Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011

Details for Mechanism ID: 9542
Country/Region: Uganda
Year: 2010
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: USAID
Total Funding: $2,738,157

HCP provides technical assistance, implements communication strategies and approaches, and supports capacity building for USAID and PEPFAR partners to achieve three intermediate results:

1. Improved ability and motivation to use services and practices that enhance health

2. Supportive social environments fostered to enable positive health behavior

3. Strengthened capacity for sustained health communication.

HCP provides HIV/AIDS communication support to services in all parts of Uganda in the following programmatic areas, and for the following populations:

HIV/AIDS prevention among young people 15 24 years old nationally through the multi-channel Young Empowered and Healthy (Y.E.A.H.) initiative and associated telephone hotline;

AIDS treatment uptake and adherence among PLHA, including young people, and children in geographic areas served by PEPFAR treatment and HCT partners;

Prevention of HIV transmission among HIV-positive young people and married adults who know their HIV status;

Couple HIV counseling and testing, risk reduction counseling, and referral for treatment and care services in 8 districts served by PEPFAR-support HCT services;

Medical male circumcision (MMC) education, counseling, and advice for men who are not circumcised, health workers, leaders, and media representatives in 6 districts that have MMC services;

Medical male circumcision education, counseling, advice, and referrals for young men who are not circumcised, leaders, parents, and health workers in 4 districts of Bugisu, and Kasese where traditional circumcision takes place.

In an effort to strengthen health systems, HCP works closely with the Ministry of Health to strengthen the Village Health Team (VHTs) system for provision of information, referrals, and some limited services at village level; to train health workers in the provision of pediatric ART services; to develop job aides and training materials for HIV/AIDS service providers and community outreach volunteers; and to disseminate policies, strategies and guidelines throughout the health system. HCP also assists the MOH and partners to innovate training approaches for health workers and VHTs that do not interrupt services or require costly residential workshops.

HCP, through its support to Y.E.A.H. for the True Manhood campaign, focuses on the cross cutting issue of gender. Through interpersonal communication supported by media messaging, True Manhood is designed to challenge young men to question gender norms that promote multiple sexual partners and alcohol abuse, inequitable attitudes toward women, violence against women, and transactional sex.

Other key issues tackled by HCP include family planning and TB. HCP integrates all health topics in the MOH minimum health care package through its distance learning programme for VHTs. In addition, HCP supports a hotline that provides counseling and referrals not only for HIV/AIDS, alcohol abuse, gender based violence, and male circumcision, but also for family planning and TB.

HCP works in partnership with Ugandan organizations to build capacity for sustained HIV/AIDS communication beyond the end of the project. It supports Y.E.A.H. to leverage funding for its activities through non-USG sources, including commercial sponsorships of the radio drama and comic book series "Rock Point 256", with the aim to achieve 100% sponsorship by the end of FY2010. HCP also works through partnerships with networks of Ugandan organizations funded through PEPFAR and non-USG donors to implement communication activities at community level, using tools, approaches, and materials prepared with HCP assistance. In many cases, partners fund production and reproduction of communication materials as well as training for community outreach workers. In these ways, HCP is able to expand geographic coverage at minimal cost. HCP relies entirely on government and private sector service providers to offer HIV/AIDS services, including counseling and communication. For example, HCP will partner with RCQHC to train public and private sector service providers in pediatric ART counseling and service provision working with the government and PEPFAR partner training systems.

HCP will continue to monitor its activities through activity reports from partners, collection of service delivery data, observation of community outreach activities, and small-scale evaluations of selected communication interventions. Also during FY2010, HCP will evaluate the effectiveness of various communication efforts through an analysis of the findings from a mid-term evaluation survey that will take place at the end of FY2009, and is comparable to the FY2007 baseline survey.

