Integrated Activity Flag: This activity is linked to Activity ID 18956.08.

SUMMARY: Recent data from the DHS 2005-2006 indicates consistent low condom use in Haiti. In

addition, findings from the Measuring Access and Performance (MAP) study conducted by PSI in 2006

revealed distinct disparities in condom coverage and accessibility among the geographic regions. The

PSI/Haiti program has used this evidence to develop a strategy that will ensure condoms are widely

available across different geographical regions of the country, specifically to high-risk groups. PSI will use

behavior change communication (BCC) messages that will positively influence underlying barriers to

condom use. This program will promote improved social marketing and distribution capacity, as well as

enhancing PSI/Haiti's support and coordination with commercial and public sector distributors of condoms.

To evaluate progress, a follow-up MAP study will be required in 2008 (to be jointly funded by USAID and the

Global Fund). The specific groups targeted under this program include: Commercial Sex Workers; youth

(15-24yrs); and sexually active men in the general population (25-49yrs).

BACKGROUND: PSI/Haiti has a condom social marketing and distribution program previously funded by

PEPFAR. PSI seeks to provide affordable, high-quality condoms to segments of the population that are not

effectively served by public and commercial sector sources. These condoms are branded and sold at highly

-subsidized prices using commercial distribution systems across the country. This strategy is supported by

the Ministry of Health as a means of ensuring condom availability throughout Haiti. PSI has partnered with

UNFPA and other partners to support the Ministry of Health in developing a national condom distribution

system for targeted populations. PSI will also continue to work with the Ministry of Health and with other

donors to reinforce branded communications campaigns aimed at increasing demand, addressing barriers

to condom use, and emphasizing the dual use of condoms for HIV/AIDS protection and avoiding unwanted

pregnancies among young, high risk women through linkages with USAID's population program.

Table 1: MAP Study Regions and Coverage of Pantè, Reyalite condoms by PSI region

RegionsDepartmentsPopulation

(2003)%

population%

of Total AreaDensity

hab/km2Coverage of PantéCoverage of Reyalité

REGION I/ IIWest2 810 72633.614.768975%25%

REGION IIIArtibonite1 706 54920.427.222570%30%

Centre

REGION IVNorth1 131 42813.513.929450%<20%

North-East

REGION VArtibonite705 5528.411.622045%25%

North-West

REGION VISouth-East997 90911.914.724545%25%

West

Nippes

REGION VIISouth1 021 58612.217.920675%20%

Grand'Anse

Nippes

TOTAL 8 373 7501001001 87952.1%9.7%

ACTIVITY 1: Nationally, Pantè is available in about half of all sampled areas (52.1%). Access to any type of

male condom is 60% for the entire the population. There are however large differences from one region to

another and coverage is generally lower in rural (39.5%) than in urban centers (66.7%). PEPFAR will

support enhancing the effectiveness of condom promotion and distribution through the private sector. In

FY08, PSI will increase the percentage of outlets that stock socially marketed condoms by 10% over FY06

levels by strategically deploying sales agents throughout the departments, doubling the number of condom

outlets nationwide. Approximately 6 million male condoms and 60,000 female condoms will be distributed.

Special attention will be given to targeting outlets in rural departments and hot zones (an area where there

is a concentration of hotspots and where a significant number of high-risk groups are present).

During promotional events, agents will conduct condom demonstration sessions where messages about

condom efficacy, risk reduction, and correct and consistent condom use will be emphasized. The brand

campaign will be reinvigorated taking into account the 2006 TRaC study results on brand appeal. TV and

radio spots will be broadcast over at least 4 stations in each department. Billboards and murals also will be

designed and selectively placed for increased visibility. Messages will be coordinated at the PEPFAR BCC

Task Working Group with other BCC prevention partners to ensure consistent messages from all partners.

In addition, PSI will scale up the distribution of condoms through NGOs and other institutional partners who

have access to Most at Risk Persons (MARPS) who are otherwise difficult to reach. A solid partnership will

be developed through trainings on behavior change social marketing and regular supervision visits of those

partners who assist PSI in referring people to condom points of sale and creating new outlets.

