stepping up the pace of HIV prevention in Uganda, package of August 2006 an analysis of trends in the Ugandan HIV epidemic between 1995 and 2005 shows some positive behaviors, especially an increasing delay in age at 1st sex young women. The trend is not as clear among young men. Data also show abstinence among young people has increased. On the other hand, the analysis shows that risky behaviors are on the increase from the late 1980s. In particular, there is an increase in casual sex, an increase in multiple partners, and a decrease in condom use with casual partners.( Prof Wabwire Mangeni IPH August 2006) In May 2006, IRC conducted an HIV/AIDS Knowledge, Attitudes, and Practices survey among the youth in Kiryandongo and Ikafe refugee settlements, which indicated that the vast majority of youth have heard of HIV/AIDS (96.4%) but that knowledge on ways to prevent HIV/AIDS is low, particularly amongst female youth. 55.9% of the youth surveyed reported using condoms; 52.3 % reported that they abstained from sex; and 44.6% reported that they were faithful to one partner. Although this was an improvement from a previous KAP survey done in 2003, the results demonstrate a need to strengthen knowledge about HIV prevention and to increase HIV/AIDS-related behavior change activities among the refugee population. These factors, along with the move toward repatriation of Sudanese refugees, have contributed to IRC's decision to increase the focus on promotion of prevention (AB and Other prevention) in 2007, in an effort to minimize the risk of HIV transmission during the repatriation process and upon return to communities of origin. Interventions promoting other forms of prevention will strengthen the existing prevention initiatives in Kiryandongo and Ikafe refugee settlements. From October 2005 through March 2006, IRC reached 8,532 individuals in the two refugee settlements with AB messages and 14,376 with other prevention messages. This was achieved with support of network of 337 trained community condom distributors and youth mobilizers. In 2007, these activities will continue and IRC shall identify and train more community-based mobilizers in preparation for repatriation, ensuring that at least one mobilizer accompanies returnees as they travel to Sudan. BCC materials with prevention messages for refugee and host populations in the two beneficiary camps and surrounding areas will be developed or adapted, as appropriate, with particular emphasis being placed on prevention of HIV during the return process. Prevention activities will be closely linked to BCC and two community mobilizers in each camp will be responsible for the distribution of BCC materials within their communities. Recognizing the particular vulnerability of in and out of school youth, IRC will direct activities in the area of other

forms of prevention to target these groups, using survey data on HIV/AIDS-related knowledge, attitudes and practices (KAP) collected in 2006 to direct programming. Communications strategies developed to address social, cultural and gender-related barriers to behavior change, which were identified in the 2006 KAP survey, will be updated and used. Through community participation, IRC will target high risk groups and areas of high transmission within the refugee community (e.g. areas of commercial sex and high alcohol consumption) to effectively focus specific HIV/AIDS activities.

In addition, emphasis will be placed on prevention of HIV transmission during the return process. IRC will support condom procurement, training of condom distributors, establishment of condom outlets and distribution networks, and production / distribution of BCC materials promoting consistent and correct use of condoms. IRC will also support mobilization and sensitization activities on the safe use of condoms. 50 condom outlets will be supported, which is calculated on the basis of one outlet per 1000 population. 50 existing condom distributor / promoters will receive refresher training and new condom distributors will be trained, depending on the need. Community based sensitization and health facility based early diagnosis, proper management and prevention of STIs will be continued and strengthened, as the presence of STI promotes the transmission of HIV. IRC HIV/AIDS program will work closely with the IRC's Gender Based Violence( GBV) program in raising community awareness on the risks of GBV and HIV during repatriation and on the and medical management of GBV survivors, including the provision of PEP (post-exposure prophylaxis).

IRC's activities in the area of other forms of prevention will be complimentary to activities promoting abstinence and being faithful and will aim to achieve the following: HIV infection risk in returning refugees reduced; HIV infection risk in vulnerable and hidden populations reduced; access to HIV/AIDS prevention services for high risk populations (including returning refugees) increased; awareness and knowledge about HIV/AIDS preventive practices increased; and full supply of condoms achieved.

This activity complements activities in 8307-PMTCT, 8305-AB, 8306-Other Preventions, 8311-OVC, 8310-TB/HIV, 8308-CT.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006 with additional PEPFAR funding. Program areas include AB and other prevention activities, VCT, PMTCT, basic care and support, HIV/TB palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, and facilitating cross-sectoral linkages key to HIV/AIDS programming.