Funding for Treatment: Adult Treatment (HTXS): $486,570

Since FY2007, HCP has worked with a variety of ART providers and PHA groups to roll out two communication campaigns on ART literary, and paediatric ART. These partners include: JCRC, PIDC, the Mildmay Center, Reach Out Mbuya, Young Positives, The Uganda Network of Young Positives, EGPAF, HIPS Project, NUMAT, and NACWOLA. During FY2009, HCP plans to expand this network to include new treatment providers, to critically assess progress under the ART communication strategy developed in 2006, and to identify communication needs for future focus. Based on this assessment, and a review of literature concerning AIDS treatment and adherence, HCP plans to assist this network to design an updated HIV/AIDS treatment communication strategy; and to implement it. It is anticipated that this strategy will include client counseling and education approaches, provider job aides and training to support provision of comprehensive information for ART and PMTCT clients at clinic and community levels. The strategy will include approaches for providing essential information for PHA, counselors, health workers, and community volunteers about treatment, prevention of transmission and re-infection, prevention and treatment of opportunistic infections including TB, family planning, nutrition, and stigma reduction. Messages and materials will be developed based on a review of relevant research and feedback from existing community volunteers and clinical providers, and with input from technical experts. The aim will be to support clinical providers and community volunteers/VHTs to provide services and information tailored to the needs of particular clients, with an aim of empowering PHA and ART clients to take responsibility for maintaining their own health and well being. HCP will assist with the training for trainers, will facilitate and coordinate the development of common messages and educational materials, and will develop and disseminate media materials that model and build the expectation for comprehensive treatment, prevention, care, and support services among PHAs and their families. These activities will be closely linked to the "Go together, Know together" couple counseling and testing campaign activities and services, to ensure concurrent positive and discordant couples are referred on for treatment services.

Near the end of FY2009, HCP will conduct a survey to assess the effects of its communication efforts since the initial survey in FY2007. The survey will provide information about the effectiveness of ART communication activities, messaging and materials. HCP also plans to evaluate adherence counseling tools to determine their effectiveness in improving client counseling and compliance.

In FY2010, HCP will assist the network of ART providers to critically assess the communication needs of PHA, ART clients, and the public, and to adjust the ART communication strategy accordingly, based on data from the HCP survey conducted in FY2009. HCP will then assist the partners to design and roll out updated communication concerning treatment. It is anticipated that this roll out will include client adherence counseling job aides and client education materials for ART clients, as well as targeted communication concerning treatment for PHAs. The focus will be on increasing uptake of services among eligible PHA, and preventing the most common adherence issues as revealed through the literature review and assessment of adherence aides.

Funding for Prevention: HIV Testing and Counseling (HVCT): $385,000

During FY2008, HCP in partnership with the National HIV Counseling and Testing (HCT) Coordinating Committee (CT17) designed and launched a communication campaign promoting counseling, testing and disclosure of HIV status among cohabiting partners in seven regions of Uganda where AIC has services: central, north central, northwestern, eastern, southwestern, West Nile, and northeastern. The campaign encourages and motivates couples to assess their risks of HIV, test, and share their status with each other, and directs them to all health facilities in their areas offering couple HCT. Although AIC is the lead implementing agency, this initiative is a coordinated effort with participation of various partners at various levels of implementation. HCP's role during FY 2008 & 2009 was to design the "Go together, Know together" communication strategy, map locations of HCT services in the 7 regions, develop/adapt campaign media and materials, develop community mobilization tools for couple testing days, assist with the development of a national couple HIV counseling and testing training manual for health workers, develop a campaign monitoring and evaluation system, and determine baseline indicators. AIC is primarily responsible for assisting the MOH to train national trainers in the updated training materials, organize couple counseling and testing weeks in 7 districts, and report on HIV counseling and testing clinical data. HCP also designed and produced a radio distance learning programme for Village Health Teams (VHT), which includes sessions on HIV counseling and testing and couple counseling and testing specifically. HCP also provided training for AIC staff in strategic communication and media relations. During FY2009, the media and mobilization campaign rolls out in all districts in the 7 regions, utilizing a mixture of communication approaches to attract couples for HCT, and to promote disclosure of HIV status among cohabiting partners, including mass media, client education and information, and community outreach. The educational campaign culminates in couple counseling and testing weeks in eight districts where AIC has services, during which HCT services are available free of charge to couples. AIC and the MOH ensure that needles and other biological wastes are disposed of according to infection prevention guidelines and protocols.

