This activity is linked to HVOP HPI (9626).

Health Policy Initiative (HPI) works with MOH/VAAC to lead prevention with positives programming in Vietnam. PEPFAR will partner with HPI to train 60 individuals to promote HIV/AIDS prevention through abstinence and/or being faithful. This training will be conducted through workshops and community outreach. This AB component is 1 key element of the comprehensive ABC prevention program targeting PLWHA to reduce stigma and to prevent HIV transmission to family members, spouses and/or sex partners. These activities also contribute to the PEPFAR Vietnam 5-Year Strategy averting new HIV infections through interventions with People Living With HIV/AIDS (PLWHA).

A design team will develop an original prevention with positives training module, based on needs assessment among PLWHA groups, incorporating HHS/CDC and OGAC prevention with positives materials and specific AB components to address challenges faced by PLWHA. AB messaging will be tailored to address gender, male norms and behaviors and women's needs in maintaining mutual fidelity. A core team of 10 master trainers will be developed to teach AB as a primary means of preventing HIV infection or re-infection.

Fifty prevention trainers, recruited from PLWHA groups in the 6 current and 1 planned focus provinces, will attend intensive training, learning to conduct prevention workshops and promote AB messages to local peers. This intensive training will also support local capacity development and encourage a network of linkages and referral systems among service providers. Trainers will establish relationships with other provincial service providers, including Counseling and Testing (CT) and outpatient clinic (OPC) sites, to enable mutual referrals.

The 50 prevention trainers will conduct workshops in the focus provinces. Three workshops in each province (total 21) will teach 2,000 participants abstinence and mutual fidelity to prevent HIV infection or re-infection. Participants will be recruited through established PLWHA groups and networks such as Bright Futures, and referred from service providers including CT and OPC sites.

To inform local and national HIV prevention policy on experience with AB messaging, ongoing process evaluation and a final evaluation in each province will measure impact on prevention skills and behavior change communication among PLWHA groups. Evaluation results, including lessons learned throughout the process will be reported to PLWHA, policy makers and other prevention stakeholders in a final dissemination workshop. Results will also be reported in Vietnamese and international HIV/AIDS publications.

This activity is linked to HVAB HPI (9481) and OHPS HPI (9428).

Health Policy Initiative (HPI) leads PEPFAR partners' support for MOH prevention with positives programming in Vietnam. PEPFAR will support HPI to develop a prevention with positives training module based on guidance from HHS/CDC HIV/AIDS Prevention Branch and OGAC, to establish a core of 50 PLWHA trainers on prevention with positives messaging. Two thousand people will be trained to promote HIV prevention messages.

These activities promote the Vietnam National HIV/AIDS Strategy, ensuring greater PLWHA involvement and addressing stigma/discrimination reduction as outlined in the PEPFAR Vietnam 5-Year Strategy. This activity targets PLWHA in geographic areas where the epidemic is the most severe. The interventions form part of a structured approach that includes multiple exposures to prevention messages and links to other relevant services including counseling and testing.

In collaboration with PLWHA groups, an HPI-trained team of 10 will develop and test a prevention with positives training module. The module will promote behavior change communication (BCC) through skills-building to adopt safer behaviors employing a range of prevention methods. The module will teach life skills, counseling (including referral for addiction treatment), and will address difficulties faced by women, and male norms and behaviors. Specific interventions will address HIV re-infection and provide support for PLWHA by providing clear referrals to the network model in the 7 focus provinces.

The module will be used to develop a core group of 50 PLWHA prevention trainers. Drawn from existing PLWHA groups, including Bright Futures, trainers will conduct workshops to build capacity among members of one or more PLWHA groups from each of the 7 focus provinces. Networking will facilitate skill and experience transfer among the prevention trainer group. This will also boost local organization capacity as well as development of networks, linkages and referral systems. Trainers will establish relationships with other service providers, including CT and outpatient clinic (OPC) sites, to enable mutual referral among trainers and service providers. The 50 PLWHA prevention trainers will hold workshops for PLWHA groups and other service providers in the 7 focus provinces. Three workshops in each province (total 21) will train 2000 participants to teach PLWHA abstinence or faithfulness or correct and consistent condom use as appropriate, establish condom outlets, and mobilize communities to promote safer behaviors. Condoms will be provided to groups and individuals as a component of the training on a regular basis. A component of this activity will link with other Emergency Plan prevention activities to ensure that PLHA groups are provided with regular and adequate supplies of condoms.