The 2004-2005 Uganda HIV Sero Behavioral Survey (UHSBS) revealed a national HIV prevalence of 6.4% among the adult population, an increased from 6% in 2000. In 2004-2005 Yumbe district, the HIV prevalence was 2.3% according to the UHSBS and in Masindi district, the prevalence was 6.9 %. From these prevalence rates, it is expected that 1,855 HIV+ individuals live in Kiryandongo refugee settlement and 452 live in Ikafe. In 2007, IRC hopes to counsel, test, and provide results to 3,466 in Kiryandongo and 2,534 in Ikafe. Based on the numbers of VCT clients and recent sero behavioral prevalence rates, as indicated above, we estimate that we will identify about 300 HIV+ clients eligible for palliative care services in 2007.

IRC will provide basic care and support services to newly identified HIV+ clients as well as to over 400 HIV+ clients enrolled in the program during 2005 and 2006. In 2005, IRC enrolled 375 clients on cotrimoxazole prophylaxis, 23 in ARV treatment, and 200 in HBC programs; this number is anticipated to increase in 2006. There will be 2 basic care and support outlets, one located in the level 3 health centers of each refugee settlement. Staff at the lower health units will refer clients to these two outlets. Services provided will include prophylaxis and treatment of opportunistic infections, treatment of malaria, and referral of clients requiring higher levels of care. IRC will also provide quality basic clinical health services for HIV+ patients, including the provision of the Basic Care Package for PLWAs (safe drinking water, cotrimoxazole and isoniazid prophylaxis, insecticide-treated bed nets, and micronutrients). Treatment of malaria will be provided and referrals will be supported for those clients requiring a higher level of care through its health program, which receives funding from other USG sources. IRC will continue supporting community-based networks providing psychosocial, spiritual, and nutritional support, as well as providing home based care kits to 300 PLWAs. Training and support to palliative care providers will continue. Community HIV/AIDS assistants, who will coordinate outreach and referral activities benefiting PLWAs, will receive refresher training in palliative care, and IRC will support and strengthen referral systems by providing transportation, food, and communication for PLWAs and their attendants during the referral process. With the current move toward repatriation of Sudanese refugees, IRC will work with its Regional Refugee Repatriation Program to facilitate linkages with government and non-government agencies providing basic care and support services in Sudan for HIV+ returnees. IRC will provide training for community based palliative care providers to ensure continuation of support to PLWAs during the repatriation process. IRC will support the development and distribution of BCC materials on palliative and home-based care, including continuation of care after repatriation.

The expected results of activities in this program area include: (1) strengthened organizational capacity to promote long-term sustainability of palliative care services; (2) increased use of wellness programs by PLWAs and their families; (3) community-based groups providing home-based services to PLWAs identified and strengthened; and (4) improved quality of basic health care clinical services for HIV+ patients.

This activity complements activities in 8305-AB, 8306-Other Preventions, 8311-OVC, 8307-PMTCT, 8309-Basic Health Care & Support, 8308-CT.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. Refugees and other conflict-affected populations have a heightened vulnerability to HIV/AIDS infection. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006, with additional PEPFAR funding. Program areas include AB and Other prevention activities, VCT, PMTCT, Basic care and support, HIV/TB Palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, facilitating cross-sectoral linkages key to HIV/AIDS programming.

The 2004-2005 Uganda HIV Sero Behavioral Survey (UHSBS) revealed a national HIV prevalence of 6.4% among the adult population, increased from from 6 % in 2000. (In Yumbe district, the HIV prevalence is 2.3% according to the UHSBS and in Masindi district, the prevalence is 6.9%.) From these prevalence rates, it is estimated that 452 HIV+ individuals live in Ikafe refugee settlement and 1,855 live in Kiryandongo. IRC currently supports basic TB activities at 2 health facilities and at the community level through the TB DOTS strategy. In 2007, IRC's activities in the PEPFAR program area of HIV/TB, will strengthen capacity of health professionals to care for HIV-infected TB patients, strengthen delivery of integrated HIV and TB services, improve diagnosis of TB, provide isoniazid prophylaxis of TB among HIV+ individuals, provide appropriate treatment of TB among HIV/TB co-infected individuals, and maintain a full and consistent supply of related diagnostics. TB DOTS programs in both of the targeted camps will also be strengthened in 2007. To achieve these targets, HIV/TB services will be provided through 4 service outlets: 1 in Kiryandongo and 3 in Ikafe and through community based TB DOTS programs. All patients who are diagnosed with TB will be offered VCT services and all HIV+ patients will be referred for TB screening, in order to identify co-infected clients. In 2006 IRC will seek approval and guidance from MoH to introduce a TB prophylaxis program using isoniazid among HIV+ clients. Through this program, IRC will conduct staff trainings and community sensitization and awareness on the availability of this service and will ensure adequate stocks of commodities necessary to provide isoniazid prophylaxis.

In 2007, IRC will provide refresher training on isoniazid prophylaxis to health staff, including TB DOTS supervisors and will expand community education regarding HIV/TB co-infection. IRC will closely collaborate with District Directorates of Health Services in the implementation of the program through technical support supervision, commodity procurement, and trainings.

