Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 10531
Country/Region: Rwanda
Year: 2009
Main Partner: To Be Determined
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $0

Funding for Testing: HIV Testing and Counseling (HVCT): $0

This is a new activity/mechanism in FY 2009

A primary aim for Rwanda under PEPFAR guidelines is to increase the number of Rwandans who undergo

routine, confidential testing and counseling (TC) each year. Counseling and testing for couples is a unique

strategy to encourage this important intervention. Knowing one's HIV status is the first step towards

prevention, care and treatment. Reaching couples with HIV testing and counseling is a vital component of a

comprehensive testing strategy. When healthy couples are reached with testing, discordant couples can be

identified, thereby creating an opportunity for prevention of new infections in the uninfected partner through

intensive counseling. Early identification of these discordant couples is also an opportunity to provide early

referral to care and treatment. Key technical differences to the model include whether couples receive TC

and/or disclosure of results together or separately. CVCT and disclosure of results may have an effect on

the number of couples tested, acceptability by clients, potential for reducing GBV, and compliance with

follow-up.

By providing counseling and testing to couples, counselors can address and help couples overcome

obstacles such as gender inequity and stigma. Couples confidential counseling and testing has many

benefits both for the couples themselves as well as the Rwandan community as a whole, including the

following providing an important opportunity to promote fidelity and strengthen relationships; identifying

serodiscordance among couples, which is common in Africa, and could account for a large proportion of

new infections; reducing the rate of HIV transmission among partners; facilitating linkages to targeted

prevention efforts to avert HIV infection; facilitating linkages to care and treatment, which can promote

healthy behaviors/practices for positive living; empowering couples by promoting family decision-making

and appropriate behavior changes; and encouraging faithfulness in concordant HIV-negative couples.

In FY 2009, PEPFAR will support a TBD partner to provide Technical Assistance to TRACPlus - Center for

Infectious Disease Control/MOH (CIDC) in couples confidential TC interventions, provide training to

counselors and VCT/PMTCT Health Center and District Hospital staff, work with CIDC in strengthening

linkages of confidential TC sites for couples with ART referral centers and developing mechanisms to track

the effectiveness of these linkages, provide technical assistance in the area of couples TC to PEPFAR and

other implementing partners, provide TA to develop interventions tailored at following up HIV Discordant

Couples and put in place a strong monitoring and evaluation system for assessing program effectiveness.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14: