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
PEPFAR re-competed the social marketing program in 2008. The awardee, Population Services
International (PSI), will begin to develop the work plan in October 2008 after which more precision will be
know regarding the planned activities.
The scope of work that PSI will deliver will strive to increase uptake of PMTCT services in the priority
provinces. PEPFAR currently supports PMTCT service provision in five high-prevalence provinces in
Vietnam - Hanoi, Ho Chi Minh City, Quang Ninh, Hai Phong and An Giang. The USG is planning for further
program expansion to additional geographic areas, however current coverage of PMTCT is low and there
are no communication activities to support uptake of PMTCT among women attending ANC clinics in the
priority provinces.
Research across different countries has identified the following challenges in promotion of
PMTCT services:
• Knowledge and awareness of vertical transmission or ability to prevent it
• Lack of access to HIV testing and treatment services
• High levels of stigma resulting in low numbers of women accepting HIV testing HIV and low numbers of
women revealing positive sero-status to partners and obtaining preventive services
• Weak linkages to sustained care and treatment services
PSI will expand promotion of and support to pregnant women to seek VCT and related PMTCT services in
early pregnancy and strengthening referral networks. PSI will work with USG partners and other service
providers in Vietnam including VCT and PMTCT services, drug rehabilitation services, care and support
services, and others engaged in outreach to high-risk populations.
The results of the program will increase uptake of PMTCT services and be monitored by the following
illustrative indicators:
• Number of service outlets providing the minimum package of PMTCT services
according to national and international standards
• Number of pregnant women who received HIV counseling and testing for PMTCT
and received their test results
• Number of individuals trained in the provision of PMTCT services according to
national and international standards.
• Numbers of individuals reached through community outreach activities that promote
HIV/AIDS prevention through other behavior change beyond abstinence and/or
being faithful
• Percentage of pregnant women tested for HIV and get counseled for PMTCT
New/Continuing Activity: Continuing Activity
Continuing Activity: 15307
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15307 12250.08 U.S. Agency for Population 7269 7269.08 PSI - Vietnam $600,000
International Services
Development International
12250 12250.07 U.S. Agency for Pact, Inc. 5180 3102.07 Community $470,000
International REACH Vietnam
Development
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
CONDOMS AND LUBRICANTS SOCIAL MARKETING AND DISTRIBUTION: $1,207,832
Social marketing of condoms and other prevention commodities, and promotion of safer
behavior, are essential elements of the PEPFAR-supported HIV prevention portfolio in
Vietnam. Although PEPFAR is supporting a large number of partners in providing targeted, outreach based
services to high-risk groups including injecting drug users (IDU), commercial sex workers (CSW), men who
have sex with men (MSM), and prospective male clients of sex workers, social marketing approaches are
necessary to ensure that key populations have sustainable access to prevention commodities such as male
and female condoms and lubricant in key high-risk settings and hotspots, and recognize the importance of
adopting safer behaviors.
PSI was recently announced as the recipient of a competitive award to continue the social marketing
activities it initiated for the PEPFAR team under the Pact, Inc. mechanism. Hence for five years starting in
FY08, PSI will have a more direct partnership with PEPFAR Vietnam as its primary social marketing
partner.
In FY09, USAID will purchase Number One condoms, Protector Plus condoms, female condoms and water-
based generic lubricants through its contraceptives and commodities fund (CCF) procurement, and PSI will
purchase branded Number One water-based lubricants due to USG restrictions on using the CCF to
purchase branded lubricant. The branded Number One products will be packaged and marketed together,
and the Protector Plus condoms, female condoms and generic lubricant will be freely distributed to targeted
MARPs as part of outreach efforts to these populations. Lubricants will always be packaged and promoted
in tandem with condoms.
In FY 09, PSI will continue to promote correct and consistent condom use as part of a comprehensive ABC
approach to reduce sexual risk, and will socially market condoms and other commodities to enhance
demand and promote sustainability. Revenues generated through condom sales will be used to offset
program costs. Communication campaigns will be refined to encourage consistent and correct use of
condoms, particularly among at-risk individuals. Interpersonal communication activities will tailor risk-
reduction messages appropriately to different sub-populations and ensure that high-risk individuals have
adequate support to consistently use condoms.
