PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
ACTIVITY UNCHANGED FROM FY2008
This activity also relates to activities in ARV and HCT.
In line with the provisions of the PEPFAR/CDC COP O8 funding requirements, Population Council (PC) will
provide abstinence/be faithful (AB) and other prevention (OP) services to male most-at-risk populations
(MARPs) through community awareness campaigns, peer education models, school based curricula,
including a "Men as Parnters" curriculum that stresses male involvement in prevention activities and
explores definitions of gender roles, and other services, such as HIV counseling and testing (HCT) and
sexually-transmitted infection (STI) management. This shall be provided through a multi partnership with
Action Health Incorporated (AHI), Africa Regional Sexuality Resource Center (ARSRC), Alliance Rights
Nigeria (ARN), and The Independent Project (TIP). The overall framework of the program targets the male
MARPS in Lagos, Ibadan (Oyo State), and Abuja (FCT).
In COP08, Population Council initiated the Men's Health Network (MHN), a consortium of three key
partners, including AHI, ARSRC, and ARN. To ensure the long term sustainability of the project, MHN is
structured as a multi-donor social franchising model utilizing both private and public sector service delivery
points to provide STI, HCT, and targeted condom/lubricant provisioning to high risk men (MARMs),
particularly men who have sex with men (MSM). During COP08, the project identified and trained 24
service providers in three intervention locations - Lagos, Ibadan (Oyo), and Abuja (FCT) - with skills
development, certified training in STI syndromic management, and HCT. Concurrently, a network of key
opinion leaders (KOLs) functioned as peer educators to stimulate demand for clinical services among
MARM/MSM. In addition, a peer education and diversity training curriculum was developed using the ‘Men
as Partners' approach and delivered in an age/gender specific manner to MARM/MSM, as well as
adolescent boys and girls for AB prevention. A minimum of 18 KOLs were trained and deployed across the
3 sites. By the end of COP08, the project successfully delivered AB prevention using the proscribed
minimum package to 16,000 beneficiaries. The condom and other prevention (C&OP) minimum package
was delivered to 10,000 beneficiaries.
In COP 09, Pop Council's sexual prevention activity is limited to 3 sites and consists of several inter-related
components: 1) the promotion of abstinence and fidelity for male adolescents and targeting MSM with "be
faithful" messages, as part of a comprehensive male involvement curriculum addressing homophobia and
violence; 2) increasing demand for and availability of condoms and other prevention activities, including STI
management to MSM and their male and female partners; 3) providing clinic and community-based HIV
care and treatment to MSM in a culturally and gender-sensitive manner; and 4) supporting a network of
opinion leaders to advocate on behalf of MSM for increased awareness and sensitivity among service
providers, community-leaders, and police, toward increased access and utilization of HIV prevention and
STI management.
Nigeria has a population of approximately 140 million people with an adult HIV prevalence of 3.1%
(UNAIDS July 2008 estimate). MARPS continue to serve as "reservoirs" of the HIV infection, thereby
fuelling the epidemic in Nigeria. This group includes female sex workers (FSW), MSM, injection drug users
(IDU), long distance truckers, uniformed professionals, and others whose practices and sexual networks put
them increased risk of contracting and spreading sexually-transmitted infections (STIs).
The 2007 IBBSS shows varied overall HIV prevalence among MARPS with MSM having the second highest
prevalence of 13.5% (25% in Lagos) compared to 25% among FSW. MSM are a particularly at-risk
population in Nigeria. The MSM community is socially stigmatized and receives scant services to promote
healthy sexual behavior and HIV/STI prevention. In Nigeria, nearly all informational education messages
focus on heterosexual transmission of STI/HIV, and MSM are not sensitized to their own risk for contracting
an STI. In addition, health professionals are largely unaware of their special needs. It is therefore
paramount to include MSM in programs to prevent HIV/AIDS, since they are at high risk for HIV/STIs but
are historically ignored by prevention campaigns and limited in their access to sexual health services.
The AB component of this intervention will include raising community awareness targeting MARMs including
MSM, as well as young people in general with generic community dialogues, peer education through the
use of social networks, and additional peer education through the use of role models. Project activities
include: conducting male involvement peer education sessions at the community level targeting young
adolescents with 'AB' messages; conducting peer education sessions at the community level targeting MSM
with 'B Only' messages; conducting male involvement peer education sessions at the community level
targeting young adolescents with 'A only' messages; developing a male involvement AB curriculum using
AB prevention messages and gender roles, sexual rights, violence mitigation/avoidance training targeting
adolescent boys; and training key opinion leaders (KOLs) in male involvement AB curriculum and
management of peer education sessions.
