The anticipated PSI/ASF FY10 activities are part of a broad three-year project launched in March 2009, built on expertise gathered, lessons learned and interventions performed during a multi round DoD- funded project in DRC since 2006. The DRC has experienced significant population movements in response to recurring conflicts, responsible for several consequences: poverty, degradation of the health system, spread of HIV / AIDS (1,3% prevalence rate ). DRC military population is estimated at 150,000 uniformed persons with approximately 2.4 millions related people (family members, civilians, veterans) . . This population is considered at high risk of HIV/AIDS transmission due to their mobility and removal of regular partner. The HIV prevalence among military is 3.8% and is twice higher among women (7.5%) than men (3.6%) .

Since 2006 with USG funding, PSI/ASF has been working with Family Health International (FHI) to support the Army Program for the Fight against AIDS (PALS) in implementing HIV/AIDS prevention and care interventions among military personnel, their family members and closed communities. Thus,

PSI/ASF and FHI consortium project is based on the HIV prevalence study among DRC Armed Forces, lessons learned from previous funding phases, and on the 5-year sectorial strategic plan adopted by the PALS (2007-2011) by strengthening: - the perception of personal risk of contamination from unsafe sex; - the awareness and the uptake of voluntary HIV counseling and testing high quality services; - the promotion of consistent and correct condom use; - the health care services dedicated to those among army and families infected by HIV.

Gender equity for accessing HIV prevention messages, counseling and testing services and care for those infected by HIV is a priority of the project. An emphasis on women is active participation in project activities is made during the choice of project actors (peer educators, community-based educators, counseling and testing service delivery personnel in health facilities). Military wives' associations based in targeted camps are involved in messages dissemination during their current activities to their peers, in sensitization of military children grouped in sport clubs, orphans NGOs and faith-based organizations, in empowering and encouraging mothers (and in turn their partners) to engage in HIV/AIDS prevention activities with their children within the context of military families.

Currently, the project covers 3 military camps: Vangu camp in Lubumbashi, N'sele camp in Mbuji Mayi and Kokolo camp in Kinshasa. After discussion with PALS, the project extension will be broadening with one additional military site, Bukavu camp in South Kivu, in FY10.

Sustainability is a major priority of the PSI/ASF program and has been a key component to strategy development and activity implementation In general, members of target groups are routinely included in the implementation of project activities, from peer educators feed back to the highest level of the hierarchy implication. One of PSI/ASF's primary priorities has been building the capacity of each of the branches of the army (Air Forces, Naval Forces, Land Forces, and Republican Guard) through the creation of a pool of peer educators. Therefore, HIV related activities become better integrated into day- to-day activities of uniformed personnel rather than being viewed as an "extra" work. Branch supervisors and zone supervisors provide more direct oversight and supervision of peer education activities. The military health chiefs, as provincial supervisors, have been trained by the project to coordinate all HIV activities including planning, monitoring and evaluation, service delivery quality. Furthermore, PSI/ASF plans to work with the DRC Ministry of Defense to integrate HIV education into uniformed schools' curricula so that HIV information is provided from the moment an individual enters uniformed service. A pool of trainers of peer educators have been trained in Mbuji Mayi and Lubumbashi and is available to conduct initial or refresher training to peers so activities can continue even after the project ends. Moreover, military health structures are equipped and personnel trained to integrate counseling and testing service delivery as well as referral systems enhanced. A network of condoms points-of-sale has

been set up around program sites and linkages have been created with the traditional national distribution network through private wholesalers to ensure product availability for the target population.

The project monitoring and data collection and reporting is integrated in the National Health information System (SNIS) at the health zone level, and local representatives of the project participate in monthly meetings of district's core teams with all key partners such as Health Services Headquarters representatives and PALS representatives. PSI/ASF will continue to implement an M&E plan to ensure service quality based on national and USG requirements and will report to the USG strategic information team quarterly program results and ad hoc requested program data.

With FY09 funding, PSI/ASF in collaboration with FHI and PNLS supports initial and refresher training of 18 counselors in HIV counseling and 6 laboratory technicians. A total of 6,000 people are expected to receive HIV counseling, testing and their results.