Late during FY2009, HCP will expand the "Go together, Know together" campaign to specifically target couples in high risk communities. Counseling and testing weeks will be expanded to 21 more districts, and the campaign will target most at risk populations, identify people who are HIV-positive, and enroll them in PLHA services, and promote HIV transmission prevention behavior among HIV-negative concordant and discordant couples. Specifically, communication will be tailored to high risk populations such as refugees, fishermen, transient laborers, members of uniformed services, and their spouses. HCP plans to work with PEPFAR-funded partners (eg. STAR Projects, HIPS and ROADS) as well as non-USG partners working in these high risk communities such as IOM and Uganda Cares. Through this national communication campaign, HCP plans to reach a minimum of 10 million adults throughout Uganda through the mass media, and a minimum of 1,000 men and women per district with interpersonal communication about HCT, resulting in an estimated 18 couples counseled per day in 290 health facilities over a 6 month period. Assuming that each facility offers couple counseling and testing services 2 days per week, the campaign will result in 250,560 couples counseled and tested between 1 October 2009 and 30 September 2010. AIC is responsible for reporting on numbers of couples counseled and tested.

In late FY2009, HCP plans to conduct a survey to evaluate the effects of its interventions, including the "Go together, Know together" campaign, to inform the design of HCT communication for FY2010 and beyond.

During FY2010, HCP will work with the CT17 to review and revise the "Go together, Know together" campaign strategy, communication tools and approaches in light of HCP evaluation survey and campaign monitoring data. Campaign materials and tools will be revised, translated to additional languages, and reproduced for use in 25 new districts in addition to the 29 reached during FY2009. The updated "Go together, Know together" campaign will then be rolled out to all 54 districts. HCP will provide communication materials and training for trainers of community mobilizers, and will orient partners to this new phase of the campaign, as well as disseminate media materials. Partners will be responsible for ensuring the availability of testing commodities, for training counselors in couple HIV counseling and testing using the national curriculum, and for supportive supervision of services. HCP intends to partner with MOH, MJAB, AIC, Uganda Cares, the STAR Projects, ROADS, HIPS, NUMAT, and any other HCT service providers interested in coming on board in the 54 districts.

Assuming an average of 10 HCT sites in each district, and 3 trained counselors in each site capable of counseling 6 couples per day, the campaign will result in 9,760 couples counseled and tested per day in the 54 districts. If we assume that couple counseling and testing services are offered on average twice each week for a period of 6 months, this will result in 466,560 couples counseled and testing as a result of the campaign in the 54 districts.

HCP will train an estimated 2 trainers each from among 8 partner organizations working in the 54 districts in community mobilization for couple HCT; these 16 trainers will, in turn, train and supervise 20 community resource persons/village health teams (VHT) per district (for a total of 1,080 community mobilizers trained) to mobilize couples for HCT in the communities served by couple HCT services. HCP will work with the CT17 and partners to design supportive supervision guidelines and tools, and a monitoring and evaluation system to track community mobilization activities.

