The Corridors of Hope III (COH III) project is a comprehensive HIV prevention of sexual transmission project. It is a continuation of a project that began in 2000 under the name the Cross Border Initiative (CBI). The CBI originally targeted most-at-risk populations (MARPs), primarily sex workers and their clients, mainly long distance truck drivers at border posts and transport corridor communities. Originally, the CBI provided diagnosis and treatment of sexually transmitted infection (STIs) and behavior change information, including the promotion of the use of condoms, to reduce risk behavior and the transmission of HIV.

In 2004, CBI changed its name to be the Corridors of Hope project and expanded its range of services to include testing and counseling (TC). It also expanded from seven to ten sites. In subsequent years, through the support of PEPFAR, COH expanded services in recognition of the generalized nature of the epidemic and due to the demand along the transport corridors.

COH III began October 1, 2009 as an Associate Award under the ROADS II Leader with Associates Cooperative Agreement. Working with the Ministry of Health, District Health Management Teams (DHTs) and in close collaboration with the District AIDS Taskforces (DATFs) of the National AIDS Council to provide comprehensive HIV prevention programming. The services are provided across seven sites: Chipata, Chirundu, Kapiri Mposhi, Kazungula, Livingstone, Nakonde and Solwezi. In FY 2010, COH III will continue at these seven sites plus add three more sites: Kasumbalesa, Katete, and Sesheke.

COH III provides a unique range of services. In addition to the innovate approaches to providing CT, COH III also provides STI diagnosis and treatment, and strategic behavior change and community mobilization interventions, using participatory methodologies designed to encourage individuals and communities to identify the drivers of HIV transmission. Strategies for addressing these drivers are then identified so as to promote sustainable behavior change. In FY 2010, COH III will continue to use these effective approaches, modified as necessary based on the experience of FY 2009.

As an Associate under the ROADS II Leader with Associates project, in FY 2009, COH III benefited from the expertise and best practices being used in the east and southern Africa. In FY 2010, COH III will continue to build upon this expertise and quality to enhance the effectiveness of the services and to address real needs and conditions that put Zambians at risk for HIV transmission. Importantly, COH will draw on the experience of ROADS in sustaining community volunteers through the cluster community-organizing model, develop real-wage jobs for vulnerable women and youth, including older orphans, address sexual and gender-based violence in the context of HIV, establish community-based alcohol counseling to strengthen HIV prevention, care and treatment. COH III will also use SafeTStop branding to help Zambian MARPs access services when in neighboring countries, and strengthen the HIV prevention and care skills of private drug shops and pharmacies, the first line of care in many transport corridor communities.

COH III's mandate is to increase the capacity of local partner organizations to provide and sustain a continuum of prevention services. COH III will continue to build local capacity to conduct CT services, integrate CT with AB and other prevention activities, and establish effective and comprehensive referral networks that are easily accessible and acceptable to MARPs. COH III will continue to strengthen all facets of its three Zambian NGO partners, Afya Mzuri, ZHECT, and ZINGO, to manage the sites and implement the program activities. Based on periodic organizational assessments, FHI will continue to provide technical assistance, training, and on-the-job mentoring to improve their technical approaches, financial management systems, human resource management, strategic planning capabilities, networking capabilities, M&E, quality assurance, and commodity/equipment logistics management. COH III will continue to pursue the exit strategy and the graduation plan articulated in FY 2009.

In addition, through its local partners, COH III will continue to develop the organizational capacities of selected local faith-based and community-based organizations (FBOs/CBOs).

COH III will build on the experiences of the previous year to provide CT services in the seven original sites: Chipata, Chirundu, Kapiri Mposhi, Kazungula, Livingstone, Nakonde and Solwezi. In FY 20020, the program will open sites in Kasumbalesa, Katete, and Sesheke. These locations have populations that have the highest HIV prevalence in the country. These communities are characterized by highly mobile populations, including sex workers, truckers, traders, customs officials and other uniformed personnel, in addition to the community members, in particular adolescents and youth, who are most vulnerable to HIV transmission by virtue of their residence in these high risk locations.

In FY 2010, COH III will provide CT and their results to over 28,000 individuals and provide training to an addition 20 individuals to provide CT.

As in FY 2009, COH III will provide CT in ways that will continue to make the service convenient and accessible. Through monitoring service delivery, COH has learned that over 85% of the individuals who access CT from COH III have done so through the mobile facilities operated at each site. In addition, women and sexually active young people, particularly vulnerable groups, access CT from mobile facilities at a higher rate than men. In FY 2009, COH III introduced, with great success, door-to-door CT providing a mode of service delivery that is valued by households because of its confidentiality and accessibility. COH II will continue these services.

Using refurbished shipping containers strategically placed near the border crossings and truck parking areas, COH III will continue to provide CT services to sex workers, truck drivers, and others who congregate or are obliged to spend time at these locations.

Through participation in the DHMTs' annual planning process COH III anticipates continuing to receive testing kits from the DHMTs which are supplied by the MOH. COH III will continue to provide data on the CT services provided to the DHMTs who integrate it into their reporting to the MOH. The DHMTs will continue to provide quality assurance supervision for the CT activities.

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At the core of implementing behavior change and social interventions, COH III will continue to create social environments that support and encourage individual change by challenging negative social norms and behaviors that put individuals and whole communities at risk of HIV infection. This requires that community members themselves drive the process of identifying their needs and development of appropriate responses, with technical support from COH III. The focus will be on interventions that increase knowledge of modes of transmission and key drivers of HIV transmission in Zambia and increase the perception of personal risk to HIV infection.

COH III partner, ZINGO, will continue to take primary responsibility for implementing interventions that promote abstinence and fidelity. As in FY 2009, ZINGO will focus on families and, working with local FBOs/CBOs, will develop skills among parents to talk to each other, to talk with their children, and to help family members to identify the risks of early/unprotected sex and to develop positive attitudes about their sexuality and skills to negotiate the pressures for early sexual debut.

ZINGO also will continue to work through its FBO/CBO members to develop interventions in schools and places of worship. It also will continue to promote sports as an alternative, engaging activity for youth.

At the core of implementing behavior change and social interventions, COH III will continue to create social environments that support and encourage individual change by challenging negative social norms and behaviors that put individuals and whole communities at risk of HIV infection. The focus will be on interventions that increase knowledge of key drivers of HIV transmission in Zambia; increase the perception of personal risk to HIV and change negative societal attitudes toward key prevention measures such as the use of female and male condoms. COH III interventions will challenge the acceptance of behaviors such an intergenerational sex, having multiple and concurrent sexual partners, and gender-based violence. Interventions will utilize the COH III Strategic Behavior Change and Social Mobilization Strategy. Project staff and community change agents will be trained in risk assessment and in counseling for behavior change. To the extent possible, local BCC project staff and peer educators will continue to work through and within participation with local FBOs/CBOs thus helping to build sustainable community institutions.

Sexually transmitted infections (STIs) are a proven contributing factor to HIV infection and COH III will continue to provide STI diagnosis and treatment. Individuals who comes to COH because of a suspected STI can be and are encouraged to take an HIV test. These services can be very complementary. Through mobile and static facilities, COH III will continue to offer STI diagnosis and treatment.

COH III will continue to promote correct and consistent use of female and male condoms and the establishment of condom outlets at locations frequented by sex workers and their clients.

The abuse of alcohol is a risk factor leading to risky sexual relations. Outreach workers will be trained to help communities and individuals address this challenge, adapting the community-based alcohol counseling model established by ROADS.

COH III will assess the potential to create real-wage jobs for vulnerable women and youth, in three sites through LifeWorks Partnership Trust (ROADS II). COH III will draw on ROADS expertise to assess the HIV prevention capacity of drug pharmacies in three COH III sites.