PEPFAR Final

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					USMHRP PEPFAR
EXCHANGE                                                                                       Volume I, September 2008




ENGAGING YOUNG PEOPLE THROUGH YOUTH CENTERS
Programs reach out to local youth to enhance education and
increase prevention, care and treatment services

The youth center in Kericho offers a           and lifestyle,” says Wyckliffe Obwiri, the
dynamic approach to behavior change and        HIV Prevention Program Assistant Manager
HIV prevention. The program combines           for PEPFAR Services in Kericho, Kenya.
recreational services as well as counseling
and testing services, which has proven         The Kericho Youth Center has been
successful in reaching out to the area youth   instrumental in ensuring that young people
between the ages of 15 and 24.                 in the district learn their HIV status, which
                                               is an important aspect to prevention and
“Services and messages for sexual healthy      access to care and treatment of HIV/AIDS.
development targeted at the youth needed
to be different and adapted to their culture   Simon Wahome, the center’s director,
                                               explains how the Kericho Youth Center has
                                               evolved to serve diverse populations. “We
                                               are currently working with vulnerable
   Welcome to the first issue                  populations to provide VCT services for
   of the PEPFAR Exchange, a                   groups such as street families and
   newsletter to share ideas                   commercial sex workers through
                                                                                               XVII International AIDS Conference
   and information for the                     moonlight (night-time) VCT, and the rural
                                               population through mobile VCT services.”           George Mwidu, MUWRP Prevention
   U.S. Military HIV Research                                                                      Coordinator (left) and Mark Breda,
   Program’s (USMHRP)                          Recreational activities like foosball, ping-
                                                                                                 PEPFAR Program Manager, in Mexico
   PEPFAR network in Africa.                                                                       City. See page 6 for an overview of
                                               pong and other indoor and outdoor games               USMHRP participation in recent
                                               act as a ‘puller’ to the youth center.                       international conferences.
                                                                       1
Wahome also credits the youth. “Trained       our newly appointed Kayunga District
Peer Youth Educators (PYE) are the            Youth Center Coordinator. The KYC
engine behind the vibrant, interactive        leaders felt that we needed to train out-
and innovative programs implemented           of-school youth to work in HIV
by the Youth Center.”                         prevention; so Moses hand-picked five
                                              male and five female idol youth and they
The center was established in partnership     were trained as peer educators, HIV
with Kericho District Hospital with support   counselors and testers.”
from PEPFAR, and provides testing and
counseling to more than 300 youth per         The Center opened in March 2006.
month on site, 300 through mobile testing     Three years later,” Mark continues, “we
and 100 on moonlight visits.                  have 38 trained youth and these
                                              individuals have turned many of our HIV     KIHUMBE Center
Notes Wahome, “By providing a                 programs around. Now under the              Tanzania
welcoming atmosphere, a broad range of        direction of a Peace Corps Volunteer,
activities and a variety of services, we      they have pretty much taken over the        One of USMHRP’s major partners in
are effectively reaching out and helping      running of the Youth Center activities      Tanzania is Kikundi Huduma Majumbani
thousands of young people.”                   which include sports, games, clubs,         (KIHUMBE), a leader in HIV prevention
                                              competitions, videos and a library.         education in the Mbeya community.
After traveling to Kericho, Makerere
University/Walter Reed Project                ‘Even more importantly, these youth         KIHUMBE has won national awards
(MUWRP) staff members Monica                  provide the bulk of Kayunga District’s      annually from the Tanzanian Art Council
Millard, Country Team Leader, and Mark        community HIV testing, counseling,          and Kilimanjaro Music Awards for their
Breda, PEPFAR Manager, were impressed         prevention, and sensitization activities,   dramas. Along with executing prevention
with the youth center there and decided       with strong emphasis in schools and on      activities, KIHUMBE also provides a
a similar center would enhance their          domestic violence and gender                number of other services, including
efforts in Kayunga, Uganda.                   issues.                                     counseling and testing (CT), OVC services,
                                                                                          and home-based care. KIHUMBE recently
Mark explains, “Our visit to the Kericho      ‘It’s been a win-win-win situation. The     coordinated the building of a new
Youth Center (KYC) provided a catalyst        youth get skills, valuable experiences,     orphanage in Mbeya.
for the expansion and improvement of          and they are quite proud of their
nearly all of our HIV programs. Beyond        contributions; Kayunga District gets        KIHUMBE has developed expertise in large-
all the exciting potential and energy,        valuable, innovative HIV programs           scale media campaigns and helped develop
Monica and I were taken by the way the        implemented and a safe space for their      a local prevention campaign known as
Kericho youth took on leadership              youth; and MUWRP can help implement         “Know the Facts.” KIHUMBE is also a
positions so passionately.”                   these programs with a relatively low-cost   founding member of the Mbeya HIV
                                              pool of highly motivated workers. All       Network Tanzania, a coalition of 13 NGOs/
‘We arranged with to have two of KYC          that... plus the youth are really fun to    FBOs providing HIV prevention and care in
leaders come to Kayunga District and          hang out with.”                             Mbeya Region that collaborate to maximize
advise us on what we needed to do to                                                      impact and coverage of their collective
have our own successful program.                                                          activities and eliminate overlap.
They met with Moses Isabirye, who was



