This activity also relates to Project Concern International (PCI) activities in Other/Policy Analysis and System Strengthening (PCI) #9171, Other Prevention (PCI) #8786, PMTCT (JHPIEGO) #9088, Palliative Care TB/HIV (JHPIEGO) #9090, Palliative Care Basic Health Care and Support (PCI) #8787, Counseling and Testing (PCI) #8785, and HIV/AIDS treatment/ARV services (JHPIEGO) # 9089.

The first component of this activity involves mobilizing and supporting 15 new Anti-AIDS youth groups in Zambia Defense Force (ZDF) primary and secondary schools. In FY 2006, 15 schools on military base will have been targeted for organizing children's clubs that include HIV/AIDS education and programs on abstinence and anti-discrimination against people living with HIV/AIDS (PLWHA). The purpose of the program is to inform, inspire, and challenge young people to choose to refrain from sex before marriage or otherwise delay debut of sexual activity. The formation of these groups is in response to numerous requests received by the ZDF from the students' parents to support such youth activities.

The first activity under this component is selection and reproduction of HIV/AIDS educational materials from among those developed for use in Zambia through the Ministry of Health (MOH), National HIV/AIDS/STI/TB Council (NAC), USG/PEPFAR-funded partners, Baptist Fellowship of Zambia or other sources. The materials selected will be those promoting abstinence until marriage for youths who are not sexually active and secondary virginity for those who are active.

The second activity will be training of 50 teachers and patrons of Anti-AIDS youth groups in mobilizing youth groups and integrating HIV/AIDS prevention and stigma reduction into their education curricular. The training will focus on the "True Love Waits" (TLW) program which will build the capacity of teachers and Anti-AIDS youth groups to actively engage the youths in HIV/AIDS related activities. The True Love Waits program began in 1993 by Life Way Publishers, in Tennessee, U.S.A., as an abstinence campaign tool targeting youth. The campaign has since been replicated in many other countries including Uganda, Malawi, South Africa, Kenya, Nigeria, New Zealand, Canada, and Zambia. Uganda, as the first African country to show a marked fall in HIV prevalence, attributes a large part of its success to youth movements promoting abstinence, including the TLW program. TLW has been an energetic youth program in many countries, proving that it is possible for young people to wait until marriage, despite the messages the media frequently gives. The main objective of this program is to apply the core values of Christian principles regarding the HIV/AIDS pandemic in society and use them to mobilize communities towards reversing the course of the pandemic. Some specific objectives include communicating to teenagers the spiritual, emotional, and physical value of abstaining from sex until marriage and providing schools with a way of supporting parents and their teenagers as they express their commitment to sexual abstinence.

The third activity under this component is to provide other logistic support (mainly stationery) for youth group activities. All these activities will be implemented in close consultation and collaboration with the ZDF education directorate. The goal of this program is to reach 7,500 youths with HIV/AIDS prevention messages and promotion of abstinence, plus reduction of stigma and discrimination against PLWHA.

The next component of this program involves reaching out to military personnel and their families with messages promoting abstinence until marriage and faithfulness to one's partner using chaplains from ZDF and other uniformed services. In FY 2005, The Baptist Fellowship of Zambia trained 63 chaplains and their assistants in HIV/AIDS prevention, care, counseling, peer support, and palliative care. In FY 2006, 80 chaplains and their assistants participated in training to build on the work done in FY 2005 and help the chaplains relate it to ministry to the family and their communities, including the "True Love Waits" abstinence-based toolkit for use with military personnel and their families. In FY 2007, training courses will be provided to 80 chaplains to continue building on the aforementioned objectives, skills, and services to additional bases. To carry out the TLW program, local TLW Clubs are to be established in communities, and churches around selected military bases. Information, education and communication (IEC) materials promoting abstinence, faithfulness, other prevention methods, stigma reduction, counseling and testing, sexually transmitted infection (STI) management, and ART will be reproduced and distributed. The goal of this program is to reach out to 8000 military personnel and their families with messages promoting abstinence and being faithful.

