Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2012

Details for Mechanism ID: 12134
Country/Region: Rwanda
Year: 2012
Main Partner: FHI 360
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $319,238

The Targeted Interventions for Prevention with Empirically-Identified Most-at-Risk Populations and Persons (TIP) project ultimately aims to reduce sexual transmission of HIV/AIDS by targeting most-at-risk persons and populations (MARPs) and is in line with the priorities of the Partnership Framework. The goal of TIP is to reduce high-risk sexual encounters in empirically identified MARPs and deploy evidence-based intensified prevention interventions using Personalized Cognitive Counseling (PCC).

During COP12, TIPs objectives will be to:1.Create a risk-score algorithm to assist HIV/AIDS Counseling and Testing (HCT) counselors in empirically identifying those most at-risk clients who would benefit most from intensified STI-HIV-related behavior change counseling; and2.Establish a tested model of intensified HIV-related behavior change counseling for HCT clients identified as most at-risk.

The TIP program covers selected urban and peri-urban health centers in Kigali city, where the prevalence of HIV and the concentration of MARPs are considered highest. At those sites, 1,483 individuals will be reached with outreach VCT and evaluated for PCC, and 4,898 clients from in-facility HCT will be evaluated for PCC during COP12.

The findings and lessons learned from this project will be disseminated to the GOR and data will be used to inform policy and programming. TIP will work with IHDPC coordinating team to make recommendations for PCC scale-up and use nationally and the program will be transferred over to the Rwanda Biomedical Center (RBC) formerly TRAC+ by the end of the year.

One vehicle was purchased in COP09. No vehicle purchase is planned for COP12.

Funding for Testing: HIV Testing and Counseling (HVCT): $144,238

In order to empirically identify and characterize most-at-risk persons in targeted health facilities, the risk-score algorithm, will be applied and tested during the first quarter of the COP12 period in HCT services organized by the health centers where the intervention is taking place. This algorithm will continue to be applied by trained counselors. The risk screening tool will be assessed in the PCC evaluation and data will be analyzed and disseminated on its effectiveness, so that the GOR may consider adopting and replicating the tool nationally.

Among the clients received within both outreach and in-facility HCT, those identified to be at high risk and responding to eligibility criteria will be offered personalized cognitive counseling (PCC), an intensified prevention intervention described in the prevention narrative. As in the previous period, a combination of clinic-based and outreach HCT will continue to be used by the health centers. It is expected that 1,483 persons will receive HCT during this period.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $175,000

As described previously, personalized cognitive counseling (PCC) is a unique counseling session that has been introduced as an integrated component of existing HCT services both outreach and facility-based HCT to target most-at-risk persons with intensified prevention intervention. The HCT clients identified as at high risk (as per eligibility criteria in the Risk Score Algorithm applied during HCT services) are offered PCC to help them identify their risk behaviors using a self-justification questionnaire, discuss and analyze their risk behaviors, and plan for risk reduction in the future.

The purpose of this project is to introduce this innovative prevention intervention in the clinical setting, in order to test its effectiveness in changing attitudes and behaviors vis-à-vis HIV/STI prevention, and to transfer the model and related lessons learned over to the GOR for replication and use nationwide, should it prove effective. The estimated number of eligible for PCC clients in COP12 is 299, which represents 6% of both outreach and in-facility HCT clients.

As described for the previous period, developed tools (Self-Justification Counseling Questionnaire and other job aides- for PCC within the HCT setting need to be revised periodically. This exercise will continue in Quarter One of COP12, so that final versions of the tools are proposed at the end of the project period. The zone covered by the intervention is 5 sites.

During the COP12 period, community outreach targeting most-at-risk persons to increase their demand for HCT will reach 4,989 individuals, of which 1,482 will be tested.

Cross Cutting Budget Categories and Known Amounts Total: $177,511
Gender: Reducing Violence and Coercion $32,275
Human Resources for Health $145,236
Key Issues Identified in Mechanism
Addressing male norms and behaviors
enumerations.Impact/End-of-Program Evaluation
Increasing gender equity in HIV/AIDS activities and services
Family Planning