Learning and Empowerment: “Key Issues in Strategies for HIV/AIDS Prevention” March 1-5, 2004, Chiang Mai Presented by Dr. Pum Sophiny, Program Officer for Frontier Prevention Project (FPP) Khmer HIV/AIDS NGO Alliance (KHANA)

030412MB_GAE005(AIDS initaitive)(HV)(dx) 1 Background to HIV/AIDS in Cambodia and KHANA’ s Response Cambodia has the most serious epidemic in the region- HIV prevalence rate of 2.6% and estimated 159,000 people living with HIV/AIDS. Khmer HIV/AIDS NGO Alliance (KHANA) established in 1996 as a project of the International HIV/AIDS Alliance registered as national NGO with national Director in 2000 KHANA currently provides technical and financial support to 45 Local NGOs in 14 Provinces and 2 municipalities to implement HIV prevention, care & support and advocacy activities USAID support for KHANA is through the International HIV/AIDS Alliance, who continued to provide ongoing technical support to KHANA KHANA receives direct funding from Global Fund, JSDF/World Bank, JICA, UNAIDS (small grant) and EU/UNFPA

030412MB_GAE005(AIDS initaitive)(HV)(dx) 2 KHANA Mission To contribute to a reduction in vulnerability to HIV/ STIs and the impact of AIDS by building the capacity of the NGOs/ CBO sector, and by strengthening strategic alliances with government and other key stakeholders to develop and scale up effective and sustainable responses to HIV/AIDS and STIs.

030412MB_GAE005(AIDS initaitive)(HV)(dx) 3 KHANA Strategic Objectives To develop and scale-up effective HIV prevention, care & support and impact mitigation responses by building technical capacity on HIV/AIDS/STIs of local NGOs/ CBOs to support vulnerable groups To increase the role of NGOs/CBOs to play a key part in a civil society response to HIV/AIDS by building their organisational and financial management capacity. To support the growth and scale-up of community action on HIV/AIDS through the provision of grants and support to secure financial resources. To improve the effectiveness of community HIV/AIDS responses by identifying and sharing good practice and lessons learnt at local, national and international level. To develop an effective response to the HIV/AIDS pandemic by strengthening strategic alliances with government, NGOs/CBOs and other key stakeholders at national and international levels. To reduce stigma and discrimination of vulnerable groups, in particular PLHA; and to promote access to comprehensive HIV/AIDS/STI services by strengthening the partnership with government in the area of policy development and policy change.

030412MB_GAE005(AIDS initaitive)(HV)(dx) 4 Background to Frontiers Prevention Project (FPP) FPP aims: To make a significant contribution to reducing HIV infections in relatively low-prevalence countries include Cambodia that are put at risk by the growing HIV pandemic. FPP works with four different types of key populations: Direct Sex Workers (DSW) Indirect Sex Workers (IDSW) People Living with HIV/AIDS (PLHA) and Men who have sex with men (MSM) KHANA are implementing FPP in the three different sites in Cambodia: Sihanouk Ville, Siem Reap and Battambang

030412MB_GAE005(AIDS initaitive)(HV)(dx) 5 FPP theoretical framework Empowerment for prevention forKPs Service and Commodity provision for KPs Enabling Environment Decrease in HIV Incidence amongst KPs Decrease in KP risky behaviour Decrease in KP STI Prevalence Decrease in HIV Incidence in site GOAL/IMPACTPURPOSE/ IMPACT INTERMEDIATE OUTCOMES (green “bubbles) ACTIVITIES/OUTPUTS (White “arrows”)

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7 Participation of Key Populations in FPP Frontiers Prevention Project (FPP) targeting key populations started in November 2002; Key Populations recruited to form assessment teams to conduct Participatory Site Assessment (PSA); Key populations presented the results from Participatory Site Assessment (PSA) to local stakeholders, including key governmental officers, NGO representatives; Key populations were involved in project design in three selected provinces in Cambodia (Battambang, Sihanouk Ville and Siem Reap); Members of key populations were recruited and employed by the NGOs to support the implementation of the project eg as Field Project Support Staff. Other participate as project volunteers; Key populations participate in ongoing project monitoring and regular reviews of project progress

030412MB_GAE005(AIDS initaitive)(HV)(dx) 8 What are the main activities of the Frontiers Prevention Project (FPP)? 8 Interventions clusters have been identified: 1. Strengthening (NGO & others) capacity to work with KPs 2. Implementing peer outreach activities 3. KP collective mobilisation for advocacy 4. Implementing KP mutual support, cultural and solidarity building activities 5. Implementing KP risk reduction skills building activities 6. Developing & disseminating IEC for KPs 7. Strengthening clinical capacity and quality of services 8. Implementing anti stigma and HIV prevention with general public

030412MB_GAE005(AIDS initaitive)(HV)(dx) 9 PSA Workshop in Cambodia

030412MB_GAE005(AIDS initaitive)(HV)(dx) 10 Feeding back PSA Findings in Cambodia

030412MB_GAE005(AIDS initaitive)(HV)(dx) 11 Major Highlights and Achievements Number of key populations reached since the start of FPP: 800 People Living with HIV/AIDS (PLHA) 4650 Men who have sex with men (MSM) 3138 Direct and Indirect Sex Workers (DSW and IDSW) 2600 General Population 225 Gate Keepers (eg brothel owners, police, beer companies) Creation of MSM Networks Decreased stigma and discrimination among key populations Key populations actively participate in advocacy campaign Female sex workers have been acknowledged their rights and gained support from governmental officials

030412MB_GAE005(AIDS initaitive)(HV)(dx) 12 Key Challenges Takes time to build capacity of key populations and to increase their confidence; Many demands and needs of key populations and difficult to respond to all; MSM still hidden populations in Cambodia and therefore difficult to reach all

030412MB_GAE005(AIDS initaitive)(HV)(dx) 13 Lessons Learned: Involvement of key populations as outreach workers increases number of clients reached; Involvement of key populations in assessments, project design and implementation increases the effectiveness of projects and empowers those key populations involved; Establishment of site coordinator increases the coordination of prevention activities; Creation of safe space for key population is an important strategy to build social capital and peer support.

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