The "Go together, Know together" campaign includes tools, job aides and client materials for post-test counseling and referral for services. The couple counseling and testing training curriculum includes instructions on post-test counseling and referrals. In addition, HCP will work with CT17 and its partners to map HIV prevention, treatment and support services in all the 54 districts, and will provide referral directories for use by counselors. In addition, HCP will conduct in-service training for telephone hotline counselors at the HCP- supported national hotline to provide information and referrals for couple counseling and testing, as well as post-test follow up and risk reduction counseling.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $516,587

Since November, 2007, HCP has been assisting the Ministry of Health and MOH Male Circumcision Task Force to provide accurate and easy-to-digest information about medical male circumcision (MMC) for HIV prevention. The purpose of this effort was to correct misinformation about MMC and HIV prevention, to inform policymakers and health workers about MMC and HIV, and to influence policy concerning the provision of MMC services. HCP, in partnership with Makerere University School of Public Health, conducted a literature review and quantitative research on male circumcision knowledge, attitudes, practices, and programmatic interventions in Uganda and elsewhere in the region, assisted the MC Task Force to develop a MMC communication strategy; produced and distributed informational materials about MMC and HIV to policy makers and health workers; conducted media relations training for MMC providers and experts, and briefings for representatives of both print and electronic media and parliamentarians; organized public debates and radio and television call-in talk shows about MMC and HIV prevention; and worked with Signal FM in Bagisu region to educate community members, leaders and traditional circumcisers about safe circumcision practices during the traditional circumcision season in 2007. HCP oriented District Health Educators from 82 districts and incorporated accurate information about MMC and HIV prevention into training materials for Village Health Teams (VHTs) and other community volunteers; incorporated sessions on MMC and HIV for broadcast during a distance learning radio series for VHTs; and trained telephone hotline counselors to provide information about medical male circumcision and prevention of HIV acquisition. Also in FY2008, HCP conducted a mapping of MMC services throughout the country through a telephone survey. While the quality of MMC services is not known in the facilities, the mapping exercise does allow MOH to know where services are currently available and their approximate case load.

HCP works in partnership with the Makerere University School of Public Health (SPH), strengthening its capacity to key research findings concerning MC and HIV into advocacy and communication materials, and supporting the development of a MMC policy and strategy for service delivery/scale up appropriate to Uganda's health and socio-political setting. During FY2009, HCP and SPH plan to work with religious, cultural and community leaders as well as health workers in seven districts where traditional male circumcision is doneMbale, Bududa, Manafwa, Sironko, Kapchorwa, Kasese and Bundibudyo. In partnership with the Association Surgeons of Uganda (ASOU), HCP will implement a combined effort to improve the quality of existing medical male circumcision services through training in the provision of MMC as well as counseling, coupled with a concerted communication and advocacy campaign aimed at convincing young men to get circumcised at MMC facilities, rather than through traditional circumcisers, and to understand the relationship between MMC and HIV prevention.

Specifically, HCP, SPH and ASOU will work with the MOH to develop a training curriculum on MMC counseling and client education for health workers, and will train 10 national trainers. These trainers will in turn train 70 health workers from a total of 25 health centers in the 7 targeted districts; 25 of the trainees will also receive training by ASOU to strengthen their skills in MMC. HCP/SPH will select health facilities in the 7 districts that already provide MMC, and together with ASOU, will conduct site assessments to determine quality improvement gaps in MMC services, and develop plans to address them.

HCP and SPH will work with local CSO partners, including Signal FM, TASO, AIC, and others, as well as the HIPS Project, to mobilize men for the strengthened MMC services. HCP will develop a community mobilization training curriculum that includes MMC, HIV/AIDS prevention, including multiple concurrent partners, condom use, and sexual violence. A total of 50 mobilizers/Village Health Teams (VHT) will be trained to talk with parents of young men and the young men who are ready to be circumcised about the dangers of traditional circumcision, the relationship between MC and HIV, and to promote MMC services. Each mobilizer will be expected to reach 3 people each week for a period 7 months, for a total of 4,200 young men and parents reached. These interpersonal discussions will be reinforced through radio programmes and discussions with cultural, religious, and other community leaders, extolling the dangers of traditional circumcision and the safety of MMC.