The long-term sustainability of this program lies in the capacity which will be built through the training of teachers, other Anti-AIDS youth group patrons, and chaplains to replicate, scale-up and manage youth-led program in the future. As with other interventions with the ZDF, sustainability is promoted through an emphasis on planning, implementing, and monitoring all activities with leadership from ZDF personnel themselves, supported by PCI and other technical resources, as well as through capacity building through training and through establishing and support ZDF-owned structures such as the drama groups and support groups. In this area, training and mobilization of support from ZDF leadership has also proved very effective at ensuring necessary support and involvement in HIV/AIDS-related programming and intervention. In FY2007, three leadership workshops will be conducted targeting 50 ZDF Directors and Brigade Commanders, 60 Commanding Officers and 60 Officers in Command.

This activity also relates to Project Concern International (PCI) activities in Other/Policy Analysis and System Strengthening (PCI) #9171, Abstinence/be faithful (PCI) #9170, PMTCT (JHPIEGO) #9088, Palliative Care TB/HIV (JHPIEGO) #9090, Palliative Care Basic Health Care and Support (PCI) #8787, Counseling and Testing (PCI) #8785, and HIV/AIDS treatment/ARV services (JHPIEGO) #9089.

The first component is continued support to two existing drama groups and technical assistance in developing HIV/AIDS-related scripts and performances. Since FY 2003, the drama groups, consisting of 39 members, have traveled to all 54 Zambia Defense Force (ZDF) facilities throughout the country spreading messages on abstinence, faithfulness, and the correct and consistent use of condoms, HIV counseling and testing, stigma reduction, the influence of alcohol on risk behavior, and other key messages identified through regularly updated qualitative research with the target group to ensure continued maximum relevance and acceptance.

Feedback from ZDF leadership, officers, and enlisted personnel alike indicates that the tours are extremely well accepted and are effective at increasing HIV/AIDS-related knowledge and promoting positive behavior change in ZDF personnel, their family members, and local communities surrounding the bases. Given the isolated nature of many of the ZDF sites, these drama performances are often the only exposure many of these communities, both military and civilian, have to HIV/AIDS prevention messages. The drama groups were mobilized quickly to participate in Zambia's National VCT Day launch in Chongwe, and have toured 12 sites in one month, reaching 3,615 military and non-military personnel with HIV/AIDS prevention messages. In FY 2007, the drama groups will continue to be supported to visit up to 40 ZDF units, camps and operational areas. Some of these visits will be in conjunction with the mobile CT units as a means of pre-CT community mobilization, and will reach an estimated 15,000 individuals.

The military is categorized as a high-risk group. According to a study conducted in 2004, about 30% of military personnel reported having sex with multiple partners in the past 12 months, which is more than three times higher than the general population rate, and condom use especially among those with multiple partners was found to be very low. Therefore, the USG will support the ZDF in promoting prevention methods such as correct and consistent condom use, along with promoting abstinence and faithfulness. In FY 2007, issues related to ART adherence, fidelity in marriage, and excessive alcohol consumption will be examined through qualitative research and added to the messages promoted through drama and other communication channels.

CT, PMTCT and ART will continue to be key focus areas, in order to strengthen links with these USG-supported activities of the ZDF. The performers will receive refresher training in Theatre for Development, a locally adapted behavior change communication strategy developed in collaboration with the Open University of Zambia. This method uses qualitative research methods together with performance arts such as song, drama, poetry, and dance for a targeted audience. PCI will continue to measure the impact of the drama tours (using pre-and post-exposure questionnaires as part of the intervention itself) to ensure quality and effectiveness of the drama tours. The training also serves as an opportunity for ZDF participants to conduct on-site qualitative research with the target population and to integrate current, key messages into updated performances.

Information, education and communication (IEC) materials promoting abstinence, faithfulness, other prevention methods, stigma reduction, counseling and testing, sexually transmitted infection (STI) management, and ART will be reproduced and distributed during the drama tours, HIV/AIDS sensitization tours by HIV/AIDS unit personnel and HIV+ personnel, mobile CT visits, monitoring visits, new recruit training and other occasions. PCI is a member of the "Prevention of Sexual Transmission of HIV" group that has recently been recognized by the National HIV/AIDS/STI/TB Council as one of their technical groups. One role of this group is to ensure that all partners are giving consistent, evidence-based messages on prevention of sexual transmission of HIV.

