Global Program on HIV/AIDS

The Prévention Active et Communication Transformatrice (Active Prevention and Transformative Communication) Program (PACT) is a two-year program (September 2011-September 2013) implemented by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU•CCP) in partnership with USAID, PEPFAR and local partners in Côte d’Ivoire.

The overall goal of the project is to reduce HIV infections, support national programs to improve the quality of care and treatment services and improve lives of people living with or affected by HIV/AIDS using PEPFAR resources. PACT is designing social and behavioral communication (SBC) programs for selected audiences and building the capacity of the Ministry of Health and AIDS and nongovernmental partners to develop and implement SBC interventions.

The Associate Award in India is a four-year project funded by USAID that addresses HIV/AIDS in India. Led by CCP under the Health Communication Partnership (HCP), the project provides technical assistance to the National AIDS Control Organization (NACO) and State AIDS Control Societies to develop a communication response to HIV/AIDS including messaging, product development, and implementation plans under different thematic areas. CCP utilizes behavior change communication (BCC) and advocacy as core approaches to mitigate the impact of HIV/AIDS.

In 2005, the President's Emergency Plan for AIDS Relief (PEPFAR) selected a consortium to implement the USAID-funded Community HIV/AIDS Mobilization Program (CHAMP). The CHAMP consortium included CCP, CHF International, Catholic Relief Services and Social Impact. The program drew upon the expertise of numerous Rwandan partners, including Caritas-Rwanda, the Rwanda Women's Network and the Rwanda Network of People Living with HIV/AIDS, among others. CCP took the lead role in planning, management and delivery of training and technical assistance in BCC and was responsible for designing strategies and messages that resonated with both men and women in urban and rural areas.

Young people in India are particularly vulnerable to HIV infection, with current prevalence among 15-24 years old estimated to be 0.47 percent. This compares with adult prevalence of 0.36 percent (NACO, 2007). Prevention of HIV, through safer-sex behaviors among the young, continues to be the most effective long-term strategy in reducing HIV infection.

The PEPFAR Gender Initiative on Girls’ Vulnerability to HIV (GIGV), the first award under the HIV/AIDS Research Sector TASC 3 IQC, was funded by USAID. Known as the Go Girls! Initiative (GGI), the project was led by CCP in partnership with Macro International. The Initiative shifted the focus from individual risk-taking to contextual factors that render girls vulnerable. The purpose of GGI was to develop, implement and test social, gender and behavior change communication approaches, in an effort to reduce adolescent girls’ susceptibility to HIV infection. Approaches included: addressing contextual factors that present barriers to accessing education; increasing girls resilience through building life-skills; strengthening parents’ and other adults ‘ability to communicate with and support girls; and community dialogue and action. The CCP teams in Mozambique, Malawi and Botswana combined quantitative and qualitative data collection methods to develop a deeper understanding of girls’ vulnerability, evaluate the initiative and disseminate and discuss results with communities and national and international partners.

The Health Communication Partnership (HCP), a five-year project funded by USAID, linked five leading institutions to strengthen public health in the developing world through strategic communication programs. The project was led by CCP in partnership with Academy for Educational Development (AED), Save the Children, The International HIV/AIDS Alliance and Tulane University’s School of Public Health and Tropical Medicine. HCP sought to create an environment that supported individuals, families, and communities to act positively for their own health and to advocate for and gain access to quality services. HCP addressed family planning and reproductive health, HIV/AIDS, maternal and child health, nutrition, safe water and hygiene, and democracy and governance. The project had global reach, implementing programs and providing technical assistance in Africa, Asia, Latin America, the Near East, and Europe/Eurasia.

The Health Communication Partnership Associate Award (HCP AA), a six-year project funded by USAID, addresses individual and community health priorities in Zambia. The project is led by Save the Children in partnership with CCP, the International HIV/AIDS Alliance, the Zambian Government and many local nongovernmental organizations in Zambia. HCP AA builds on the foundation of ZIHPCOMM which changed individual behavior, mobilized communities, created an enabling environment for sound health practices, and made social services more people-centered. CCP uses the strategic approaches of community mobilization, leadership, mobilization of youth, and message harmonization to support Zambian health priorities around HIV/AIDS, family planning and reproductive health, child survival, adolescent health and malaria.

The Health Initiatives in the Private Sector (HIPS) project, a three-year project funded by USAID, works with the Ugandan business community to ensure access to vital health services for company employees, their dependents and the surrounding community. Led by Emerging Markets Group (EMG), the project provides technical assistance to design and implement comprehensive workplace health programs that maximize accessibility to HIV/AIDS, TB and malaria prevention and treatment services. The project also imparts reproductive health and family planning (RH/FP) knowledge. CCP provides technical expertise, partnership brokering and a small grants program to facilitate expanded and improved service delivery, especially to underserved populations and those living in the conflict zones of northern Uganda.

