The PEPFAR Prevention Small Grants program is a new mechanism designed to assist communities and local organizations with projects that promote HIV/AIDS prevention within communities at a grassroots level. The goal of this project is to build on the success of prevention efforts to date, by further reducing the acquisition and transmission of HIV through higher quality, more effective, and community identified and led sustainable prevention activities like Abstinence/Being faithful (AB), Testing & Counseling (TC), and Other Prevention (OP) services. This project will aim to support more effective prevention of HIV infection over the next five years, relying on a "comprehensive" or "combination" Zambian-led, community-based prevention approach that incorporates behavioral, and structural prevention interventions to a much greater extent in community settings than previously.

These funds could be accessed by well organized community groups who have agreed to pursue common goals of ensuring that the incidence rates or some other agreed upon measures, within their catchment area are reduced. The Prevention Small Grants program will help to build local capacity by encouraging new partners to submit applications for review. Programs will be designed to continue to promote the reduction of stigma associated with HIV and promote linkages at the community level. Applicants will be encouraged to work closely with current USG partners that are Prevention oriented to establish sound referral systems and to ensure continuity of services. The Prevention Small Grants Program will target an average of 20-25 innovative, evidence-based, community approved prevention activities to reach a total of 10,000 (depending on the definition of the "community") people. Community-based groups, women's groups, youth groups, faith-based organizations (FBOs), groups focusing on gender issues, and groups of persons living with HIV/AIDS (PLWHA) from all 9 provinces are among the groups that will be encouraged to apply.

The four main prevention-related program/technical areas that this program will promote, as defined by PEPFAR guidance, are 1) Abstinence/Being faithful prevention programming (including partner reduction) 2) Other Prevention, 3) Testing and Counseling, and 4) Encouraging male participation in Prevention of Mother to Child Transmission (PMTCT). The program will also promote male circumcision (MC), but will not provide clinical MC services. The program will address cross-cutting concerns such as alcohol and substance abuse, gender-based violence, and social norms that contribute to acquisition and transmission of HIV. This project will also target all sexually active people of all age groups. It will have special prevention messages for children, youths, and those that are married.

Generally, PEPFAR activities are carried out in all 9 provinces and 72 districts of Zambia. As this will be the first time this program will be implemented, activities will be carried out in areas with high population densities and high HIV incidence rates. In determining suitable projects, PEPPFAR will also target communities where USG PEPFAR funds have not been issued before. This means serving areas that are geographically located beyond the reach of current PEPFAR prime partner activities. The Small Grant's program serves a unique niche, providing financial support where there would otherwise be none.

All of the projects to be funded are prevention oriented. Illustrative activities include, outreach activities, youth friendly corners, adult "insakas" (traditional meeting place) to promote fidelity, condom distributions, women's clubs and others that may be unique to a particular community and must be innovative and implementable. These proposed activities are designed to ensure that individuals, households, and communities affected by HIV/AIDS access more effective, gender-sensitive, higher-quality community led HIV prevention. They will also provide an opportunity to strengthen the continuity and coordination of, as well as commitment to, effective, efficient and sustainable HIV prevention as well as improving efficiency, and sustainability of the response to HIV/AIDS.

These funds will also provide support for one full-time PEPFAR Prevention Small Grants Coordinator to work in the Coordination Office. This position will develop project guidelines, promotional materials, application and other documents as well as coordinating review of applications, and determining qualification of projects. In addition, the position is also responsible for project monitoring and evaluation, and providing close program management to selected programs.

The Testing & Counseling (TC) result for this project will be based on community sensitization aimed at encouraging community members to take up TC as a means to HIV/AIDS prevention. This will utilize the many peer educators available in the community who are expected to work as frontline community educators. The program will ensure that peer educators are trained in areas where they do not already exist.

The Prevention small grants program will identify at-risk youth and adults before they are infected, and refer them for more in-depth counseling, to help them protect themselves through appropriate messages and behavior change services. The project will also endeavor to identify PLWHA in the home or community as early as possible, in order to help them change their behaviors so that they do not infect others, as well as to link them proactively and immediately to existing care and treatment services.

From the lessons learned t in PEPFAR One, this program will equally target HIV negative clients. This is based on the fact that the over 85% of Zambian clients who test HIV negative needs to change or maintain their behaviors so that they remain negative especially after a negative test result. Therefore, peer educators together with the Counselors will screen them for HIV risk, and develop HIV risk profiles. Community-based educators will design locally applicable prevention activities, implementing them to those with high risk profiles.

All prevention efforts will employ a "combination" approach, comprising behavioral and structural interventions, to achieve comprehensive community led and designed prevention targets and reduce transmission of HIV. The project will ensure prevention efforts are fully integrated and continuous across all program/technical areas with a bias towards behavioral aspects. Activities will promote abstinence, delay of sexual debut or secondary abstinence for the unmarried, fidelity and reduction of MCP among married couples and related social and community norms that impact these behaviors and aggressively promote reduction of multiple concurrent partnerships. A special focus of this project will be to increase and improve on prevention efforts to protect the 85% of Zambians who are HIV negative. Youths and community members of different age groups will be encouraged to adopt life styles that will ensure that they remain negative. In particular, it will identify those who are at highest risk of acquiring HIV infection, and provide targeted behavior change activities.

All prevention efforts will employ a "combination" approach, comprising behavioral and structural interventions, to achieve comprehensive community led and designed prevention targets and reduce transmission of HIV. The project will employ lessons learned from other programs that are implementing OP activities. Selected implementing partners will choose from a full range of other prevention strategies and interventions, which may include the provision of male and female condoms, make them widely available through community centers i.e. bars, "Tutembas" (Little community based tuck shops) and encourage the critical importance of consistent and correct condom use. In addition to condom promotion and distribution, reduction of risk behaviors including alcohol and other substance abuse, reducing gender-based violence, and addressing behaviors such as soliciting or providing transactional or trans-generational sex in exchange for money or goods will be addressed by this program. The OP services will equally promote other efficacious prevention activities such as Male Circumcision which have not been part of the way of life for most Zambians and link closely to AB and TC prevention.

Peer educators across all age groups will be utilized to actively promote the above activities. These have been segmented into different age groups so that information passed on is age appropriate. It would also help in disrupting unethical, myths about HIV/AIDS which circulate within age groups.