The second component of this activity is to continue assisting in the mobilization of people living with HIV/AIDS (PLWHA) to encourage their involvement in HIV/AIDS prevention activities. Whereas in 2003-2004 there were no openly positive ZDF personnel participating in the HIV/AIDS prevention, care, and support program, to date there are

close to 100 individuals associated with the ZDF actively participating in the program through HIV/AIDS sensitization with their colleagues, peer education, and support group formation, which has been initiated at five ZDF units. In addition, the ZDF has established a new position at its national HIV/AIDS unit, filled by an openly-positive Major, to spearhead the formation, guidance, and supportive supervision of support groups at individual ZDF sites. PCI will build on this success through continued support for these activities and continued support for the formation of HIV-positive support groups or post-test clubs at ZDF installations. PCI will provide training and technical support to HIV-positive ZDF personnel in organizing and programming visits to 54 military units to promote counseling and testing, ART, and stigma reduction. This group will also participate in HIV/AIDS leadership workshops for 54 Commanding Officers, which have proved to be extremely successful at engaging ZDF leadership and support at different levels for HIV/AIDS prevention activities in ZDF units.

In all prevention activities, the role of alcohol in the transmission of HIV will continue to receive emphasis. Current training materials developed by PCI and the Defense Force Medical Services (DFMS), including the peer leader training guides, educational video ("Watch Out Soldier") and facilitation guide, and written educational materials already incorporate messages in this regard and will be updated as needed. Awareness-raising by peer educators, PLWHA, the drama teams, mobile and facility-based clinical staff, and the HIV/AIDS unit through ongoing tours, training of new recruits, and training of pre-deployment personnel will also emphasize the impact of alcohol. Possible policy-level interventions will be discussed and planned for especially at the leadership workshops and at the HIV/AIDS Unit and DFMS levels. Lessons learned from the September 2005 workshop on HIV/AIDS and alcohol, at which a presentation by the ZDF was made, will be incorporated as feasible into PCI's interventions, under guidance from a working group of participants from Zambia established after the workshop.

As with other interventions involving the ZDF, sustainability will be promoted through an emphasis on planning, implementing, and monitoring all activities with leadership from ZDF personnel themselves. PCI and other technical resources will support these endeavors such as drama troupes and support groups. In this area, training and mobilization of support from ZDF leadership has also proved very effective at ensuring necessary support and involvement in HIV/AIDS-related programming and intervention.

The goal of this program is to reach out to 22,500 troops including family members with community outreach that promotes HIV/AIDS prevention through other behavior change beyond abstinence and/or being faithful.

This activity also relates to Project Concern International (PCI) activities in Other Prevention Activities (PCI) #8786, Other/policy analysis and system strengthening (PCI) #9171, Abstinence/be faithful (PCI) #9170, PMTCT (JHPIEGO) #9088, Palliative Care TB/HIV (JHPIEGO) #9090, Counseling and Testing (PCI) #8785, HIV/AIDS treatment/ARV services (JHPIEGO) #9089, and the Navy Medical Centre, San Diego (NMCSD) program #9172.

This program aims to ensure that chronically ill HIV positive patients in the military health facilities receive comprehensive palliative care services that include medical care, treatment of opportunistic infections, pain management, psycho-social support, legal services, material support, nutrition and food supplementation, referral and adherence to anti-retroviral treatment (ART), and other HIV-related services. Through this activity up to 5,000 HIV-positive patients including Zambian Defense Force (ZDF) members, their family members, and people living in the surrounding community will receive quality palliative care services. The ZDF serves as the only source of such care for communities in many locations, given the remote nature of many of the ZDF units.

PCI will support the Defense Force Medical Services (DFMS) to carry out this comprehensive program in all 54 ZDF units in nine provinces, with a focus on eight existing model sites (Maina Soko Military Hospital in Lusaka, ZAF Livingstone, Tag-urgan Barracks in Ndola, ZNS Kitwe, Gondar Barracks in Chipata, Chindwin Barracks in Kabwe, ZNS Mbala and ZNS Kamitonte in Solwezi) and four additional model sites (L85 in Lusaka, ZNS Luamfumu in Mansa, Luena Barracks in Kaoma and ZAF Mumbwa) to be established in FY 2007. This will be done in collaboration with other DOD-PCI activities and with JHPIEGO, to ensure integration of services and effective referrals between CT, TB/HIV, STI, HBC, ART and other services.

Capacity building includes formal and informal training for HIV/AIDS unit staff including the Home Based Care (HBC) Manager, HIV/AIDS unit coordinators at the 54 ZDF units around the country, and ZDF caregivers. Logistical support to enable ongoing supervision and monitoring of palliative care activities by the DFMS is provided, and linkages with indigenous sources of technical support such as the Palliative Care Association of Zambia (PCAZ) have been made in order to ensure that the ZDF has access to technical input, national palliative care guidelines, training packages, etc. adapted to their situation and needs.

