Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011

Details for Mechanism ID: 12024
Country/Region: Central Asia Region
Year: 2010
Main Partner: Population Services International
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $0

The goal of the Health Outreach Program (HOP) is to increase access to quality HIV prevention and tuberculosis (TB) prevention and treatment interventions among most at-risk populations (MARPs) through direct outreach services, technical assistance, and training. The guiding vision for HOP is to achieve and maintain improved health behaviors among MARPs in CAR, including increased use of HIV services. The program will be co-funded with other USG TB funds; PEPFAR funds will only fund HIV-related activities.

HOP will target MARPs most likely to contract or transmit HIV: IDUs, SWs, migrants, MSM, prisoners, and PLWHA. The project will support activities to prevent HIV transmission through unprotected sex and through injecting drugs among MARPs. The Health Outreach Project will support Targeted Outreach Package of Services (TOPS) across MARPs. This will include IEC materials to address identified barriers and determinants to HIV prevention and interpersonal communication such as one-to-one sessions, small group discussions, peer education and interactive events in locations convenient to MARPs. TOPS also includes provision of condoms and knowledge of how to correctly and consistently use them. Motivational interviewing will help MARPs explore and resolve ambivalence towards obstacles preventing changes in behavior. The project will build demand for services among MARPs such as VCT for HIV and testing and treatment for sexually transmitted infections (STIs). HOP will also create demand and refer to drug treatment and drug demand reduction services and TB services. Since many MARPs distrust health care providers and face discrimination when revealing their risky behaviors, outreach workers will provide moral support by escorting MARPs to services.

Linkages to services are a critical component of HOP. The current national systems of HIV prevention, counseling and testing, and treatment are very fragmented throughout CAR, due to many vertical and parallel programs without systems of referrals between services. HOP will fill the gap between services through direct outreach to MARPs, providing referrals to services throughout the continuum of care, and escorting clients to needed services. Additionally, HOP will work in conjunction with the Drug Demand Reduction Project, and the two projects will provide comprehensive and targeted outreach and support services in conjunction with the existing national systems. HOP will work closely with the National AIDS Centers, where as DDRP will work closely with the National Narcology Centers.

HOP will provide organizational capacity building to NGOs by training outreach workers and peer educators and through a grant mechanism. The NGOs will be supported through training on planning and implementation of projects to increase access of MARPs to HIV prevention services, counseling and testing and treatment. HOP will improve capacities of NGOS in monitoring and evaluation of project results through trainings on TRaC surveys and on analysis of data from the surveys.

HOP will implement outreach programs in 16 sites in four Central Asian Republics of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan targeting different MARPs in every site but focusing mainly on IDUs and SWs. As a sub-partner, AIDS Foundation East-West (AFEW) will target prisoners in seven sites in three countries excluding Uzbekistan. Project HOPE is a sub-partner under HOP to develop the TB component of outreach to MARPs and is the only organization that is registered in Uzbekistan. Project HOPE will implement activities in Uzbekistan and reach out to MARPs with information about HIV and TB and referral to HIV prevention and TB services in the country focusing mainly on IDUs and SWs. Due to the legal ban on working with MSM and prisoners, Project HOPE will try to reach MSM who are drug users or SWs and ex-prisoners with the same outreach activities.

Key issues addressed through this implementing mechanism are mobile populations, gender, and TB. Outreach to migrants will target both outgoing and incoming labor migrants responding to regional migration trends focusing on health and legal services to prepare for migration in Tajikistan, Kyrgyzstan and Uzbekistan as well as on provision of friendly services to receive incoming migrants in Kazakhstan. The majority of SWs migrated from rural areas or from other Central Asian countries and have no local registration to access services such as STI diagnosis and treatment. Gender will be addressed through gender-specific outreach activities, increasing equity in HIV activities, and addressing male norms and behaviors. Since this program is co-funded with TB monies, it will also address TB prevention and adherence.

Subpartners Total: $0
AIDS Foundation East West: NA
Kazakh Association of People Living with HIV: NA
Project HOPE: NA
Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services
Mobile Populations