In addition, HCP will support the 10 national trainers to train health workers in hospitals and HCIV in Kampala that already offer MMC services, TASO and AIC clinics to educate clients and correctly answer their questions concerning MMC and prevention of HIV acquisition, as well as male norms and behaviors that increase risk of HIV transmission, including multiple sexual partners, and sexual violence. Training for health workers in MMC will also be integrated with health worker training being conducted by other PEPFAR and USAID-supported projects (eg. family planning/reproductive health, malaria, HIV/AIDS, or TB/HIV).

It is anticipated that by FY2010, Uganda will have a national policy on MMC, and the roll-out of MMC services will be underway by the MOH. HCP will assist the MOH and its partners to get the word out about MMC and HIV, and direct clients to MMC services nationally, with an emphasis on the 7 districts from FY2009 plus 8 additional districts. This will be done through a combination of targeted community mobilization and media programming, supported with in-facility client education and counseling. HCP will focus on improving the availability of client counseling and information about MMC/HIV at an additional 40 health facilities in 8 districts, by training 100 health workers. HCP will also train 100 VHTs/community mobilizers in communities surrounding the 40 health facilities. These mobilizers in addition to the 50 mobilizers trained in FY2009 will be expected to reach 3 people per week over a 12 month period, resulting in 21,800 people reached with information about MMC and HIV prevention.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $800,000

HCP has been working in Uganda since July, 2004, assisting the Uganda AIDS Commission to establish a national multi-channel communication initiative for young people 15 24 years old called Young Empowered and Healthy (Y.E.A.H.). Y.E.A.H. is managed by a partnership of Ugandan organizations led by Communication for Development Foundation Uganda (CDFU), and has launched three consecutive multi-channel communication campaigns for young peopleone discouraging transactional and cross-generational sex, one called the Be a Man campaign that promoted more gender equitable attitudes and behaviour among men, and most recently the True Manhood campaign which equates masculinity with attitudes and practices that prevent HIV. All campaigns promote HIV/AIDS prevention through abstinence, partner reduction, faithfulness, and HIV counseling and testing.

In FY 2005, Y.E.A.H. launched a weekly half-hour radio serial drama called "Rock Point 256", which won an international award for excellence in HIV/AIDS communication in 2007, and has an estimated listenership of 59% among young 15 24 year olds, according to a survey conducted in 14 districts by HCP in 2008. Y.E.A.H. is a national campaign, implemented in six major languages: Luganda, Runyoro/Rutoro, Runyankole/Rukiga, Luo, Ateso, and English. During FY 2008, Y.E.A.H reached more than 2 million young people through mass media and 50,000 through community outreach promoting gender equitable relationships, faithfulness and partner reduction, open and non-violent communication between intimate partners, couple counseling and testing for HIV.

Near the end of FY 2008, HCP assisted Y.E.A.H. to launch the True Manhood campaign, which focuses on alcohol, violence against women, multiple concurrent partners, and transactional sex. True Manhood is a phased campaign, and Y.E.A.H. launched the first phase umbrella campaign in June, 2009. The second and third phases on alcohol and violence against women are planned for FY2009. This includes a continuation of Rock Point 256 radio serial drama and comic books in four languages, radio spots, print materials, as well as community outreach activities. The emphasis will be on social and individual change to create an environment where multiple sexual partners and transactional sex are no longer associated with manhood; where young people, especially men, recognize the association between alcohol, violence, concurrent partners and HIV; and where community resource persons such as the police and peer educators are trained to assist young people resist alcohol abuse and violence against women, adopt abstinence, faithfulness or condom use as HIV prevention strategies; and avoid stigmatizing and discriminatory practices and language toward people with HIV and AIDS.

HCP will also work with the media and influential leaders at both national and community level to ensure that they recognize concurrent partners, violence against women, alcohol abuse, and HIV/AIDS related stigma as underlying factors to HIV infection and speak out against these practices. Additionally, HCP will work with the media to encourage portrayals of the underlying causes of HIV (violence against women, alcohol abuse, multiple sexual partners, transactional sex, and HIV/AIDS related stigma) in a more serious and constructive manner. All media will continue to refer young men and women to a hotline that was established during FY 2008 for personalized information and counseling.

