The overall knowledge of HIV and means of protection is low in Angola. Data indicates that the main reason for the generally low and inconsistent condom use in Angola derives from social/cultural reasons rather than lack of information. It is very common for couples in established romantic relationships, to initially use condoms and then stop when they perceive that trust is established. Among other target populations, such as Commercial Sex Workers (CSW), data shows a similar pattern with recurrent clients who demand unprotected sex in exchange for higher payment. This is an example of how social and gender norms give men the power of decision making, leaving women with limited negotiating power. The USG team believes that social, cultural and gender norms need to be taken into consideration when addressing the marketing and promotion of condoms.

The PEPFAR program in Angola is initiating a comprehensive, multi-faceted prevention programs to promote normative change and adoption of safer sexual behaviors, with the aim of reducing new HIV infections among the general population, including youth and most at risk populations (MARPs).

The purpose of the project is to ensure the availability of condoms; both commercial and generic for prevention interventions, specifically in areas considered "hot spots" are which crucial forums for targeted prevention activities. To avoid vertical programming and in order to achieve the maximum results with limited funds, it is important to focus efforts in an efficient, comprehensive and integrated manner. In terms of the implementation of prevention, USAID's prevention efforts will be split into two main projects; a Community Based Prevention Project targeting the general population, including a specific focus on youth and a Comprehensive Prevention Project targeting MARPs. Additionally, USAID also supports an integrated health system strengthening project which aims to improve service delivery and increase capacity of health staff.

Upon further discussion with the USAID and PEPFAR interagency team, it was realized that a Condom Social Marketing intervention was a gap in the program and was needed to strengthen the services and outreach interventions in both the MARPs and Community Based Prevention projects. A gender lens will be integrated into all activities, recognizing that cultural and gender norms may reinforce key drivers of the epidemic such as multiple and concurrent partners and transactional sex and the need for specific marketing campaigns to reach these sub-populations.

This program will primarily focus on the B and C components of an ABC approach. FY10 funding will be used to support these key components of the intervention:

Promotion of condom use, linked to a national system for condom social marketing and a national distribution system of free condoms.

Condom social marketing of branded condoms at the national level, with efforts in key geographical areas and key populations.

Distribution of generic condoms with targeted messaging. Experience shows that branded condoms for sale and unbranded condoms distributed for free cater to different target groups and as such constitutes complementary strategies. This activity will coordinate with other PEPFAR Prevention Interventions, GRA/INLS, Civil Society and other stakeholder both nationally and locally to link condom distribution and BCC and ensure that prevention interventions have condoms available for promotion and distribution.

BCC efforts linked to the overall national strategy, including additional information, discussion and messages on alcohol/substance abuse and gender issues (GBV, social and cultural norms) promotion, referral and linkages to C&T, PMTCT and other related services

On-going efforts and emphasis on using the data collected from the PLACE, and other relevant studies, for program design, and on-going quality refinement and improvement.

Emphasis on monitoring and evaluation efforts and scale-up as appropriate