With FY10 funds, keys activities include, through a sub agreement with FHI: - Training of 21 counselors and 9 laboratory technicians for high quality TC service delivery; - Provision of rapid tests and laboratory supplies to HTC integrated centers; - Continuation of TC activities according to national standards via integrated sites, resulting in the testing of 16,550 people. Within the project's integrated sites, TC will be proposed to all individuals coming to the health facility, making TC a routine, integrated element of health-care services ("opt-out" approach); - Strengthening a strong referral and counter referral system for people tested HIV positive to care and treatment health facilities, related to specific people needs (ARVT, PMTCT, TB, etc.). PSI/ASF will also rely on existing referral systems at the national level and among other PEPFAR implementing partners. At sites that don't offer all services, this information will be shared with national authorities, PEPFAR, and other stakeholders to discuss possible opportunities to expand service offerings; - Rehabilitation of one incinerator in Bukavu to reduce accidents due to exposure and handling of waste by the health workers and the public; - Reinvigorate and/or establishment of 2 post-test clubs in Kinshasa and Bukavu to complete Katanga and Kasai Oriental ones. Their main mission is to provide psychological support to people tested HIV positive through an exchange of experiences, the promotion of partner notification and the introduction of self-management to promote income generating activities; - Quarterly quality control for tests in LNRS/PNLS (for Mbuji Mayi, Kinshasa and Bukavu) and provincial laboratory of Katanga (for Lubumbashi) for laboratory quality insurance; - Regular supervision conducted by health zones headquarters (BCZS), HIV provincial coordination offices (Katanga, Kasaï-Oriental, Kinshasa and Sud Kivu), PALS, FHI, ASF/PSI based on a consolidated and validated monitoring plan.

With FY10 funds, the project will build upon previous project activities to expand prevention interventions in existing project sites, adding some sites for specific interventions as explained above. Key activities promoting HIV prevention through AB methods will include: - Advocacy to PALS (National Defense HIV Program) to integrating basic knowledge about HIV in the curriculum and training of teachers in military initial training schools and if possible in primary and high schools located in military camps to reach military children and closed civilian population, and to introducing Sud Kivu in the project; - Identification, initial and refresher training of community-based animators and peer educators among military personnel, military wives associations members and military children leaders; - Production of revised BCC tools (such as flip charts) based on results of PSI/ASF's formative research

study (Tracking Results Continuously, or TRaC), to be shared with PNLS (National AIDS Control Program), PALS and DoD, to support partners activities; - Behavior change communication activities focused on abstinence and delay of sexual debut, delivered by peers and influential elders and including recreational and cultural activities among youth; - Activities focused on young girls, such as training women as peer educators who can lead activities that promote exchanges among young girls about their specific vulnerabilities and issues. - Behavior change communication activities focused on abstinence and being faithful through inter personal communication and mass animation; In addition, PSI/ASF will : - Conduct a TRaC survey to identify key behavioral determinants to narrow with adapted behavior change messages to be promoted among military personnel and relatives; - Carry on regular meetings with peer educators, community-based educators and partners leaders to give feedback related to periodic project data analysis; - Continue regular internal and quarterly external supervisions, with standards-of-performance tools, to improve consistently the quality of interventions, in collaboration with PNLS, PNMLS (National Multi- sector AIDS Program), PALS and Health Zones Chiefs.

In FY 010, a total of 4,800 individuals are expected to be reached through interpersonal communication session based on abstinence and being faithfull.28,800 people will be reached during mass animation with MVUs for abstinence and mutual fidelity adoption.

With FY10 funds, the project will build upon previous project activities and key interventions promoting HIV prevention through other means of prevention will include: - Advocacy to PALS (National Defense HIV Program) to integrating basic knowledge about HIV in the curriculum and training of teachers in military initial training schools, and introducing of Sud Kivu in the project; - Identification, initial and refresher training of community-based animators and peer educators among military personnel, military wives associations members and military children leaders; - Pre test, production and dissemination of a communication campaign for HTC uptake promotion (TV spot, radio spot, posters, flyers), with an emphasis on couples counseling, awareness of the benefits and availability of TC; - Production of revised BCC tools (such as flip charts) based on results of PSI's formative research study (Tracking Results Continuously, or TRaC), to be shared with PNLS (National AIDS Control Program),

PALS and DoD, to support partners activities; - BCC activities focused on condom use, HTC promotion, stigma and discrimination reduction, gender based violence, alcohol abuse and related risks, through inter personal communication and mass animation; - Condom packaging and distribution. Point-of-sales are created inside military camps by peer educators trained by the project in condom social marketing. Additional point-of-sales are created by PSI/ASF sales agents around military camps and in hot spots (as bars) usually frequented by target groups; In addition, PSI/ASF will : - Conduct a TRaC survey to identify key behavioral determinants to narrow with adapted behavior change messages; - Carry on regular meetings with peer educators, community-based educators and partners leaders to give feedback related to periodic project data analysis; - Continue regular internal and quarterly external supervisions, with standards-of-performance tools, to improve consistently the quality of interventions, in collaboration with PNLS, PALS and Health Zones Chiefs.

In FY10, 34,200 individuals are expected to be reached through interpersonnal communication sessions focused on other means of prevention than AB. 67,200 people will be reached during mass animation with MVUs.