During FY2009, HCP will also assist YEAH to continue training facilitators among men's groups and youth groups at community level, and vocational training institutions, universities to facilitate interactive discussions using materials and tools produced by Y.E.A.H.. HCP will assist Y.E.A.H. to adapt successful tools and approaches produced by various partner organizations and train facilitators to use them during community outreach work. Community-based interpersonal approaches will be designed to raise consciousness and stimulate changes in the ways men and women relate to one anotherspecifically, encouraging more responsible drinking behavior, non-violent resolution of differences, mutual respect and equity in relationships, faithfulness and partner reduction. Campaign media and interpersonal approaches will be designed to reinforce one another, leading to informal dialogue about these issues among young people and their influencers, and changes in individual and collective practices. Y.E.A.H. will orient the peer educators and community resource persons it has already trained in the use of community outreach tools on alcohol, violence against women, sexual networks, and multiple concurrent partners. In addition, Y.E.A.H. has developed a flipchart for use by community leaders and police Community Liaison Officers, and will orient 44 to use this tool to discussion alcohol abuse and violence against women in small groups. These peer educators and community resource persons will each counsel and facilitate discussions 1 2 times per month over a 3 month period for groups of approximately 23 young people, resulting in a total of 44,298 young men and women reached through community outreach with alcohol and HIV prevention information.

HCP is also assisting Y.E.A.H. to mobilize resources to ensure sustainability of its activities after HCP ends in 2012. During FY2009, Y.E.A.H. plans to leverage private commercial sponsorship for Rock Point 256 comic books and radio programmes; institutional support through private foundation funding; and applying for bilateral or multi-lateral donor funds to support future campaign activities.

In July, 2010, HCP will assist Y.E.A.H. to evaluate the reach and impact of its communication through a second household survey in the same 14 districts as were surveyed in FY 2007.

In FY2010, HCP and Y.E.A.H. will launch a third campaign under the True Manhood umbrella focusing on transactional sex and multiple concurrent partners. The campaign, which will run for six months, will use a mix of community outreach and individual communication reinforced with mass media and print. Assuming Y.E.A.H. has secured sponsorship for "Rock Point 256", the drama will be designed to carry storylines about transactional sex, sexual networks and the increased risk of HIV, masculinity and gender equitable attitudes and practices. The campaign will rely heavily on HIV/AIDS prevention partners for community outreach activities, and will direct young men and women to the telephone hotline for individualized counseling and information about HIV/AIDS, transactional sex, multiple concurrent partnerships, sexual networks, alcohol, violence against women, and other risky practices.

At community level, Y.E.A.H. will train existing peer educators and community resource persons in five regions (Busoga, Northern, Southwestern, Central, and Kampala) to conduct small group interactive sessions of not more than 25 people to discuss transactional sex, multiple sexual partnerships, sexual networks, male gender norms, and to give young men and women an opportunity to practice life skills necessary to reject the practice. A total of 89 peer educators at tertiary institutions, community and youth groups, will each conduct 1 or 2 sessions each month for a total of 2 months, reaching a total of 20,424 young men and women with HIV prevention messages promoting abstinence or faithfulness.

Y.E.A.H. has designed checklists and guidelines for supportive supervision of peer educators, which its staff and partners use when observing and supervising community outreach activities. Y.E.A.H. trainers and outreach supervisors will visit the five regional lead organizations quarterly to co-facilitate supportive supervision visits to outreach volunteers/peer educators, observe the quality of interactions, and provide feedback. In addition, all peer educators will be trained to use standard tools when conducting outreach activities.

Y.E.A.H. works in partnership with organizations that provide HIV/AIDS services, or prevention guidance, including the AIDS Information Center, Straight Talk Foundation, Save the Children, and Student Partnerships Worldwide, Reproductive Health Uganda, among others. Through these partners, young people get direct referrals to services.