     Prevention Messaging Through Sports
     Uganda

                                                       During school breaks in the Kayunga District, Uganda, the Youth
                                                       Center hosts activities to keep youth actively engaged in positive
                                                       recreational activities. Recently they led a netball tournament, a
                                                       volleyball tournament, two soccer tournaments and an essay
                                                       competition. The tournaments provided a great opportunity to
                                                       share informative messages regarding HIV and health. During the
                                                       halftime breaks, MUWRP staff discussed stigma and HIV with the
                                                       crowd. “It was a good mix of educational information and fun,
                                                       and everyone enjoyed it,” said Katherine Peters with MUWRP.


                                                                      2
                                   Employee Profile
USMHRP HQ Staff
Department of International        Wyckliffe K. Obwiri joined Walter Reed
HIV Prevention, Care, and          Project-Kenya in 2006 as the HIV
Treatment                          Prevention Program Assistant Manager for
                                   PEPFAR Services.
Tiffany Hamm
USMHRP PEPFAR Program              “Having tested HIV-positive at 23, my
Director                           desire to support HIV prevention effort in
thamm@hivresearch.org              the community ballooned to full throttle. I
                                   had barely completed my undergraduate
Andrew Rosa Borges                 studies in Communication and Media
                                                                                 otherwise predispose individuals to HIV
Deputy Director                    technology. I knew my goal was to de-
                                                                                 infection,” notes Obwiri.
arosaborges@hivresearch.org        stigmatize HIV and HIV services, and
                                   promote sustained behavior change
                                                                                 One of the projects he works closely with
Becky Cathcart                     among the most at-risk populations.“
                                                                                 is the Kericho Youth Center, which offers a
Monitoring and Evaluation                                                        dynamic approach to behavior change
Officer                            The program has provided VCT to more
                                                                                 and HIV prevention. The Center has been
rcathart@hivresearch.org           than 100,000 individuals since it began in
                                                                                 instrumental in ensuring that young
                                   2004. “Knowing one’s HIV status
                                                                                 people in the district learn their HIV status
Kelley Lennon                      empowers people to make informed
                                                                                 and gain access to care and treatment for
Senior Program Officer             decisions about their lifestyle that would
                                                                                 HIV/AIDS.
klennon@hivresearch.org

Colleen Caleb
Administrative Assistant
ccaleb@hivresearch.org




Judith Chamberlin
jchamberlin@wrp-ksm.org

Dr. Chamberlin, based in
Kisumu, Kenya, is our new
PEPFAR Program Evaluation
Advisor, with the primary
responsibility of coordinating
the multi-site PHE protocols
and developing a cross-          Clockwise from upper left: Kenyan staff welcomes US visitors with song; DoD HIV Program-
program evaluation focused       Nigeria staff; WRP - Tanzania staff in Mbeya; PEPFAR visit to Galiraya Health Center,
                                 Kayunga District, Uganda.
on quality of services.

