Strategies & Activities considered.

1. HIV blood screening

Donor recruitment—including everything related to motivating, educating, recruiting, selecting, screening, counselling and retaining blood donors. Blood collection—including all costs of collecting blood from accepted donors. HIV testing—including the first and any subsequent confirmatory tests. Blood processing—including all costs (except HIV testing) related to the processing of blood, including other testing, blood grouping, preparation of blood products, and all measures taken to ensure safety of blood prior to storage. Blood storage/distribution—including all steps taken in storing and transporting blood through to its final transfusion in hospital. Training—training of all personnel, including laboratory, medical, managerial and support staff. Management and administration—including planning and supervision of the strategy

2.Mass media

Development and production of IEC materials—often includes focus group discussions and market research; testing, revision and re-testing of messages with sample audiences; and translation of the materials into a range of local languages. The costs of the production of the IEC materials, once they are designed, should also be included here. Transmission/distribution of IEC materials and messages—modes and costs of transmission will vary according to the type of media being used. Sometimes these activities will include pre-publicity by advertising firms, for example prior to launching television or radio dramas. Management and administration—including costs of the overheads of the campaign, planning costs and the cost of evaluating the strategy (including baseline surveys and post-campaign evaluations).

3. HIV school education

 Development and production of curriculum and educational materials— includes preliminary work such as focus group discussions and testing, revision and re-testing of messages with sample audiences, as well as the production of the final materials. There may also be continuous production of materials for the project, for example when an AIDS magazine or newsletter is established. Training—a variety of school staff may be taken away from their routine activities and given training to implement the new curriculum. Ideally, training should address teaching methods as well as provide information on AIDS. If the new curriculum becomes an on-going activity, staff should be given refresher training as well as initial training. Implementation of curriculum—comprises in-school teaching activities of the staff responsible for teaching the AIDS curriculum. Management/administration—day-to-day management and administration of the strategy by the overseeing department (for example the Ministry of Education or Ministry of Health); also includes the costs of planning and evaluating the strategy.

4. Condom social marketing

Development and production of IEC materials—may include market research, testing, re-testing and any necessary translation. Although promotional materials may be produced for mass media transmission, some may also be produced for more local distribution, particularly in countries where explicit advertising of condoms is restricted. Local promotional materials may include such items as calendars, diaries, key rings, stickers and T-shirts. Technical assistance from specialist marketing consultants is commonly brought in from time to time during the project. Training—includes retailers receiving some guidance on the correct use of condoms so that they can relay this information, and possibly other HIV prevention information, to their customers. Necessary training may be undertaken by the social marketing organization or contracted to the commercial manufacturer. Transmission of IEC materials/messages—includes all advertising and promotion activities. Activities may include sponsored conferences and professional seminars, award ceremonies for achievement, use of mass media, face-to-face distribution of promotional materials through health professionals, pharmacists, midwives, traditional birth attendants, traditional healers, shopkeepers and itinerant salesmen, and mass distribution in hotels, bars and companies. Condom distribution—includes costs of storing and packaging the condoms as well as distributing them to wholesalers or retailers. Distribution channels may be private or public sector or both. Packaging and distributing may be contracted out. Management and administration—includes day-to-day activities, planning and evaluation activities and technical support from management consultants.

5. STD treatment

Development/distribution of diagnostic and treatment protocols—this may include strengthening of existing laboratory facilities. Training—including clinical and support staff. Diagnosis—includes both laboratory and syndromic diagnosis. Counselling—including drug and condom provision. Partner notification—partner tracing, notification and counselling. Management and administration—including planning, supervision and evaluation

6. Sex worker peer education

Development and production of IEC materials—for the target population. Recruitment of peer educators—can be thought of as a social mobilization component in the project. This activity will occur throughout the lifetime of the project, although the main recruitment will occur at the beginning. Both staff and other peer educators could do this. Training—of all staff and particularly of the CSW peer educators who will have responsibility for conducting the educational sessions; includes refresher training. Transmission of IEC materials/messages—to the target population, through individual and/or group sessions. Condom distribution/sales. Management and administration—including planning, supervision and evaluation of the strategy

7. Counselling & testing

Development and production of IEC materials—clients may be shown a video, or handed educational materials at the pre-test counselling session; materials require development, testing, and production. Training—counsellors need to be trained in appropriate techniques, with fullytrained counsellors available to conduct the training and supervise staff with lesser levels of training. Counselling—pre-test—done with individuals, couples, or groups. Individual counselling may be followed or preceded by a group session, sometimes involving showing a video. Condoms may be distributed free of charge or sold. Blood may be drawn immediately for those who decide to proceed with the test, or at a separate visit. Testing—laboratory testing of blood may be done on site or at a central facility. Counselling—post-test—all individuals may be given their results at a post-test counselling session, or only those found positive. Management and administration—especially for the free-standing centres, there will be a number of management activities to be carried out.

8. Harm reduction

Development and production of IEC materials—often includes focus group discussions and market research; testing, revision and re-testing of messages with sample audiences; and translation of the materials into a range of local languages. The costs of the production of the IEC materials once they are designed should also be included here. Transmission/distribution of IEC materials and messages—modes and costs of transmission will vary according to the type of media being used. Recruitment of peer educators—can be thought of as a social mobilization component in the project. This activity will occur throughout the lifetime of the project, although the main recruitment will occur at the beginning. Both staff and other peer educators could do this. Counselling—designed to decrease risky behaviour, such as sharing equipment. Syringe/Needle Exchange—exchange of used needles/syringes for clean ones. Disposal of contaminated needles—this could include provision of sharps containers, transport, biohazard disposal and possible incineration. Bleaching/Distribution of substances to clean equipment—distribution of, and advice on, cleaning solutions. Condom distribution—includes costs of storing and packaging the condoms as well as distributing them to wholesalers or retailers. HIV testing—including the first and any subsequent confirmatory tests and counselling pre- and post-test. Referral to other services—includes referral to other medical services (e.g. STD treatment), social welfare and legal support. Training—training of all personnel, including laboratory, medical, managerial and support staff. Management and administration—including planning and supervision of the project.

9. Mother-to-child transmission

Strengthening Antenatal facilities—including provision for HIV testing. Training—of staff. Purchasing and storage of ARV drugs and replacement feeding. Counselling—before notification of results, during ARV regimen and for follow-up. Management and administration—including planning and supervision of project and follow-up of mothers and infants.