In COP09, the project will reach 13,182 men and women with AB community outreach activities comprised
of the minimum AB package. At the end of COP09, 3,295 individuals will be reached through abstinence
only messages. KOLs among the MSM will be trained as both peer educators and role models, and as
facilitators to map MSM social networks. Population Council has developed a comprehensive behavioral
change communication (BCC) model comprising ‘Men as Partners' (MAP) curriculum, which will also
explore behavior change and safe sex practices through small group discussions, inter-personal
communications, and community dialogues. A total of 48 individuals will be trained to promote MAP AB
messaging through a gender-sensitization curriculum aimed to reduce male gender roles promoting
violence, alcohol consumption/abuse, and sexual risk-taking. A beneficiary is considered ‘reached' upon
having participated in three of the following planned activities: community awareness campaign; peer
education models; school-based approaches; peer education plus; and/or workplace programming.
The C&OP component of this intervention will include: activities to increase demand for prevention activities
among MSM in Nigeria; the identification and mapping of 9 social support networks; identification, training
and support of 27 opinion leaders promoting prevention and care-seeking behavior through BCC messages;
Activity Narrative: identification of 27 MSM-friendly provider networks offering services to MSMs; and the creation and support
of 9 outlets to distribute and promote the correct and consistent use of condoms and lubricants to persons
engaged in high-risk behaviors. This program will train healthcare providers to provide HCT, STI
management, and condom and lubricant distribution in a gender sensitive manner. It will also engage the
mass media in promoting men's health through TV and radio jingles. Quality assurance and quality
improvement for STI syndromic management will be performed among public and private laboratories
affiliated with the project, although no direct laboratory funding is provided under this agreement.
Population Council will aim to deliver these services through a comprehensive community HIV prevention
package, in which clients receive IEC materials, condom and lubricants, interpersonal communications, and
STI services, while community awareness sessions will also include focused small group discussions
(SGDs), dialogues, workshops (MAP), and consolidation of ABC messages. In addition, 9,848 individuals
will have been reached through local-language community outreach that promotes HIV/AIDS prevention
through other behavior change beyond abstinence and/or being faithful; 27 individuals will have been
trained in local languages to promote HIV prevention through behavior changes beyond abstinence and/or
being faithful; and 2500 clients will have been treated for STIs using nationally approved syndromic
management guidelines. A beneficiary is considered ‘reached' with OP activities upon having participated
in three of the following planned activities: community awareness campaigns; community outreach that
provides condoms and lubricants; peer education models; workplace programming; and STI syndromic
management and provision of pre-packaged STI therapies.
The AB and C&OP components to this program provide a vital linkage to onward referral services for OP
program areas, specifically for men engaged in high risk practices. Access to quality HCT, STI and other
health services will improve through the establishment of an MSM-friendly network of healthcare providers.
In the first year, three public and private sector clinics were selected and shaped into MSM-friendly clinics.
In subsequent years, the project will expand by 25% per year in terms of number of clinics and cities. Policy
-level interventions are not specified in this activity; however, significant engagement with NACA, CISHAN,
and complementary donors is essential to gradually move forward with rights-based agendas to support
protection of services to MSM.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
These activities contribute to the COP09 targets by reaching at least 13.182 individuals through community
outreach that promotes HIV/AIDS prevention through abstinence and/or being faithful individuals and 9,848
individuals through other behavior change beyond abstinence and/or being faithful. This is consistent with
PEPFAR's 5-year Strategy for averting new infections in Nigeria.
LINKS TO OTHER ACTIVITIES:
This activity relates to Counseling and Testing and ARV. This service will also complement HCT services
for those who ultimately test HIV negative. Through this program as well as basic care and support,
Population Council will ensure access to quality HCT, STI and other health services through the
establishment of an MSM-friendly network of healthcare providers.
POPULATIONS BEING TARGETED:
This activity will target adolescent and key opinion leaders (KOLs) and youth, as well as female sex workers
(FSW), MSM, injection drug users (IDU), long distance truckers, and uniformed professionals. This program
will train healthcare providers to provide HCT, STI management and condoms and lubricant distribution in a
gender sensitive manner. It will also target males (both in- and out-of-school) within and around the target
group communities, such as male spouses, friends, neighbors, and fiancés.