Improved Community Health Care Project Liberia (ICH-Africare) was a five-year project funded by USAID and Africare. Led by Africare, ICH aimed to improve the availability, quality, and reach of primary health care (PHC) and family planning services. CCP worked with local NGOs to design mass media and community-based, behavior change communication activities promoting modern health care and family planning.

The CCP-headed HCP South Africa field office was registered as a local NGO -- Johns Hopkins Health and Education in South Africa (JHHESA) -- in October 2004. Supported by USAID, JHHESA provides technical assistance and financial support to over 16 local institutions working at the national, provincial and local levels to build capacity to design, implement, monitor, evaluate, and manage HIV and AIDS related behavior change communication programs in South Africa. JHHESA's partners -- PEPFAR, the Government of South Africa and numerous South African media and civil society organizations -- use a combination of interpersonal communication, community mobilization and mass media to emphasize messages around HIV prevention, treatment, care and support, HIV counseling and testing, and OVC. All of JHHESA's partners' activities fall into one or more of the three domains of South Africa's Pathways to a Competent Society Conceptual Framework: the social political environment, service delivery systems, and communities/individuals.

The Leadership, Management, and Sustainability 2 (LMS2) project is a continuation of LMS, which provided technical assistance to Haiti’s Ministry of Health (MOH) to coordinate and plan interventions aimed at reducing HIV transmission. A five-year project, LSM2 is funded by USAID and led by CCP in partnership with Management Sciences for Health (MSH) and Haiti’s MOH. LMS2 will continue to reinforce the MOH capacity, strengthen the capacity of local organizations involved in HIV/AIDS prevention, and fight against workplace HIV stigma and discrimination. LMS2 is also mandated to coordinate sexual prevention interventions through the existing PEPFAR behavior change communication (BCC) technical working group.

Malawi’s BRIDGE II is the next generation of prevention programming designed to scale up and deepen HIV/AIDS prevention activities in Malawi by removing barriers to individual action and confronting drivers of behavior at the normative/society level.

The BRIDGE II Project is a five-year USAID funded HIV prevention program aimed at promoting normative behavior change and increasing HIV preventive behavior among the adult population in Malawi. The program is implemented by Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP) in partnership with Save the Children Federation (SC), Pact Malawi and The International HIV/AIDS Alliance (Alliance). Local partners include Corporate Graphics, Youth Net and Counseling (YONECO), Galaxy Media Consultants, Story Workshop, and National People Living with HIV/AIDS in Malawi (NAPHAM).

The overall program objective is to contribute towards the reduction of new HIV infections among the adult population in Malawi. By 2014, we envision BRIDGE II will achieve the following outcomes:

• Men and women will have personalized understandings of their HIV risk, and believe they have the skills, knowledge, and motivation necessary to prevent infection.
• Supported by normative change, proactive services, and dynamic institutions, individuals are using available HIV services and adopting safer sexual behaviors, particularly those related to a key driver of the epidemic, Multiple Concurrent Partnership (MCP). Their behavior change is deep and lasting, and an inspiration to others.
• Norms are redefined to recognize, value, and reward couple communication about prevention and sero-status, compassion for those with HIV and AIDS, protection of self and others, gender equity, and rejection of cross-generational sex, alcohol/substance abuse, and harmful traditional practices.
• HIV and other health care providers never miss an opportunity to provide both HIV negative and positive clients with proactive information, counseling, and referral. They will do this through traditional venues, such as client visits, and new approaches, such phone hotlines, cell phone technology, and community events.
• Malawian institutions are taking the lead in HIV prevention in an atmosphere of coordination and collaboration, with a vibrant exchange of ideas, information, and best practices.

BRIDGE II is a strategic, evidence-based communication program that builds on the Nditha! [31] (“I can”) brand developed under BRIDGE I [32], a USAID funded HIV Prevention project that was led by CCP from 2001-2008. Through the combination of proven community methodologies, interpersonal communication and innovative approaches, BRIDGE II is scaling-up BRIDGE I’s [32] successes while confronting specific drivers of HIV such as multiple concurrent partnerships (MCPs), alcohol/substance abuse, women’s vulnerability, and male norms, and promoting collective efficacy and normative change. In addition, BRIDGE II is linking prevention and referral systems with other HIV/AIDS-related services through existing networks while using m-health to increase access while strengthening forums for exchange of ideas, research, and strategy harmonization, and building capacity of local institutions to lead a coordinated and sustained HIV prevention effort.

The Measure DHS project, funded by USAID, is a five year project implemented by ICF Macro. The DHS program provides assistance to countries with the Demographic and Health Survey, the Service Provision Assessment (SPA) Survey, the HIV/AIDS Indicator Survey (AIS), Malaria Indicators Survey (MIS) and qualitative research. prjoect. Since October 2008, ICF Macro has partnered with five internationally experienced organizations CCP, PATH, The Futures Institute, CAMRIS Internatonal, and Blue Rastter to expand access to and use of the DHS data. CCP's role focuses largely on dissemination activites at both the country and global level.

The Regional Outreach Addressing AIDS through Development Strategies (ROADS) project, a three-year project funded by USAID, addressed HIV prevention along the transport corridors of East Africa. Led by Family Health International (FHI), ROADS aimed to reduce HIV transmission, improve care, and reduce the impact of HIV and AIDS along Kenya and Uganda’s highways. CCP assisted ROADS in strengthening the institutional and technical capacity of implementing partners, as well as HIV and AIDS professionals. CCP developed approaches and tools for emerging issues, such as alcohol abuse and gender-based violence, and built the capacity of community-based partners to implement effective community outreach.

Roads to a Healthy Future, a four-year project funded by USAID, builds on its predecessor, the Regional Outreach for Addressing AIDS through Development Strategies (ROADS) Project. Led by Family Health International (FHI), Roads to a Healthy Future seeks to fund new approaches and support African regional partners to design and expand HIV prevention and health activities in transport communities in Kenya and Uganda. The purpose of the project is twofold: to increase access to multi-sectoral HIV/AIDS, health, and other services for mobile populations and vulnerable communities along East African transport corridors; and to increase the capacity of African regional institutions to support rapid scale up of innovative practices in HIV and health. CCP partners with African institutions to advance strategic communication in health and development. CCP also provides technical assistance in a number of health areas and support the African Network for Strategic Communication in Health and Development (AfriComNet).

Staying Alive is MTV's global HIV/AIDS awareness and prevention campaign aimed at youth. As a new extension of this project, MTV is repackaging and expanding Staying Alive materials for use by community-based youth outreach groups in an initiative dubbed, “Staying Alive in a Box.” With one year of funding from the Bill & Melinda Gates Foundation, CCP is leading a series of research studies that will provide formative input into program development, monitor implementation and assess impact of this initiative in three countries: Kenya, Zambia and Trinidad & Tobago. The research will include baseline and end-line surveys, reception analysis, focus group discussions and feedback from listening groups. Results of the studies will strengthen the Staying Alive in a Box strategy and demonstrate the potential of local community-based interventions tied to an international movement to shift youth norms, reduce stigma associated with HIV/AIDS and reduce risk behavior.

Strengthening the AIDS Response, Zambia (STARZ), a five-year project funded by DFID, was a technical assistance program that provided institutional strengthening to the National AIDS Council (NAC) as well as civil society and the private sector to better coordinate and implement the national response to HIV and AIDS. STARZ also strengthened the ability of NAC to collect and disseminate strategic information, including the establishment of a national monitoring and evaluation system and the national resource centre, to facilitate information dissemination. These aspects of the programme were fully integrated into the NAC structures. Beyond that, STARZ provided over 10 million USD in small and medium grants to communities and NGOs, and provided support to the private sector for the mainstreaming of HIV and AIDS.

Tchova Tchova, Juntos Vamos Mudar (Moving Forward Together We Will Change), the Social and Behavioral Change Communication project for HIV/AIDS Prevention, Treatment and Capacity Building was a three-year project in Mozambique funded by PEPFAR. JHU•CCP led the project in partnership with World Vision, the International HIV/AIDS Alliance and N’Weti to support the Mozambique Ministry of Health, National AIDS Council, and many civil society and media organizations. The project aimed to reduce HIV transmission and stigma in Mozambique and increase use of HIV services. CCP implemented a coordinated communication approach that integrated related PEPFAR priorities to target one of the main drivers of the HIV/AIDS epidemic--multiple concurrent partners--by tackling underlying social and gender factors.

Ex-Offenders in Baltimore participate in reducing structural risk through service provision and housing reconstruction.

The TLC’s program, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), seeks to address individual and structural sources of risk for the ex-offender population returning to selected communities in Baltimore. The project will seek to show that observed positive changes in structural risk are associated with decreased prevalence of Substance Abuse and HIV among re-entry residents. The focus will be on men, 21-50 years old, who have been released from prison or jail in the last 2 years. Phase I involves profiling the TLC Project Area in terms of socio-demographic, epidemiological characteristics, and available resources. Phase II is the intervention phase which involves a two part intervention strategy that will address the short-term individual sources of risk and expand upon the existing, long-term initiatives that make up TLC (there is a job training program, house reconstruction and in-house counseling and medical referral service that is supported by the Open Society Institute and the Abell Foundation). Phase III will involve reentry participants directly as they work with TLC staff to develop and implement action plans. These plans will focus on providing a peer driven approach that combines the long-term strategy of structural change with the short-term strategy of implementing prevention programs. Plans will target opportunities to address behaviors, programs, policies, or practices associated with SA and HIV acquisition and transmission. Johns Hopkins University School of Medicine will work with the Center for Communication Programs at the Bloomberg School of Public Health to provide program direction as well as the development of the monitoring and evaluation system and epidemiological support.