This activity complements activities in 8305-AB, 8306-Other Preventions, 8307-PMTCT, 8310-TB/HIV, 8309-Basic Health Care & Support, 8308-CT.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006, with additional PEPFAR funding. Program areas include AB and Other prevention activities, VCT, PMTCT, Basic care and support, HIV/TB Palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, facilitating cross-sectoral linkages key to HIV/AIDS programming.

Support to OVC is a notable gap in all refugee sites, with no single program addressing the particular needs of this vulnerable group. Since 2005, IRC has provided educational support to 267 OVCs from Kiryandongo and Ikafe settlements. IRC has also trained 50 OVC care providers and supported them with farming equipment to help strengthen community safety networks for OVCs.

In 2007, IRC will collaborate with other partners and various sectors to strengthen activities supporting OVCs, with emphasis placed on improving access to social services such as education and health. To achieve this goal, IRC will provide educational support to 350 OVCs; and will work with 50 community leaders, caretakers of OVCs, and OVC service providers to provide ongoing psychosocial support. In addition, existing OVC support programs will be strengthened and expanded to address the needs of OVCs and their family members and to encourage them to protect themselves from HIV infection with preventive measures such as AB, condom use, and accessing VCT. There will be improved district coordination and management structures in support of OVCs. The key legislative issues addressed in this program area are increasing gender equity in OVC programs by giving equal opportunity to the girl child, increasing women's access to income and productive resources, and increasing women's legal protection. Stigma and all forms of discrimination shall also be addressed.

This activity complements activities in 8307-PMTCT, 8305-AB, 8306-Other Preventions, 8311-OVC, 8310-TB/HIV, 8309-Basic Health Care & Support.

Uganda is host to approximately 240,000 refugees; refugees from Sudan (approximately 180,000) and the Democratic Republic of Congo (approximately 20,000) represent the majority. In 2005, IRC established comprehensive HIV/AIDS programs in refugee camps in Kiryandongo in Masindi District (population approx. 14,888 with a surrounding host national population of 12,000) and Ikafe in Yumbe District (population approx. 9,653 with a surrounding host national population of 10,000). These activities were continued and expanded in 2006 with additional PEPFAR funding. Program areas include AB and Other prevention activities, VCT, PMTCT, Basic care and support, HIV/TB Palliative care, and assistance for OVCs. Following upon successful implementation of HIV/AIDS interventions in Kiryandongo and Ikafe in 2005 and 2006, activities will be continued and strengthened in 2007, with increased emphasis being placed on prevention activities. IRC is well placed to expand its HIV/AIDS interventions in the refugee population, having established a quality, comprehensive package of health services, including reproductive health and gender-based violence, in both Kiryandongo and Ikafe refugee settlements, with funding from UNHCR and PRM. Moreover, IRC implements interventions in multiple sectors in both settlements, including education and community services, facilitating cross-sectoral linkages key to HIV/AIDS programming.

IRC will maintain 4 static VCT sites: 1 located in Kiryandongo and 3 in Ikafe. IRC has hired and trained nurse/counselors and laboratory assistants to provide counseling and testing services in Kiryandongo and Ikafe refugee settlements. IRC will continue to support both facility-based and community-based counseling and testing activities in each camp, with VCT services being provided at static sites, and community VCT outreaches being conducted regularly. In addition, innovations such as home-based VCT, introduced in 2006 to increase uptake of counseling and testing services, will be strengthened. In 2005, IRC counseled, tested, and provided results to 2,952 clients in Kiryandongo (8.7% HIV positive) and 2,652 individuals in Ikafe (2.9% HIV positive). VCT is one of the entry points for any HIV/AIDS activities and, therefore, vigorous BCC campaigns will be supported to mobilize the beneficiary communities. Other community initiatives such as post-test clubs and support groups will be supported through community mobilization. In order to ensure wider coverage and mobilization for VCT, IRC will identify 20 community members to be trained as counseling assistants. The counseling assistants will mobilize community members to access VCT and strengthen ongoing community counseling to members of the post test clubs. It is also envisaged that the community counseling assistants will provide ongoing counseling during repatriation as a way of ensuring sustained behavioral change among members of post test clubs and the community. 6,000 VCT clients will be targeted during the program period, on the basis of 100 clients per site per month, with minimum staffing of three counselors and one lab personnel per site. VCT will be linked to AB and other prevention interventions, TB/HIV care, and palliative care. It is expected that with successful implementation of the program, there will be an increased utilization of HIV testing and counseling services, increased public information and understanding of HIV counseling and testing, and increased and enhanced quality of CT services. There will be enhanced linkages between CT services and care and treatment facilities. IRC will ensure a continuous supply of related diagnostic and medical supplies.