Comprehensive Community HIV Prevention Program for Key and Vulnerable Populations (CP2)

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The program’s goal is to contribute to the improved health status for all Tanzanians through a sustained reduction in new HIV infections in Tanzania in support of the Government of Tanzania’s (GoT) commitment to HIV prevention. The primary implementation approach is achieving high levels of coverage, or saturation, among priority populations within a defined geographic area with the appropriate mix of population-specific behavioral, biomedical, and structural interventions. In order to maximize HIV prevention efforts and address epidemiologic trends, specific at-risk groups have been identified as critical to halting the spread of the epidemic. These comprise key populations, including sex workers (SWs) and men who have sex with men (MSM), as well as vulnerable populations, including vulnerable young women ages 15-24, clients of sex workers, men in mobile occupations, and other populations at heightened risk per local context and epidemiology. Within both key and vulnerable populations, the CP2 will reach PLHIV to promote a positive healthy lifestyle with dignity and to prevent onward HIV transmission. CP2 will support the implementation of GoT, PEPFAR, and internationally recommended policies for SWs and MSM. Programmatic elements include empowering peer-led outreach, integrated community services with drop-in centers, the provision of condoms and lubricants, community-based HIV testing and counseling (CBHTC), family planning (FP), community-based care, referrals for sexually-transmitted infection (STI) and TB diagnosis and treatment, and tracked linkages to treatment for those infected with HIV. Among vulnerable populations, CP2 will provide skills to engage in sexual risk reduction, promote positive male engagement in various settings, increase knowledge of HIV status through CBHTC, offer FP services, and link clients to more specialized FP and comprehensive care and treatment services. CP2 will actively collaborate with health facilities to return to care HIV-positive beneficiaries who have been lost to follow-up. Those who are diagnosed as HIV-positive through CBHTC will be measurably linked to comprehensive, facility-based care, treatment, and family planning services. Those who are diagnosed as HIV-negative will be guided through risk-reduction planning and supported in accessing other community- and facility-based services, including VMMC. Innovative, yet practical and measurable tracking referral systems will help ensure that priority populations, irrespective of HIV status, benefit from the appropriate package of behavioral, biomedical, and structural interventions. Fundamental to CP2 results is communities’ engagement in and ownership of comprehensive HIV prevention services. Community leaders, networks, businesses, civil society organizations (CSOs), and local government authorities (LGAs) will understand their epidemic and provide and advocate for quality HIV prevention interventions in their communities. Many of these services will be increasingly supported and funded through the public and private sectors and civil society. Over time, communities will grapple with and address harmful norms that place Tanzanians at risk of HIV. This includes taking a gender-conscious approach and institutionalizing gender equity and meaningful male involvement messages throughout project’s activities. Underlying this program is a focus on sustainability that will help ensure a long-term return on USAID/Tanzania’s investments. A robust learning agenda will guide both program implementation and Tanzania’s national response to HIV prevention, and document the outcomes of program interventions. There is a particular need to demonstrate evidence of effective structural interventions in the Tanzania context, as well as how geographic areas can progressively achieve saturated coverage of a combination package.

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