HWWK works in the Rift Valley region, with an HIV prevalence of 6.3 % among the general population and is also one of the regions in Kenya with the highest number of HIV infected adults who are unaware of their infection status. Using combination prevention evidence informed HIV interventions, the program goal is to contribute to reduction in incidence of HIV among the most-at-risk population (truckers and female sex workers) and youth and general population. In implementing biomedical and behavioral interventions, the project aims to reduce the risk of HIV acquisition and transmission in the target population. HWWK works in partnership with government and community based groups in program implementation. This ensures that activities are anchored and supported within existing and available structures. Provision of integrated services optimizes the populations access and utilization to HIV prevention, care and treatment services, and improving program outcome. This is a Kenyan partner with country ownership and leadership. Received donation of fully loaded truck with mobile unit for conducting mobile HIV Testing and Counseling and provision of services for the MARPs.Target populations, geographic coverage, and M&E plans are included in budget narratives.

Hope World Wide (HWW) supports implementation of comprehensive HIV prevention services targeting the youth, general population and MARPs in the Rift Valley region. In FY 2012, HWW will continue to expand access to high quality combination evidence informed behavioral interventions (EBIs) for the following priority populations: youth 10-14 (26,447) and youth 15-19 years ( 20,042) who are at risk of early sexual debut and increased risk of HIV acquisition, males 30-44 including truckers(4,757) who engage in concurrent and unprotected sexual partnerships and finally the Discordant couples(1,847) and People living with HIV/AIDS ( 1,643) where there is increased risk of HIV transmission. The EBIs will be implemented in Kajiado, Eldoret, Keiyo and West Pokot counties. All EBIs are linked to other HIV services such as HIV testing and counseling, provision of condoms, care and treatment and community care and support services.

Healthy Choices I and II (HCII) targets both in and out of school youth and aims to delay sexual debut, promote secondary abstinence or have protected sexual intercourse, by providing knowledge and skills on correct and consistent condom use, handling peer pressure, and learning ones HIV status. HC I consists of 8 modules of approximately one hour each. It can be delivered in 4 sessions of 2 hours each or in 8 sessions of 1 hour each.

Prevention with Positives is an ongoing 5-10min group and individual level intervention that targets HIV infected persons in clinical and community settings, focusing on partner testing, risk reduction, condom use, disclosure, adherence, STI reduction and family planning.

RESPECT will be implemented along with HTC and provision of condoms for males and females ages 20 24, males ages 30 -44, and persons with STIs. Respect has 2 brief individual sessions targeting general population and youth, originally for heterosexual negative persons. It focuses on reduction of STDs/HIV, risk reduction, condom use and clients understanding of personal risk.

Eban is a couple and group level intervention targeting sero-discordant couples. Its 8 weekly 2 hour sessions for 3-5 couples focusing on talker-listener technique, risk assessment, enhancing couple communication and shared health responsibility.

To ensure quality, the program adheres to national standards and guidance from the National TWG on EBIs. These include use of approved national curricula; maintaining fidelity to the respective curricula and use of trained and certified facilitators. Trainings on EBIs are conducted by certified national trainers and there is observed practice of implementation done soon after training. The program uses standardized, national data tools at every stage of EBI implementation and regular field visits by trained program staff are conducted to check on delivery of EBIs and offer support supervision.

M&E will be conducted with EBI approved data capture/monitoring tools.HWW has a data monitoring plan for tracking program performance. This activity supports GHI/LLC.

Target population: HWWK is working in selected districts in the Rift Valley region. The target population includes the Most-At-Risk-Population (MARPs) primarily the female sex workers and long distance truck drivers; as well as the youth and general population. HIV prevalence in this region is 6.8% (KAIS 2007) , however the (national) HIV prevalence among MARPs is 22 %. This region also accounts for one fifth of HIV infections in Kenya, with the HIV testing coverage in men at 39.8% while that in women is 54.2%.(KDHS 2008-2009). In FY 12, HWWK will provide HTC services to increase knowledge of HIV status among female sex workers and their families, long distance truck drivers, Youth in school and out of school, and the general population.

HTC approaches: HTC services are provided through client initiated approaches to reach the specific target populations in the community. Stand alone VCT sites, outreach/mobile sessions including moonlight VCT and targeted campaigns such as the National HTC campaigns are settings where these services are provided.