This activity is linked HBHC MOH/VAAC (9529), HBHC HCMC-PAC (9533), HBHC FHI (9558), HBHC Pact (9563), and OHPS HPI (9428).

HPI is the lead PEPFAR organization in assisting Vietnam's implementation of the HIV/AIDS Law at the provincial level, and ensuring that PLWHA have access to supportive services to support their rights to education, heath care, employment, and other rights outlined in Vietnam's legal system. PEPFAR will support HPI to train 140 civil liberties lawyers who indirectly will provide legal and consultative services to 5,000 PLWHA in 7 focus provinces. HPI will also establish 2 hotlines to provide telephone guidance to PLWHA on their rights based on the Vietnam legal system, and to monitor the implementation of the National HIV/AIDS Law.

With the recent passing of the National HIV/AIDS Law, PLWHA and their families are poised to develop stronger advocacy for their rights to employment, education, social services, health care and a stigma-free life. However, the existence of the Law, which comes into effect in January 2007, is not sufficient to ensure that PLWHA can exercise their rights without exclusion. A 2005 ISDS study on stigma and discrimination demonstrated that the majority of PLWHA still face great discrimination. PLWHA have lost their jobs, HIV-infected and affected children are barred from schools or are prevented from going by their families, and entrepreneurs have lost revenue due to customer recidivism. HPI will work with PLWHA groups and associations (see HPI Policy System Strengthening) to raise their awareness on the rights of PLWHA as outlined by the National HIV/AIDS Law and the Vietnam legal system via training sessions in each of the 7 focus provinces.

HPI will train 140 lawyers (20 per province) on the new HIV/AIDS Law and other laws related to civil liberties, who in turn will liaise with PLWHA support groups in focus provinces to ensure that PLWHA leaders have access to legal support and can effectively refer PLWHA. Select PLWHA groups in each province will be supported by HPI to conduct training sessions for PLWHA on their basic rights, and HPI will develop easy-to-understand materials outlining these rights and how to ensure they are upheld. HPI estimates that over 5,000 PLWHA will access legal support services and the awareness-raising training workshops described above.

In addition, HPI will support the development of legal centers in each focus province, which will be based in existing PLWHA group centers or in the offices of leading lawyers receiving support from HPI. HPI will also support two hotlines, 1 in Ho Chi Minh City, and 1 in Hanoi, with media promotion and promotion via PLWHA networks, to ensure that PLWHA can access information inexpensively and anonymously, and to enable them to report on shortcomings in the implementation and enforcement of the Law. HPI will pilot the development of a monitoring mechanism linked to the 7 legal centers and 2 hotlines, as well as the PLWHA network (see HPI Policy/Systems Strengthening), to track implementation and enforcement of the Law. This monitoring mechanism will also link to policy makers and new Community Party cadres who will receive training via the Harvard and HPI training program (see Pact/Harvard Policy/System Strengthening) to assist in tracking implementation of the Law and to help inform policy makers of PLWHA concerns in a timely manner.

This activity is linked to HVSI FHI (9370).

In FY07, Health Policy Initiative (HPI) will continue the Analysis and Advocacy (A2) project funded in FY05 to advocate for the use of available data to formulate appropriate responses to the Vietnam HIV/AIDS epidemic. Using HCMC and Haiphong as case studies, a model will be developed for the use of information to inform HIV/AIDS policy development and resource allocation.

With experience and lessons learned from FY 2005, HPI aims to: 1) complete the development of the Goals Model and Asia Epidemic Model interface and complete resource allocation analysis for Vietnam; 2) in collaboration with FHI, present major outcome results by the end of FY06; 3) conduct workshops in collaboration with FHI on the use of data from the integrated biologic and behavioral surveillance which will provide updated findings on prevalence, behavior and coverage of the minimum package of services for IDUs, CSWs, and MSMs in the 7 focus provinces; 4) provide concrete programmatic implications to the USG team as well as to USG partners; 5) collaborate with other international and local partners to continue supporting MOH/VAAC in advocacy under the framework of A2 (this project will utilize the strengths of both organizations for the appropriate use of data in policy-making and intervention development); and 6) apply the A2 framework to advocacy activities in other focus provinces including Hanoi, Quang Ninh, Can Tho and An Giang.