PSI has already built strong relationships with entertainment establishment (EE) owners through existing
projects and has done a significant level of mapping of strategic EEs -- such as hotels, guest houses,
karaoke bars and massage parlors -- and non-traditional sales outlets for education and social marketing
activities. In FY09, PSI will extend the scope of its work to reach to EE-owners and staff. These efforts will
allow PSI to provide more comprehensive HIV prevention programming to at-risk populations in these
settings.
PSI will also support the PEPFAR team by developing and maintaining logistical networks that deliver and
monitor distribution of prevention commodities (male and female condoms and lubricant) for free distribution
among MARPs by PEPFAR partners throughout Vietnam. The free distribution plan for Protector Plus
condoms and generic lubricant will be developed in close collaboration with existing PEPFAR outreach
programs. Products and services for MARPs in a matter that promotes the adoption of risk reduction
practices and provides linkages to services for sustained behavior change.
PSI will strengthen partnerships with Provincial Health Departments (PHD) and local NGOs to improve their
ability to develop evidence-based, client-focused social marketing programs. These efforts will the capacity
of these organizations to implement sustainable social marketing approaches and to develop compelling
behavior change campaigns. Social marketing workshops will be offered to Provincial Health Departments
(PHD) involved in MOH/VAAC HIV/AIDS activities, as well as other organizations involved in HIV
prevention.
PSI will carry out regular assessments and formative evaluations to inform the development of more
effective strategies for targeting and reaching most-at-risk populations with condom social marketing
services.
Through its FY09 activities, PSI will provide prevention services and commodities at 1000 non-traditional
outlets (NTOs); 8 million (8,000,000) male condoms will be distributed; 10,000 female condoms will be
distributed; 300,000 lubricant sachets will be distributed; more than 2,000 CSW and MSM will be trained in
the use of female condoms (FC) and lubricants, and 45,000 individuals will reached through community
outreach that promote HIV/AIDS prevention. Approximately 380 individuals will be trained to promote
HIV/AIDS prevention as a component of this program.
Number of targeted condom service outlets: 1,000
Number of individuals reached through community outreach that promotes HIV/AIDS prevention through
other behavior change beyond abstinence and/or being faithful: 45,000
Number of individuals trained to promote HIV/AIDS prevention through other behavior change beyond
abstinence and/or being faithful: 380
Continuing Activity: 15344
15344 9598.08 U.S. Agency for Population 7269 7269.08 PSI - Vietnam $1,000,000
9598 9598.07 U.S. Agency for Pact, Inc. 5180 3102.07 Community $875,000
* Addressing male norms and behaviors
* Increasing women's legal rights
Estimated amount of funding that is planned for Human Capacity Development $121,000
Table 3.3.03:
BREAK THE CYCLE: $300,000
Many prevention interventions in Vietnam focus on potential "core transmitters" such as injecting drug users
(IDU) and commercial sex workers (CSW) who are already engaged in very high-risk behavior. The Break
the Cycle (BTC) program seeks to minimize the spread of HIV due associated with drug use by integrating
drug demand reduction into existing behavior change communication and outreach activities targeting most-
at-risk populations.
Preventing the initiation of drug use is fundamental to addressing the upstream cause of most new HIV
infections in Vietnam. The vast majority of current IDU were first introduced to injection drug use by
injecting peers, sexual partners or family members. The BTC program seeks to limit the size of the IDU
population by establishing and reinforcing norms among existing IDU that prevent the introduction of new
users to drugs. Many IDU have regrets that they themselves initiated drug use, and can therefore provide
compelling personal arguments against drug use initiation. Specifically, the BTC program works by
engaging active IDU through peer networks, and encouraging them to:
•Reduce injecting in the presence of non-injectors,
•Reduce discussions about injecting when at-risk youth or non-injectors are present,
•Refrain from teaching non-injectors how to inject, and to
•Develop skills for refusing/managing requests to give others their first injection.
An evaluation of the original implementation of the BTC model in the UK found that the program was
associated with a 50% reduction in injections in the presence of non-injectors, greater disapproval among
IDU for initiating new users, reductions in the number of requests received by IDU to initiate others, and
significant declines in the initiation of new users. With USG support, the model has been adapted and
implemented to support HIV prevention in Central Asia, but this initiative marks the first adaptation of BTC
to the South-East Asian context.