ACTIVITY 2: Support and technical assistance will be provided to improve coordination with public sector

condom distribution. This assistance will improve the coordination of condom distribution with the public

sector and ensure that all market segments - including people living with HIV/AIDS (PLWHA) - have access

to condoms from the appropriate source. PEPFAR will support the development of networks and linkages

between condom social marketing, the private sector, and the public sector (primarily UNFPA and the

Ministry of Health) to increase condom distribution coverage and efficiency throughout Haiti.

ACTIVITY 3: In 2008, PEPFAR will support increasing demand and use of condoms among Most at Risk

Persons (MARPS) and integration of target group specific behavior change messages based on 2006 TRaC

and PEER studies.

CSWs: PSI/Haiti currently uses a network of 20 peer educators and supervisors in the greater metropolitan

areas of Grande Anse and Artibonite through support from KFW and the Global Fund. In FY08, PSI

anticipates training 10 new peer educators and reaching 3000 CSWs through IPC activities. Peer education

activities will focus efforts on self-efficacy, risk perception and attitudes towards condoms. We will continue

to partner with FOSREF as a referral service to CSWs for medical services such as HIV/AIDS testing and

IST treatment.

Youth: Working in collaboration with FOSREF, PSI currently has 100 peer educators working with in-school

and out-of-school youth. This program is funded by KfW and the Global Fund. PSI will use COP08 funds to

train 60 new in-school youth peer educators on the importance of delayed sexual debut, adopting safe

sexual behaviors such as condom use and personal risk assessment. Support will be provided to assist in

organizing education and entertainment activities as well as promotion activities during special events (i.e

Activity Narrative: World AIDS Day, World Youth Day, Carnaval, etc) that draw large crowds teeming with youth. These

activities will be supported by youth-friendly mass media campaigns. The Youth TRaC study results will

also be integrated into the design of peer education and mass media communications activities. It is

estimated that the expanded peer educator activities will reach over 2,000 youth directly.

Men and the General Population: Given that Haiti has a "mixed" epidemic, the social marketing program

will strategically target condom prevention messages to both men and the general population. This year,

the social marketing component will continue to increase condom use among most at risk populations,

especially men with multiple partners. In FY08, PEPFAR will satisfy the need to better target men and

young boys with messages to increase the correct and consistent condom use and reduce high risk sex.

Prevention messages will include personal risk assessment, partner reduction, condom use,

intergenerational sex, gender based violence and women empowerment issues. PSI will continue to

broadcasts selected mass media (TV, radio, wall painting) campaigns and organize mass events (i.e

Carnival, Patron Saints Days and Music Festivals) targeted to men in the general population. It is

anticipated that over 20,000 men will be reach through this activity.

EMPHASIS AREAS:

Commodity Procurement

Community mobilization/Participation

Information/Education/Communication

TARGETS:

Number of targeted condom service outlets: 600

Number of individuals reached through community outreach that promotes HIV/AIDS prevention through

behavior change beyond abstinence and/or being faithful: 50,000

Number of individuals trained to promote HIV/AIDS prevention through other behavior changes beyond

abstinence and/or being faithful: 70

TARGET POPULATIONS:

General Public

Women

Men

Youth

Adults

High Risk Populations

KEY LEGISLATIVE ISSUES

COVERAGE

Nationwide

Diarrhea is with acute respiratory infections the two most important causes of infant mortality in Haiti. In the

context of HIV/AIDS, infectious diarrhea is even more of a concern in a country where according to

EMMUS/DHS 2005 - 2006, 67 % of the population does not have access to treated water.

Jointly with CDC technical assistance and USAID funding, PSI has developed and is actually social

marketing a product for safe water named Dlo La Vi (water for life) which is to be used at household for the

family.

Leveraging on the fact that the Dlo La Vi product is already available in Haiti and promoted by NGO

partners in maternal and child health interventions, PEPFAR is setting aside additional funds for PSI to

make this product available to children infected and affected by HIV/AIDS and their families. This approach

will mitigate stigmatization and help reduce diarrhea incidence in the population of PLWHA.

PSI will provide Dlo La Vi through PEPFAR NGO partners conducting community based palliative care and

OVC activities.