The ultimate goal of this activity is to inform policy makers in focus provinces and at the national level on the situation of the epidemic and resources needed to respond appropriately and effectively to HIV/AIDS in Vietnam.

This activity is linked to HBHC HPI (9599).

PEPFAR will support HPI to: build the capacity of 17 community-based organizations (CBOs) and develop their ability to form a single network with other CBOs to advocate for the rights of PLWHA; provide legal aid for PLWHA in 7 focus provinces to ensure enforcement of the HIV/AIDS Law; support strategic provincial planning for Government of Vietnam (GVN) HIV/AIDS programs using the GOALS model in 7 focus provinces; and link with the Harvard training program to train 200 government cadres from 16 provinces.

Building on support in FY05 and FY06 to fledgling PLWHA CBOs in 3 focus provinces, HPI will expand support to and build the network of 17 indigenous PLWHA CBOs (some existing, such as Bright Futures chapters in focus provinces, and some to-be-determined) in all focus provinces and additional provinces. These CBOs will receive technical and financial assistance (TA) through HIV-related institutional capacity building. HPI will also support the development and expansion of an NGO network focusing on PLWHA issues/rights. Via partnership with Community Mobilization Center for HIV/AIDS Control (VICOMC), HPI will conduct 4 workshops targeting 150 PLWHA CBO staff. These workshops will enable PLWHA CBOs to develop communication and management skills to strengthen advocacy activities. They will also enable PLWHA CBOs to share best practices via the establishment of a national network of PLWHA organizations. HPI will work closely with PLWHA-elected leaders representing the northern, central and southern regions of Vietnam to liaise with the Communist Party, the National Assembly, relevant government ministries and major donors to support the legal establishment of the PLWHA network. HPI will support this network to conduct 3 regional meetings on general community mobilization with a focus on prevention, care and treatment for PLWHA. Roughly 1500 PLWHA will participate in these workshops. The PLWHA network will produce and disseminate a network newsletter on a monthly basis and an e-forum linking member groups and will collate feedback for national policy makers on PLWHA needs.

HPI will also support the implementation of the impending HIV/AIDS Law at the provincial level in the 7 focus provinces. Support will assist the Vietnam Lawyer's Association to provide legal aid to PLWHA (see HPI Palliative Care Basic) to advocate for themselves (key legislative issue: stigma and discrimination), in conjunction with program monitoring by HPI staff on the enforcement of the law. In order to monitor the efficacy of the HIV/AIDS Law, HPI will assess attitudes and practices of key policy makers, service providers, employers and PLWHA to develop a monitoring tool to measure changes following the dissemination of the Law (in select focus provinces). Lessons learned will be disseminated nationally at the end of FY 2007 to assist policy makers in improving communication around and enforcement of the Law. HPI will partner with the legal department of the Ministry of Health (MOH) to assist in disseminating findings. In addition, HPI will support PLWHA organizations to report inconsistencies in implementation of the HIV/AIDS Law.

In conjunction with technical support for management and planning oversight provided via the VAAC cooperative agreement to provincial VAAC offices, HPI will assist provincial health departments to use the GOALS model to make strategic resource need and allocation decisions for HIV/AIDS programs in 7 focus provinces. The GOALS model (not an acronym) is a computer-based analysis model that allows program managers to manipulate human resource and financial inputs to assess how effectively they address the local epidemic, based on various indicators. The GOALS model has proven effective in Ho Chi Minh City Provincial AIDS Committee (HCMC-PAC) for financial and human resource planning and the development of the HCMC HIV/AIDS Action Plan, and was requested by the MOH to be expanded to additional provinces during COP 07 review sessions. HPI will utilize experienced staff from the HCMC-PAC and technical staff from HPI to train additional focus provinces on the use of the GOALS model. Provinces will then produce HIV/AIDS action plans that realistically estimate human and financial resource needs. Additional training and human resource needs will be addressed in conjunction with support to the MOH and HCMC-PAC cooperative agreements for program planning, monitoring and implementation.

HPI will complement Harvard in the implementation of the HIV/AIDS policy training via the provision of TA and logistical coordination of training (see Harvard Policy Activity). This activity will train incoming Communist Party cadres who will take office following their induction as a complement to the UNAIDS program, which will train existing Communist

Party cadres.

These activities will contribute to the development of leadership capacity and sustainability as described in the PEPFAR Vietnam 5-Year Strategy.