In FY 2004 and FY 2005, 295 caregivers were trained. PCI's training of caregivers in comprehensive palliative care was coordinated with PCAZ to ensure the consistency of the training and care services with those of other USG-funded programs. An additional 80 caregivers were trained in the FY2006 program. These caregivers are actively involved at all 54 ZDF units in 9 provinces, responsible for identifying and registering chronically ill patients both among military personnel and their families, as well as from non-military populations in surrounding communities, providing community level care services in support of families, and referring patients to DFMS or other health facilities for additional care and treatment services. In FY 2007 an additional 60 caregivers will be trained in palliative care. An important component to be included in this training is adherence support for clients on ART, in support of the expansion of ART services at both ZDF and Ministry of Health (MoH) facilities.

Continued support for development and provision of HBC kits for clients and their caregivers will be provided. These HBC kits have been evaluated in collaboration with the DFMS and PCAZ and will include patient education materials relating to medicines, doses, nutrition, physical fitness, and referral information printed in local languages. The kits are refilled on a monthly basis according to the number of patients reflected in the HBC registers and monthly field reports. Material support to the caregivers, such as bicycles, umbrellas, bags and shoes, will be provided as a means of facilitating their work and motivating their continued participation. The effectiveness of training will continue to be assessed and monitored through pre-and post-training tests, as well as through ongoing supportive supervision visits by HBC trainers, DFMS clinical staff, HIV/AIDS unit coordinators, and PCI, in order to reinforce the training and to identify and address any performance and/or training gaps.

As another part of the comprehensive palliative care program, 200 positive living

personnel from ZDF support groups and/or post-test clubs will undergo a two-day positive living training, using curricula and training supports currently being developed with support from the (NMCSD) twinning program. Trainers trained by NMCSD in October 2006 will be supported by PCI to conduct workshops in FY 2007. The workshops will focus on promotion of health and wellness, with support in dealing with HIV symptomology, depressive symptoms, stigma, and beliefs about illness, adherence to ART, behaviors, self-efficacy, and substance use. Positive living materials developed by the Health Communication Partnership (HCP), the Academy for Educational Development (AED)/USAID, and other local groups have been reviewed by the NMCSD team for adaptation and will be used under this activity.

Finally, through a partnership with the Baptist Fellowship of Zambia, the capacity and involvement of military chaplains in HIV/AIDS counseling will be strengthened, with emphasis on ministry skills relating to the individual and the family, including marital relationships, parenting, and development of peer support systems. Training sessions also deal with child and spousal abuse, addictive behaviors, management of family crisis, illness, death, trauma, and setting up family crisis services at a targeted number of bases and their communities. In FY 2006, the Baptist Fellowship of Zambia trained 63 military and police chaplains in palliative care including spiritual counselling. They also provided on site technical assistance to 17 clergymen at ZAF Livingstone which is one of the model sites for palliative care and CT. In addition, they reproduced an HIV/AIDS manual used in faith-based communities for use by the chaplains. An additional 80 chaplains and their assistants will soon participate in training to build on the work done previously and help the chaplains relate it to ministry for the family and their communities. In FY 2007, 80 chaplains will be trained to provide the above services to additional bases.

In order to ensure the sustainability of the activity, PCI works in close collaboration with the DFMS HIV/AIDS unit, which has through PEPFAR support recently established a palliative care office, through which all activities are planned, implemented and monitored.

This activity also relates to Project Concern International (PCI) activities in Other Prevention Activities #8786, Abstinence and Be Faithful (PCI) # 9170, Other/Policy Analysis and system strengthening (PCI) #9087, PMTCT (JHPIEGO) #9088, Palliative Care TB/HIV (JHPIEGO) #9090, Palliative Care (PCI) #8787 and HIV/AIDS treatment/ARV services (JHPIEGO) #9089.