                                                        3
                                                                                            Kenya Department of
2008 World AIDS Day                                                                         Defense (KDoD) Tree
                                                                                            Planting
The 1st of December, World AIDS Day, is the
day when individuals and organizations from                                                  During a June 2008 site visit
around the world come together to bring                                                      to multiple KDoD
attention to the global AIDS epidemic. 2008                                                  installations, USMHRP HQ
marks the 20th anniversary of World AIDS Day.                                                staff participated in an
                                                                                             environmental revitalization
                                                                                             tree planting ceremony at a
For more information and resources, visit:
                                                                                             KDoD Voluntary Counseling
http://www.worldaidscampaign.org
                                                                                             and Testing site, 4th Brigade,
                                                                                            Nanyuki. This is one of the
                                                     Kenya Army program facilities that offers VCT/PMTCT services and
                                                     serves as a referral center for those under care and treatment.
HIV Vaccine Awareness DAY


                                                     Peace Corps Volunteers Praise
                                                     Tanzanian Partners
                                                     Peace Corps Volunteer Sheila Porter took the time to thank NGO
                                                     SHDEPHA - a partner of the PEPFAR efforts of the Walter Reed
                                                     Program – Tanzania. In her letter, Dr. Porter said that “The
                                                     SHDEPHA staff clearly believe in the value of their work and this
                                                     genuineness carries over to the villagers. Particular efforts are
                                                     directed toward engaging one of the highest risk groups, young
                                                     adult males.”
Walter Reed Project – Kenya (WRP) once
again marked HVAD on May 18th 2008.                  As Dr. Porter wrote, “It is through supporting change in one
                                                     community at a time, in one small corner of the world, that we
Highlights of the day included a procession in
                                                     can all hope for a better future for the Mbarali District, for
the town’s streets, entertainment and                Tanzania, and for Africa. This in turn will make the world a
speeches, a 10K run, and Volunteer                   better place for us all.”
Counseling and Testing (VCT).
                                                     Peace Corps Volunteer Nancy McCarthy, Ph.D., also sent a letter
                                                     to USMHRP staff in Tanzania after traveling with program
                                                     partners. She accompanied hospital staff, the local dance/
                                                     theatre NGO MMOTA, and representatives of SHDEPHA as they
                                                     went to six under-served villages in the Rujewa ward to promote
                                                     HIV testing and healthy living practices.

                                                     On the way, they encountered many obstacles, including a
                                                     bridge that had been washed away. After witnessing them
                                                     rebuild portions, she noted that, “No-one complained….
                                                     Nothing but energy, optimism and mission in mind.”



To mark 2008 HVAD, MUWRP donated
mattresses to a clinic in the fishing village
of Garilaaya, Uganda.



                                                 4
Nigerian Defense Launches
HIV/AIDS Control Policy
Guidelines
In May 2008, the Nigerian Ministry of Defense and United
States Department of Defense launched the Armed Forces
HIV/AIDS control policy guidelines, as reported in the Daily
Trust newspaper.

Minister of State for Defense, Mrs. Fidelia Njeze, stated, "I am
glad that the Defense headquarters has articulated this
document to guide HIV/AIDS prevention and control activities             HIV Care and Treatment Clinic in Uganda
in the Nigerian Armed Forces. I am equally happy that in line
                                                                         Community members at the opening of the HIV care and treatment
with these policy guidelines, our armed forces have
                                                                         clinic at the Kayunga District Hospital in Uganda, March 2008.
established committees at all levels for the effective
prosecution of the war against HIV/AIDS.”

                                                                         New Infectious Diseases Center in Tanzania
The DoD HIV Program - Nigeria’s PEPFAR Program Manager,
Joanne Katzman, was quoted the Daily Trust newspaper                     Mbeya Center for Infectious
saying “it was gratifying that through the services of the 44            Diseases, a clinic that is part
Nigerian Army Reference Hospital Kaduna, to both the
                                                                               of the Mbeya Referral
military and civilian community, over 7500 patients have                 Hospital, opened in January
been tested, while 2600 and 1400, respectively, have been                 in Tanzania. USMHRP and
diagnosed and treated.”                                                              partners support
                                                                                    one quarter of all
                                                                                      USG-supported
                                                                                     patients on ARTs
                                                                                          in Tanzania.
               Ambassador Mark Green
               (right) presided over the
                   opening ceremony in
                      January in Mbeya,
                               Tanzania.