Targets and achievements: In the past 9 months, HWWK provided HTC services to 31,264 individuals surpassing the annual target of 30,000. 21 counselors received refresher training on HTC focusing on re-testing recommendations and use of the HTC register. In FY 2012, HWWK will provide HTC services to 119,000 individuals with a target of 60% for new testers and 55% men. The program will also target to reach 20% couples in the target population.

Proportion allocation of funding: HTC is a key component in HIV prevention strategies for MARPs and is provided as part of the comprehensive HIV prevention package. 40% of the budget is allocated for this.

Testing algorithm: National HIV Testing algorithm is used.

Referrals and linkages: Following HIV testing and counseling, HIV infected clients are referred to HIV care and treatment sites for further investigations and enrolment into appropriate services. The national (NASCOP) referral form is used for making referrals facilitating access to the HIV care and treatment sites. These referral forms allow for comparison of total clients referred and total clients accessing the referred services. HIV positive clients are also provided with prevention with positive (pwp) interventions which enhances follow up to ensure clients access the services referred to. In the MARPs program, all clients are given a unique identifier that is used to monitor linkages. The peer led network used in this program also allows for follow up. The program gets regular information on individuals not accessing services and through the peer led network is able to make the appropriate follow up. The program reviews data to determine the success rate in the referral and linkage strategies.

Quality management: National HTC guidelines are utilized in service provision, counselor training and certification and testing algorithm. Functional HTC QA systems are in place as per the national guidelines including participation in proficiency testing and support supervision.

Monitoring and evaluation: National HTC tools are used to capture and report data both for couples and individuals receiving HTC services.

Promotional activities: To create demand for HTC services, the program utilizes mass media campaign and community mobilization strategies targeting the general population with key messages. Peer networks are used to encourage the MARPs to access services.

Hope World Wide supports implementation of comprehensive HIV prevention services targeting the youth, general population and MARPs in the Rift Valley region. In FY 2012, the mechanism will continue to expand access to high quality combination evidence informed behavioral interventions (EBIs) for the following priority populations: youth 15-19 (10,325), males 20-24 years including truckers(8,824), females 20-24 (29,601), males 30-44 including truckers(14,273), Discordant couples(5,541), persons suffering from STIs(1,471), People living with HIV/AIDS ( 4,929 and Female Sex Workers (13,369). The EBIs will be implemented in Kajiado, eldoret, Keiyo and West Pokot counties. All EBIs are linked to other HIV services such as HIV testing and counseling, provision of condoms, care and treatment and community care and support services.

Healthy Choices II (HCII) targets both in and out of school youth aged 13 17 years and aims to delay sexual debut, promote secondary abstinence or have protected sexual intercourse, by providing knowledge and skills on correct and consistent condom use, handling peer pressure, and learning ones HIV status. HC II consists of 8 modules of approximately one hour each. It can be delivered in 4 sessions of 2 hours each or in 8 sessions of 1 hour each.

Prevention with Positives is an ongoing 5-10min group and individual level intervention that targets HIV infected persons in clinical and community settings, focusing on partner testing, risk reduction, condom use, disclosure, adherence, STI reduction and family planning.

RESPECT will be implemented along with HTC and provision of condoms for males and females ages 20 24, males ages 30 -44, and persons with STIs. Respect has 2 brief individual sessions targeting general population and youth, originally for heterosexual negative persons. It focuses on reduction of STDs/HIV, risk reduction, condom use and clients understanding of personal risk.

Comprehensive HIV prevention interventions will be implemented for female sex workers. These interventions will include Sister to Sister, a 20 minute individual level intervention that targets women of reproductive age that focuses on self efficacy, safer sex negotiation skills and condom use.

Eban is a couple and group level intervention targeting sero-discordant couples. Its 8 weekly 2 hour sessions for 3-5 couples focusing on talker-listener technique, risk assessment, enhancing couple communication and shared health responsibility.

To ensure quality, the program adheres to national standards and guidance from the National Technical Working Group on EBIs. These include use of approved national curricula; maintaining fidelity to the respective curricula and use of trained and certified facilitators. Further, trainings on EBIs are conducted by certified national trainers and there is observed practice of implementation done soon after training. The program uses of standardized, national data tools at every stage of EBI implementation and regular field visits by trained program staff is conducted to check on delivery of EBIs and offer support supervision.

Monitoring and evaluation will be conducted with EBI approved data capture / monitoring tools. Mechanism has a data monitoring plan for tracking program performance.