Observation of previous Counseling and Testing (CT) activities and results from research supported by (PCI) and PEPFAR (2005) reveal that military personnel may be more resistant to CT than the general public. According to the research, although nearly seven in ten Zambia Defense Force (ZDF) personnel know of the availability of VCT services in their camp/unit, only 10% have ever participated in VCT. This is worrying in light of the relatively high risk behavior among military personnel and despite the fact that over 30% believe they might already be HIV infected. Military personnel are also hard-to-reach with static services because military bases are scattered all over the country and many personnel are highly mobile or are stationed in very secluded locales. The remoteness of ZDF units, relatively poor infrastructure, poor linkages with national supply systems (e.g. of VCT kits), and the organizational isolation of the military, also make providing CT services costly.

PCI will continue its efforts to assist the ZDF through strategic and innovative approaches developed through more than three years experience working with the ZDF in HIV/AIDS prevention, care and support. The overall goal of this activity is to strengthen the capacity of the Defense Force Medical Services (DFMS) to provide accessible, confidential, quality counseling and testing services. In FY 2005, four model medical sites were strengthened to provide comprehensive HIV/AIDS services including counseling and testing, anti-retroviral treatment, palliative care, and PMTCT services (in collaboration also with PCI and JHPIEGO). In FY 2006, four additional model sites were established. The vision is to have one model site in each province. While these eight sites (Maina Soko Military Hospital in Lusaka, ZAF Livingstone, Tag-urgan Barracks in Ndola, ZNS Kitwe, Gondar Barracks in Chipata, Chindwin Barracks in Kabwe, ZNS Mbala and ZNS Kamitonte in Solwezi) maintain the current services, four additional sites will be established in FY2007 to provide the same services, targeting other areas where significant number of military personnel are stationed (L85 in Lusaka, ZNS Luamfumu in Mansa, Luena Barracks in Kaoma and ZAF Mumbwa). Moreover, support for basic levels of CT services will continue to be provided at 42 other ZDF units, who will have the opportunity to visit and learn from the model sites.

Funding will cover procurement of necessary medical supplies and equipment and additional training for the DFMS staff in the new sites, plus procurement of HIV test kits (while efforts continue to be made to effectively integrate the ZDF in the MOH's national supply system, in collaboration with USAID's JSI/Deliver program). 20 DFMS staff will undergo training in counseling and testing, using national guidelines, to ensure that all four sites have adequate human resources to provide high quality counseling and testing services. HIV counseling training is facilitated jointly by PCI and DFMS counselor trainers and local HIV counselor training organizations, such as Zambia Counseling Council, Kara Counseling, and Chikankata AIDS Management and Training Services. The HIV testing training will be facilitated by personnel from Maina Soko Military Hospital Virology Laboratory in Lusaka, using national guidelines. In addition, 20 senior DFMS staff, mostly counselors and/or supervisors from the new and existing model CT sites, will be targeted for refresher training in counseling and testing and trained to develop their skills in monitoring, managing, and evaluating HIV counseling and testing services; developing linkage/referral networks for follow-up treatment and care in ART, TB, PMTCT and Palliative Care; and ensuring quality standards for services in the comprehensive sites. The trained counselor supervisors will serve to reinforce CT training through ongoing supportive supervision visits and on-the-job training, and the effectiveness of training will continue to be assessed and monitored through pre-and post-training tests.

The second component of this activity is to continue supporting the operation of two mobile CT units established in FY 2006 which are operated by the DFMS with support from PCI. The first mobile unit was launched on 14th August 2006 targeting two sites on the Copperbelt province and three sites in Northwestern province. Response to the service has been excellent; at the first three sites alone, well over 600 individuals were counseled and tested. The community mobilization dramas and written materials are promoting

couple counseling and testing, to address issues such as disclosure and discordance.

The mobile services will gradually increase their coverage to DFMS sites and surrounding communities throughout the country, taking into account geographical coverage by static and mobile services, and focused on remote, underserved regions where ZDF units are typically found. Funding will be used for operation and maintenance of two vehicles, refresher training and logistical support for medical staff (a core DFMS team and supplemental staff from the ZDF units in the areas targeted), community mobilization by the ZDF drama teams, peer educators, and others, and procurement of HIV test kits (to supplement those accessed through Zambia VCT Services) and other medical supplies. Updated and targeted education materials on VCT, ART, sexually transmitted infections (STIs) and stigma reduction will be reproduced and available at the counseling and testing sites. The need and feasibility of including other health services such as STI diagnosis and treatment or reproductive health services will be explored, and may help to overcome the stigma that would otherwise be associated with a mobile service devoted solely to HIV counseling and testing. PCI will continue to collaborate with other USG-funded partners with experience in mobile CT, including SFH/New Start and CHAMP to assist DFMS in refining operational procedures and guidelines to manage and maintain the effectiveness and efficiency of the mobile services and its operations, particularly staffing, operational budgets, monitoring and evaluation, quality assurance, outreach programs and educational materials.