    Helping Improve Farm Practices
    Uganda

    To address nutritional needs among patients in Uganda receiving ART, MUWRP—through its treatment club program
    —helped support the establishment of a market-driven communal farm. The result: two subsequent harvests have
                                                 benefited all the contributing members. Nutrition is also discussed at
                                                 regular club meetings with supervision from a MUWRP nutritionist. The
                                                 clubs are now expanding this activity and three more farms have started.

                                                        The farming project represents MUWRP’s initiative to utilize HIV
                                                        treatment clubs as an effective way to address the full spectrum of HIV
                                                        services in resource limited settings by successfully linking PLHIV with
                                                        group support, training and community service groups.

                                                        Many of our partners have begun to initiate nutrition and farm practices into
                                                        their services as well.


                                                                     5
USMHRP PEPFAR Programs Highlighted at                                                  Public Health
International Conferences                                                              Evaluations
The 2008 HIV/AIDS Implementers’ Meeting for PEPFAR                                     USMHRP is actively working on an
Kampala, Uganda, 3-7 June, 2008                                                        initiative sponsored by PEPFAR known as
                                                                                       Public Health Evaluation (PHE) studies. PHE
The theme was "Scaling Up Through Partnerships, Overcoming Obstacles to
                                                                                       assess the effectiveness and impact of
Implementation” and attracted more than 1,700 delegates from around the world.
                                                                                       PEPFAR programs; compares evidence-
Dr. Tiffany Hamm, who directs USMHRP PEPFAR activities, served as the
                                                                                       based program models in complex health,
Rapporteur Coordinator. Oral Presentations by USMHRP included:
                                                                                       social and economic contexts; and
  Cheap and Enthusiastic - HIV Clinic Treatment Clubs Provision Key HIV Services       addresses operational questions related to
  with PLHIV Play an Integral Role                                                     program implementation within existing
  George Mwidu, Uganda                                                                 and developing health systems
                                                                                       infrastructures. USMHRP PHE activities
  Success, Optimism, and Unexpected Benefits - Rollout of RTC to Four Rural
                                                                                       include:
  Ugandan Health Centers
  Moses Isabirye, Uganda
                                                                                       Clinic-based ART Diagnostic Evaluation -
                                                                                          Kenya
XVII International AIDS Conference
Mexico City 3-8 August, 2008                                                           PMTCT - Kenya
                                                                                       Facility Based AIDS Care In Kayunga
Program researchers made presentations on a range of topics, including HIV                District (FBAC) - Uganda
prevention, cohort research, and care and treatment. Oral presentations included:
                                                                                       Judith Chamberlin, the new PEPFAR
  Lost patients but not losing hope - tracing ART patients deemed lost-to-follow-up    Program Evaluation Advisor, will be
  at their homes                                                                       supporting USMHRP multi-site PHE
  Alfred Nyero, Kenya                                                                  activities.

  Using male "traditional circumcision" as novel approaches for HIV prevention
  messages: experiences & opportunities from the Southern Rift Valley of Kenya
  Frederick Sawe, Kenya
                                                                                                   Site staff visit PEPFAR HQ
Track 1.0 Anti-Retro Viral Therapy (ART) Meeting                                                   during meetings in the
Washington DC, 11-12 August                                                                        U.S. Pictured here, left to
USMHRP presenters included COL Nelson Michael,                                                     right, are Andrew Rosa
                                                                                                   Borges (HQ), Charles
Charles Sigei and Fred Magala.
                                                                                                   Sigei (Kenya), Ignatius
                                                                                                   Kiptoo (Kenya), Fred
            Visit www.hivresearch.org                                                              Magala (Uganda) and
               for a complete list of                                                              Tiffany Hamm (HQ).
               poster presentations.




                                                   USMHRP PEPFAR Programs:              Exchange Editors:
     The U.S. Military HIV Research                DoD HIV Program - Nigeria (Abuja)    Lisa Reilly, Communications
        Program (USMHRP) is a                                                           Kelley Lennon, PEPFAR
                                                   MUWRP/Makerere University
     multi-disciplinary HIV vaccine                Walter Reed Project (Kayunga)        Please send your story ideas,
   research program that successfully              Walter Reed Program - Tanzania       comments and suggestions to
                                                   (Mbeya)                              PEPFAR@hivresearch.org
    integrates HIV/AIDS prevention,
           care and treatment.                     Walter Reed Project - Kenya
                                                   (Kericho)



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