EMPHASIS AREA:
An emphasis area for this activity is human capacity development through a comprehensive community
HCT package in which clients receive IEC materials, condom and lubricants, interpersonal communications,
and STI services. Messages are reinforced through community awareness sessions, focused small group
discussions, community dialogues, and workshops such as the MAP activity. Other emphasis areas include
gender and reduction of stigma and discrimination.
COVERAGE AREAS:
Lagos, Oyo, FCT, Rivers and Imo states
New/Continuing Activity: Continuing Activity
Continuing Activity: 21687
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
21687 21687.08 HHS/Centers for Population Council 9406 9406.08 $400,000
Disease Control &
Prevention
Emphasis Areas
Gender
* Addressing male norms and behaviors
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $25,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.02:
Continuing Activity: 21706
21706 21706.08 HHS/Centers for Population Council 9406 9406.08 $350,000
Table 3.3.03:
partners, including Action Health Incorporated (AHI), Africa Regional Sexuality Resource Center (ARSRC),
and Alliance Rights Nigeria (ARN). To ensure the long term sustainability of the project, MHN is structured
as a multi-donor social franchising model utilizing both private and public sector service delivery points to
provide sexually transmitted infection (STI) services, HIV counseling and testing (HCT), and targeted
condom/lubricant provisioning to high risk men (MARMs), particularly men who have sex with men (MSM).
During COP08, the project identified and trained 24 service providers in three intervention locations -
Lagos, Ibadan (Oyo), and Abuja (FCT) - with skills development, certified training in STI syndromic
management and HCT. At the same time, a network of Key Opinion Leaders (KOLs) who function as peer
educators will stimulate demand for clinical services among MARM/MSM. Training protocols, quality
assurance standard operating procedures (SOPs) and task shifting activities were undertaken to bring
capacity in private and public sector service providers up to standards. A training curriculum in
gender/sexual orientation communication for providers was initiated to reduce stigma and improve service
delivery. In addition, a peer education and diversity training curriculum was developed using the ‘Men as
Partners' approach and delivered in an age/gender specific manner to MARM/MSM as well as adolescent
boys and girls for abstinence/be faithful (AB) programming for prevention. A minimum of 18 KOLs were
trained and deployed across the 3 sites. By the end of COP08, the project has successfully administered
8,000 HCT to MARM/MSM beneficiaries.
In COP09, Population Council's HCT activity will consist of the following inter-related components: 1) To
promote abstinence and fidelity for male adolescents with abstinence messages, and target MSM with "be
violence; 2) To increase demand for and availability of condoms/lubricants and other prevention activities
including STI management to MSM and their male and female partners; 3) To provide clinic and community-
based HCT to MSM in a culturally and gender-sensitive manner; and 4) To support a network of opinion
leaders to advocate on behalf of MSM to service providers, community-leaders, and police, through
strategic-information activities.
Nigeria has a population of approximately 140 million people with a current adult HIV prevalence of 3.1% in
(UNAIDS, 2008) and about 2.6 million individuals living with HIV. The HIV epidemic in Nigeria has been
recently described as "generalized", spreading from the high risk to the general population. The most-at-
risks-populations (MARPS) continue to serve as "reservoirs" of the HIV infection, thereby fuelling the
epidemic in Nigeria. This group includes female sex workers (FSW), MSM, injection drug users (IDU), long
distance truckers, uniformed professionals, etc.
prevalence of 13.5% (25% in Lagos) compared to 25% among FSW. MSM are a particularly at high risk
population in Nigeria. The MSM community is socially stigmatized, and receives scanty services to promote
The HCT component of this intervention will include: provision of clinic and community-based HCT to MSM
in culturally and gender-sensitive manner within identified networks and meeting places (those testing
positive for HIV will be requested to give consent so their partners/family members can also be tested);
provision of confidential HCT and screening for TB at 9 clinics; testing of 2,500 clients for HIV using
nationally approved serial HIV rapid testing algorithms; and provision of results to clients. 2,500 clients will
also be screened for TB using standard tools and appropriate referrals made. 24 counselors, consisting of
health facility staff, key opinion leaders in the target community and volunteers from partner organizations
will be trained in local languages in confidential counseling and testing of individuals/couples using the
National HCT training curriculum. Test kits will be procured using the USG Supply Chain Management
System. Test kits and other consumables will be stored centrally by Pop Council and distributed to the sites
based on projected needs with proper LMIS and inventory management by designated staff. Condoms will
be sourced from Society for Family Health (SFH) for distribution as part of HCT activities.
