With support from the United States Government (USG), the United Nations High Commissioner for Refugees (UNHCR) has made progress in reaching its strategic objective of containing HIV transmission and morbidity, through scaling up effective prevention interventions to people of concern. This has been done with emphasis on community participation, especially among women, children, and people with special needs to ensure they have access to HIV prevention information.

UNHCR is currently operating in three locations Mayukwayukwa settlement in Western Province, Meheba settlement in North Western Province as well as in the urban area, Lusaka Province. In August 2011, the refugee population totaled 49,203 (Mayukwayukwa - 9,986, Meheba 17,710 and Urban area - 6,025).

Prevention interventions have been focused on expanding existing services through training peers in couple counseling, male circumcision, condom education and life skills among the youth. UNHCR plans to focus on specific areas that are crucial to the achievement of effective prevention strategies targeting men and boys, women and girls for gender-specific activities and ensuring an all-inclusive prevention strategy which will cover related reproductive health issues.

Outreach workers will conduct community awareness programs such as door to door campaigns on the benefits of male circumcision in the reduction of HIV infection. The targets for this intervention are males to access circumcision services, females to encourage their male partners to get circumcised and parents to take their male children for circumcision.Male circumcision awareness will be conducted in all three locations but PEPFAR funded actual surgical procedures will only be conducted by MoH in Meheba. In Meheba MoH will train 25 male circumcisers, procure male circumcision kits and conduct the surgical procedures to a target of 500 males aged 0-15 years and above. In Mayukwayukwa, MCDSS will conduct community awareness on the benefits of male circumcision and facilitate for actual procedures with MoH (Mayukwayukwa) who are funded by UNHCR to perform the actual surgical procedures. Target groups reached with information on male circumcision will be captured under other prevention. In the urban area, AAH will utilize existing networks conducting male circumcision services such as the health centres in five compounds as well as Society for Family Health. AAH will facilitate community members access circumcision services, avail information and make the necessary follow up.

Abstinence activities, using the stepping stones curriculum, games and other life skills programs, will target a total of 4,250 girls and boys (aged 10-16 years). Messages on abstinence will be presented alongside other reproductive health messages while taking into account the gender specific needs of the target groups. In schools, trained youth will champion abstinence activities such as boys storytelling sessions, girls talks, debates, youth camps and so on. Through the established youth friendly centres and community outreach activities, out of school girls and boys of the same age group will be reached with life skills education and other behavior change programs.

200 boys and girls will be trained in life skills and behavior change, for sustainability purposes, as these will provide a ready resource for abstinence programs.

Males and females aged 17 years and above will also be reached with abstinence and be faithful messages. Youth friendly centres in the settlements, and urban area, have been furnished and equipped with games and videos of interest thus increasing the number of youth accessing services. It is through these that the target group will be reached.

Community awareness campaigns will be conducted, in all the three locations, targeting couples to access counseling and testing together, parents to take their children for testing, youth and women at risk. Through scheduled outreach or mobile testing, routine testing at the health centres, 2300 individuals are targeted to get counseled, tested and receive their results. Out of total target, 250 couples will be tested and 300 children (aged less than 15 years).

To scale up counseling and testing, 100 community members will be trained in psychosocial, couple and pediatric counseling. Moreover, linkages with organizations engaged in counseling and testing will be strengthened. In Mayukwayukwa, MCDSS will raise awareness, counsel and refer clients to MoH (Mayukwayukwa) to conduct the testing. In the urban area, in addition to the testing and counseling by AAHi, partnership and collaboration will be developed with New start centre and the public health facilities in order for refugees to access their counseling and testing services. In Meheba, MoH will conduct routine testing and counseling at the health facility as well as schedule outreach testing and counseling programs in each of the nine blocks. To encourage community members to access the service, music, drama presentations combined with video shows will be utilized at the testing points.

Prevention activities will target 6,750 refugees. Planned interventions will cover topics such as prevention of mother to child transmission targeting pregnant women and their partners, male circumcision as a method of prevention and condom education campaigns targeting male and female refugees aged 15 years and above. Sensitization will also be conducted on risky behaviors such as multiple concurrent partnerships, sexual and gender based violence and alcohol abuse. This will be done through interpersonal communication channels such as group discussions, drama and debates. To promote quality assurance, outreach workers will also reach community members through door to door campaigns. Prevention activities will be integrated with other services such as ante natal care services, food and non food items distribution, social events etc. Moreover, platforms such as football matches, refugee sector or zonal meetings will be utilized as channels for reaching key opinion leaders.

A total of 50 women at risk will also be reached with sexual and reproductive health messages integrated with life skills training.

Targeted outreach activities will also be conducted among people living with HIV/AIDS (PLWHA). Among the topics to be covered are; consistent and correct condom use, self esteem thereby reinforcing positive prevention practices.

Condom education activities will be conducted among community members. Distribution points will be increased from the current 80 to 100. Open discussions on condoms will be integrated with other prevention activities.