Each peer educators is required to submit monitoring forms to the regional lead organization in his/her locality. Each month, the regional lead organizations summarize and submit returns to Y.E.A.H. headquarters in Kampala. Y.E.A.H. maintains a database to compile all the monitoring data for community outreach activities. In addition, Y.E.A.H. supports a team of radio monitors who listen to the weekly radio broadcasts and report to Y.E.A.H. when broadcasts are missing or cut short so Y.E.A.H. can contact the radio stations. Y.E.A.H. also receives many letters from young people who listen to its radio programmes or participate in its activities. Y.E.A.H. maintains a tracking system for these letters, and once a year conducts an analysis of letter content. The results are shared with the radio drama script writers and Y.E.A.H. program officers to improve future programming. Once every 2 years, HCP assists Y.E.A.H. to conduct a household survey in 14 districts to assess the reach and effects of its programming. The first such survey took place in July, 2008, and will be repeated in July, 2010.

A comparison of the data will help to identify program strengths and areas for improvement , and will contribute to the body of knowledge concerning the effectiveness of prevention efforts.

During FY2010, HCP will continue to assist Y.E.A.H. to secure funding for other sources, and to build its capacity to design and implement communication activities independently. HCP will decrease its level of technical assistance during the year to give Y.E.A.H. a chance to work more independently. HCP will assist Y.E.A.H. to write and submit at least 3 proposals for external funding, and to market its services and products to commercial and non-USG partners.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $550,000

In FY2008, HCP worked with Y.E.A.H., the Uganda Network of Young Positives, Joint Clinical Research Center (JCRC) and Paediatric Infectious Disease Center (PIDC) to reach out to HIV-positive adolescents between 15 and 24 years of age, including those on ART, with two purposes:

1) to encourage them to disclose their HIV status to their sexual partners, and to use condoms to prevent transmission and re-infection; and

2) to promote adherence to their ARVs.

HCP and Y.E.A.H. prepared two entertaining and educating tools for use with groups of young positives: the "Make a New Start" board game with HIV/AIDS facts and information, and the Jessica and Mike comic book and audio story about a discordant young couple and how they have dealt with it. Y.E.A.H. trained peer educators from JCRC and the Uganda Network of Young Positives in 5 districts to facilitate small group sessions, during which young positives participated in the exercises, discussed issues having to do with disclosure of status, stigma, adherence, condom use, and prevention of HIV infection. In FY2009, YEAH plans to extend this activity to 13,440 additional young positives in 8 additional districts.

During FY2010, Y.E.A.H. will turn its attention from positive prevention to the prevention of sexual transmission among young people living in communities at high risk of HIV/AIDS, including communities on transport corridors, fishing communities, and areas around police and UPDF barracks. Y.E.A.H. will train 24 peer educators to conduct interactive sessions with young men and women to discuss transactional sex, multiple concurrent partnerships, sexual networks, condom use, and HIV/AIDS prevention, using tools and materials produced by Y.E.A.H. Each peer educator will conduct 1 2 sessions per month over a period of 2 months; each session will reach approximately 23 young people, leading to a total of 2,967 young men and women reached. Peer educators will be trained to use standardized interactive tools, and will conduct condom demonstrations during the sessions. When possible, peer educators will collaborate with a condom social marketing group or health workers from local health facilities to provide condoms for the participants.

Please see the description of the Y.E.A.H. supportive supervision, monitoring and evaluation systems described in the AB narrative for HCP. The same system will be used with these peer educators.Community level activities will be reinforced through radio and print media, and through larger community events featuring characters from the popular radio drama "Rock Point 256".

Subpartners Total: $0
AIDS Information Center: NA
Communication for Development Foundation - Uganda: NA
Makerere University: NA
Media for Development International: NA
Regional Center for Quality of Health Care: NA
Cross Cutting Budget Categories and Known Amounts Total: $100,000
Gender: Gender Based Violence (GBV) $100,000