The sustainability of this activity is by strengthening the capacity of the DFMS to plan, implement and manage CT services with technical support. Capacity strengthening is achieved through joint planning, assessments, and monitoring of activities, as well as through formal training of ZDF staff, on-the-job training from experienced CT implementers from PCI and other partners, ensuring access by the ZDF to national guidelines and policy, basic infrastructural support, and linking ZDF services with locally accessible sources of resources and technical support (e.g. Zambia VCT Services). In FY 2006, PCI supported the registration of 20 ZDF VCT centers by Zambia VCT Services. This has allowed the centers to access government HIV test kits and other services. Already, PCI has linked DFMS with the government Medical Stores for provision of test kits for the mobile VCT program. This will also contribute greatly to the sustainability of CT services.

The target of this activity is to have 5,500 people receiving counseling and testing at the 12 model sites and other ZDF medical sites. The two mobile units will target an additional 3,000 people with counseling and testing.

This activity also relates to Project Concern International (PCI) activities in Other/policy development and system strengthening (PCI) #9171, System Strengthening (JHPIEGO) #9087, PMTCT (JHPIEGO) #9088, Palliative Care TB/HIV (JHPIEGO) #9090, Palliative Care Basic Health Care and Support of Project Concern International (PCI) #8787, Counseling and Testing (PCI) #8785, Other Prevention (PCI) #8786, Abstinence/be faithful (PCI) #9170, HIV/AIDS treatment/ARV services (JHPIEGO) #9089.

This activity is aimed primarily at further supporting and strengthening Zambian Defense Force (ZDF) capacity in monitoring and evaluation (M&E) and systems support. Funding for this activity will be used to assess and improve communication systems in ZDF units to increase their capability in managing information, M&E and situation analysis. This activity will also help to build on ongoing efforts to strengthen and systematize linkages between Defense Force Medical Services (DFMS) facilities and the Ministry of Health District Health Management Teams (DHMTs). These linkages are essential as they are proving helpful in allowing the DFMS to benefit from technical and systems support, from drug supplies and medical supplies, and from DHMT assistance in community mobilization of the civilian population. This is critical to the strategy for promoting the longer-term sustainability in health care services managed by the DFMS.

To further strengthen DFMS capacity, computers, printers, UPS devices and other supplies will be procured to support HIV/AIDS information management at four new model sites for ART, PMTCT, palliative care and CT (L85 in Lusaka, ZNS Luamfumu in Mansa, Luena Barracks in Kaoma and ZAF Mumbwa).

The M&E Manager at DFMS will be supported to undergo a short course in M&E offered by the University of Zambia. This training will build his skills in Health Management Information Systems (HMIS) including M&E data collection, management and reporting. It is expected that following this training, the M&E manager will have improved capacity to strengthen these areas in ZDF health facilities, and thus this approach is also a means of building sustainable institutional capacity in this area.

To complement this effort, and building on two previous workshops which served successfully to build capacity as well as commitment to monitoring and reporting, 54 ZDF HIV/AIDS unit coordinators plus six central HIV/AIDS unit staff will undergo a refresher training in Monitoring and Evaluation, to continue building their capacity to effectively monitor, supervise, and report on all HIV/AIDS-related activities on their units. The FY2007 refresher workshop will run for four days and will cover in detail components such as M&E systems, M&E planning and developing M&E frameworks. The workshop will be facilitated by PCI staff together with an M&E specialist from the National AIDS Council (NAC) to maintain national standards. A significant ongoing challenge in terms of monitoring progress in ZDF health services is getting feedback from the field units. It is expected that annual refresher trainings in M&E will help to identify and jointly address constraints related to data collection and dissemination, and will further raise awareness and commitment towards the importance of regular data collection, monitoring and reporting and to increase the number of ZDF units that are consistently submitting their monthly activity reports.

Funding will also be used to conduct initial facility surveys for the four model FY2007 sites, in coordination with DFMS and JHPIEGO, in order to plan effectively for establishing of these sites as model sites. Supportive supervision tours of ZDF units, with leadership from the DFMS HIV/AIDS office (and including the Director General Medical Services, who joined these monitoring tours for the first time with DOD/PEPFAR support in 2006), will continue to be supported. Finally, follow-on to the 2004/2005 knowledge, attitudes and practices and intervention impact study will be conducted to help measure the impact of various prevention, care and treatment interventions of the past two years and to identify areas needing additional support.