In addition, the project will provide technical assistance to support 2 networks of advocates around MSM
service delivery for strategic information activities, as well as 8 individuals receiving training in strategic
information (covered through other funding sources). This includes training in monitoring and evaluation,
surveillance, and/or health-management information systems. Quality assurance and control (QA/QC) will
be performed among public and private laboratories affiliated with the project, though no direct laboratory
funding is provided under this grant. Activities around HCTs will be used as an entry point to also assess
other services such as distribution of condoms and lubricants, STI management, TB screening, IEC
(information, education, and communication) materials, referrals for ARV, and TB management.
Population Council intends to pilot a Computer-Assisted Self Interviewing (CASI) method to aid efficient
delivery of HCT services and easy mapping of the network of MSMs in the target communities. This will be
largely client initiated through referral from identified networks and key opinion leaders. The HCT
component to this program provides a vital linkage to onward referral services for condoms and other
prevention (OP) program areas, specifically for men engaged in high risk sexual practices, and serves as an
essential gateway for linked/clustered services under the Global Fund strategy of clustered providers for STI
treatment, ART, and care and support. Access to quality condoms and lubricants as well as STI syndromic
management and other health services will improve through the establishment of an MSM-friendly network
of healthcare providers. In the first year, three public/private sector clinics will be selected and shaped into
MSM-friendly clinics. In subsequent years, the project will expand by 25% per year in terms of number of
clinics and cities.
Activity Narrative: Policy-level interventions are not specified in this activity; however significant engagement with NACA,
CISHAN, and complementary donors is essential to gradually move forward with rights-based agendas to
support protection of services to MSM.
Appropriate protocols will be used to ensure adequate biomedical waste management system, in close
collaboration with the biomedical management team of the CDC.
CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to the Emergency Plan five-year strategy in preventing new HIV infections
specifically among male MARPS by improving knowledge and awareness on safe sex practices, create
demand for and access to the use of condoms and lubricants, HCT and STI management, TB surveillance
as well as reduction of stigma and violence. It also promotes mutual faithfulness, reducing STI and HIV
transmission and abstinence/delayed sexual initiation among adolescent males.
The project will contribute approximately 1% of the 2009 PEPFAR targets in the region through the use of
multiplier organizations and local NGOs, social networks and community advocates as key opinion leaders.
LINKS TO OTHER ACTIVITIES
This activity also relates to activities in Sexual Prevention (AB and other prevention (OP)).
The HCT component to this program provides a vital linkage to onward referral services for OP program
areas, specifically for men engaged in high risk sexual practices, and serves as an essential gateway for
referral services under the Global Fund strategy of clustered providers for STI treatment, ART, and care and
support. Access to quality condoms and lubricants as well as STI syndromic management and other health
services will improve through the establishment of an MSM-friendly network of healthcare providers.
POPULATIONS BEING TARGETED
Most-at-risk-populations of men especially men that have sex with men, male sex workers and at-risk
youths/adolescents.
KEY LEGISLATIVE ISSUES ADDRESSED
The target group is largely a hidden population, faced with stigma, violence and social exclusion. This
programme will build capacity on strategic information, policy analysis, routine data analysis and monitoring
and evaluation (M&E). This is to enable the civil society organizations to generate appropriate information
from data in order to approach relevant authorities with right based issues to reduce stigma, violence and
discrimination among the networks of the MARPS.
The major legislative issues addressed will include increasing gender equity in HIV/AIDS programs;
addressing male norms and behavior; reducing violence and coercion; and increasing men's access to
information on safe sex and high-risk sexual practices.
EMPHASIS AREAS
The emphasis areas will center on gender issues - male norms, behavior, gender equity, legal rights,
increasing gender equity in HIV/AIDS program - to reduce stigma and discrimination. The programme will
also build local organizational capacity to strengthen the social networks of the MSM, support on project
management, management information systems (MIS) and quality assurance in HCT and STI service
centers.
COVERAGE AREAS In COP09, the program will cover Lagos, Ibadan (Oyo), and Abuja (FCT).
Continuing Activity: 21695
21695 21695.08 HHS/Centers for Population Council 9406 9406.08 $140,000
Estimated amount of funding that is planned for Human Capacity Development $2,500
Table 3.3.14:
