Increasing Access to and Uptake of HIV Prevention, Confidential Voluntary Counseling and Testing and Care among the Uniformed Services, their Partners, Migrant Populations, and Truck Drivers in the Republic of Côte d'Ivoire Under (PEPFAR)

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The dual purpose of this program is to strengthen HIV/AIDS prevention and care among uniformed personnel and their families, and to build synergies between prevention programs with these groups and other vulnerable mobile populations such as transport workers, migrant workers, sex workers and communities along highly travelled transport corridors. The two programs, while distinct, should be tangentially linked. Officers of each of the uniformed services have established formal or informal barriers along transportation routes and can contribute to the vulnerability of mobile populations through negative practices such as intimidation or trading sex for safe passage. Specifically, the recipient of this award will strengthen the capacity of the Ivoirian uniformed services (military, gendarmes, national police, customs, water and forest agents) to expand quality HIV prevention, behavioral and change communication (BCC), confidential HIV counseling and testing (CT), and treatment of sexually transmitted infections (STI) by ensuring that medical service providers, counselors and trained peer educators can provide quality programs that target the uniformed service members and their partners/families. Activities should also address structural barriers to service delivery through advocacy with senior leaders in each uniformed service to: 1) increase local resources for support programs; 2) enact policies and practices to extend the time between transfers among trained peer educators so they can be more effective in their roles; and 3) provide support for service members' spouses to conduct care and support activities for people living with HIV/AIDS (PLWHA) and vulnerable children on and near their base. This agreement includes building on or continuing existing prevention approaches (such as personal risk assessment, condom demonstration, STI education and testing mobilization with truckers) and conducting research to better target HIV prevention, care and treatment programs for mobile populations. Increased access to, and uptake of, prevention services among mobile vulnerable populations are intended to lead to safer sexual behaviors, including abstinence, fidelity, and correct and consistent condom use for populations engaged in high-risk behavior. To promote sustainability, programs for truckers and other transportation workers should include: building the capacity of the Syndicat of Transport Workers; working in partnership to conduct basic situation analyses, Knowledge, Attitude, Practice and Behavior (KAPB) studies, updating strategies based on data in BCC for HIV prevention; promoting condom service outlets, and mobilizing HIV testing and referrals to local care and treatment programs. The agreement should also develop initiatives to foster partnerships between the Syndicat of Transport Workers (or other organizations responsible for operation of truck and taxi stations), businesses, regional or community-based organizations to connect vulnerable children and women with income generation and training or apprenticeship opportunities to reduce vulnerability. The agreement should engage public-private partnerships and provide alternatives to transactional and commercial sex work in and near the truck and taxi stops. This program will also engage and sustain community involvement and build system capacity to adapt, implement and monitor HIV prevention through evidence-based interventions. The program will promote the use of HIV care and treatment services through a strong referral network to complementary programs for each of the two components of this agreement (uniformed services and transport corridors). Along with the Ministry of the Fight Against AIDS (MLS) the grantee will support function of the national integrated coordination platform for uniformed services, and actively contribute in meetings of the National HIV Prevention for Highly Vulnerable Populations technical working group (GTTHVP) and other relevant coordination bodies to facilitate joint planning and implementation of HIV prevention, testing, and care and treatment referral strategies, activities and operations research. These approaches are complementary and will help promote broader individual and group interventions within a community-based framework. Monitoring and evaluation of all programs and interventions will be essential in measuring the success of these activities.

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