The emphasis in this program area is on sustainability of the efforts, through a focus on training and systems support to build capacity within the ZDF, and in particular in those responsible at central and unit levels for the design, implementation, monitoring and evaluation of HIV/AIDS related activities.

This activity also relates to activities in Strategic Information by Project Concern International (PCI) #8788, System Strengthening (JHPIEGO) #9087, PMTCT (JHPIEGO) #9088, Palliative Care TB/HIV (JHPIEGO) #9090, Palliative Care Basic Health Care and Support (PCI) #8787, Counseling and Testing (PCI) #8785, Other Prevention (PCI) #8786, Abstinence/be faithful (PCI) #9170, HIV/AIDS treatment/ARV services (JHPIEGO) #9089.

The goal of this activity is to build on the involvement of the Joint United Nations Program on HIV/AIDS (UNAIDS) globally and in Zambia in strengthening the capacity of uniformed services personnel in HIV/AIDS programming, through policy development and other technical assistance, with a particular focus on UN peace keepers. The Zambia Defense Force (ZDF) has been actively involved in peace keeping missions in the African Region. ZDF completed drafting the Defense Force HIV/AIDS policy in 2006 with technical assistance from UNAIDS and the U.S. Government. During this workshop, the need to develop a policy on pre- and post-deployment testing and effective prevention programs for personnel being deployed for peace keeping missions was identified. Currently the ZDF relies on host government or UN protocols for deployment procedures including HIV/AIDS pre-testing, post-testing and prevention activities during deployment. There is also no restriction on the deployment period, which further contributes to the vulnerability of military personnel and their families to HIV/AIDS infection.

PCI will work together with UNAIDS in strengthening the capacity of the ZDF in planning, developing, implementing, monitoring and evaluating its HIV/AIDS program and toward its sustainability. UNAIDS will work with the ZDF to develop action plans and strategic planning tools based on the new policy. In addition to the Ministry of Defense (MOD), UNAIDS will also work with other government institutions which are involved in the peacekeeping operations such as Ministry of Home Affairs.

To further strengthen ZDF capacity in addressing HIV/AIDS in its peace-keeping operations, PCI and UNAIDS will work to strengthen peer education as a key component of behavior change communication and in reducing stigma and discrimination. Given the absence of peer educators trained from among the senior ranks of the ZDF, and the importance of the active participation of ZDF leadership in the response to HIV/AIDS in the military, including its peacekeeping operations, 60 senior officers including platoon commanders from 10 major ZDF units will be trained as peer educators. The training will help to build their capacity in communicating HIV prevention messages with their troops during peacekeeping operations. In addition, PCI will collaborate with the UNAIDS in targeting Zambian peacekeepers prior to deployment to other countries, including facilitating HIV/AIDS sensitization workshops as part of the pre-deployment sessions, assuring the presence of peer educators among the peacekeepers, and equipping them with educational materials.

Gender will be mainstreamed consistently throughout all programs, taking into account the special environment in ZDF, and thus addressing masculinity perceptions, attitudes and risk behaviors amongst male and female staff. Female peacekeepers will be targeted specifically, addressing their particular situation as women and a minority. Further and importantly, the families of the peacekeepers, most often the wives will be targeted as part of a multi pronged approach.

In order to strengthen the capacity of the ZDF to sustain its HIV/AIDS program, UNAIDS will also assist the Defense Force Medical Service (DFMS) with resource mobilization including identification of other potential indigenous partners for the ZDF HIV/AIDS programs, coordination of activities and trainings, and coordination of partners such as other bi-lateral donors, the MOH, National AIDS Council, other UN organizations. Building resource mobilization skills, strengthening policy development and implementation, and increasing capacity to effectively plan and manage HIV/AIDS activities will support the sustainability of the ZDF's HIV/AIDS activities which currently rely heavily on USG funding. The UNAIDS will also advise the ZDF in conducting sensitization training, soliciting and dissemination of existing information, education and communication (IEC) materials. Through all these activities, UNAIDS will ensure that the ZDF HIV/AIDS program reflects the effective mainstreaming of AIDS and gender.