With FY08 funding, PEPFAR will pilot the adaptation and integration of BTC program components into
existing PEPFAR-supported IDU peer outreach programs in two provinces (Quang Ninh and Hai Phong).
Focus groups and surveys among IDU in targeted locations will be conducted to determine local factors
surrounding initiation of injection and to inform adaptation of the existing model to Vietnam.
In FY09, PSI will further adapt the model to the local context and mainstream its implementation through
existing peer outreach programs for IDU in Vietnam. At least 80 peer educators from existing PEPFAR
programs operating in these locations will be trained to implement the intervention. The provision of this
additional training should help to address an often expressed desire on the part of outreach workers to bring
novel educational content to the IDU populations they currently serve. All training, program implementation,
educational materials, and monitoring and evaluation activities will be consistent across program sites. By
leveraging the large existing IDU outreach networks PEPFAR has helped to establish in Vietnam, it should
be possible to efficiently integrate the materials and lessons learned from the BTC pilot into existing IDU
outreach efforts.
other behavior change beyond abstinence and/or being faithful: 5,000
abstinence and/or being faithful: 100
New/Continuing Activity: New Activity
Continuing Activity:
Estimated amount of funding that is planned for Human Capacity Development $60,000
Table 3.3.06:
VCT SOCIAL MARKETING: $1,111,766
In the past several years, PEPFAR has dramatically expanded its support for HIV counseling and testing
(CT) services in Vietnam through a variety of partners and mechanisms, and recognizes that demand
creation and the social marketing of these services to high-risk individuals is essential to increase service
uptake.
As one of the leading social marketing experts in Vietnam, PSI has been awarded the AIDSTAR Task Order
in FY08 to work with PEPFAR on strengthening its HIV CT social marketing program.
In FY09, PSI will continue to use social marketing approaches to increase awareness of and trust in CT
among most-at-risk populations, reduce stigma associated with these services, and increase the capacity of
Provincial Health Departments (PHDs) to develop effective, non-stigmatizing social marketing campaigns.
This campaign has been focused on increasing awareness and emphasizing the confidentiality of services,
the benefits of counseling, and the benefits of knowing one's HIV status.
PSI will carry out regular assessments that will be used to describe effective strategies for targeting and
reaching most at risk populations in a sustainable manner as well as effective approaches, and will continue
to support promotion of a national testing month in COP09 to help reduce the stigma of HIV testing and
encourage more high-risk individuals to seek CT.
PSI will build the capacity of local partners to communicate effectively to high-risk individuals by replicating
a successful series of evidence-based, client-focused CT social marketing programs implemented in eight
PEPFAR focus provinces. These activities are designed to provide a better understanding of the nature and
effectiveness of CT social marketing approaches, and to increase capacity to produce non-stigmatizing and
compelling CT behavior change campaigns. Social marketing training workshops will be offered to
PHD/Provincial AIDS Centers involved in PEPFAR supported CT activities, as well as to organizations such
as Women's and Youth Unions and NGOs involved in CT. Relevant program staff and community outreach
workers who implement CT will be trained in CT Behavior Change Communication (BCC) messaging and
distribution of IEC materials.
PSI will collaborate with other organizations involved in advocacy for Greater Involvement of People Living
with HIV/AIDS (GIPA), particularly the Bright Futures Group, to support the development of locally
appropriate CT social marketing campaigns and promotional materials. Through collaborations with other
USG partners conducting peer outreach programs for most-at-risk populations, PSI will expand uptake of
CT services to individuals with the greatest needs. PSI will continue to work in the eight PEPFAR priority
provinces and will provide training to 100 individuals in social marketing.
Number of service outlets providing counseling and testing according to national and international
standards: N/A
Number of individuals who received counseling and testing for HIV and received their test results (excluding
TB): N/A
Continuing Activity: 15345
15345 5334.08 U.S. Agency for Population 7269 7269.08 PSI - Vietnam $1,200,000
9513 5334.07 U.S. Agency for Pact, Inc. 5180 3102.07 Community $900,000
5334 5334.06 U.S. Agency for Population 3652 3652.06 (INGO- former $515,000
International Services AIDSMARK)
Estimated amount of funding that is planned for Human Capacity Development $111,000
Table 3.3.14:
