1. Africa Impact Evaluation Program on AIDS (AIM-AIDS) Cape Town, South Africa March 8 – 13, 2009 1 Ethiopia Behavioral Change interventions in MARPs Meskele Lera Tsegay Legesse Tsegay Legesse Florence Kondylis Tiruye Damtew Mengistu Kefale Tibebu Asfaw

2. Background The community conversation which is widely implemented in the country has resulted in increased uptake of services, particularly HCT and ART. There are studies indicating increase in risky behavior

3. Intervention Target groups: Migrant workers (Construction Industries: Roads, housing, power plantations, agro industries) and people in the surrounding areas. –Unit of Intervention: Hotspots & surrounding communities –Planned Coverage: Nation wide, with multi-arm intervention

4. Intervention (1) Intervention: MARPs Community Conversation and Peer education Treatment Group I: sensitization, condom promotion and distribution, STI, peer to peer education, Treatment Group II: sensitization, condom promotion and distribution, STI, peer to peer education and, MARPs community conversation Controls: sensitization, condom promotion and distribution, STI

5. 5 Questions “What interventions would lead to better behavioral change among MARPs and surrounding communities?”

6. 6 Expected outcome 1.Increase in comprehensive knowledge 2.Reduction in multiple sexual partnership 3.Increase condom use 4. Increase uptake of HCT and STI services 5.Reduction in HIV Prevalence

7. 7 Evaluation Design (1)  Mapping of MARPs & their surrounding population,  MARPs type and population size  Type & size of surrounding population  Identification of existing interventions  Design: randomized experimental design into treatment and control groups: oIntervention areas will be defined as hotspots & surrounding communities that lie within 5 kms radius of the identified hotspots.

8. 8 Sample and Data Sample –Treatment & control sites will be selected randomly based on: Mapping of MARPs and their surrounding population

9. Source of Data MARPs Nation wide surveys (2009) EDHS (2010) BSS (2009) Population based Sero-survey Service reports Baseline for the selected groups

10. 10 Staffing Plan National Evaluation Team will be established (HAPCO, MoH, EHNRI, CSA, Universities, EPHA, WHO, CDC, World Bank, UNAIDS, National & international Consultants

11. 11 Timeline 1.Refine and finalize the concept note,End of Mar.09 2. Mapping of MARPs and surrounding Communities April –Mid June 09 3. Identify treatment and control groupsEnd of July 09 4. Set Impact Evaluation design Mid of August 09 5. Design evaluation instrumentsEnd of August 09 Select and train data collectorsMid of September 09 collect baseline data End of September- 1st Week of November 09 Initiate the interventions in the groupsJanuary 2010 onwards Progress follow up evaluationEvery six months Make Impact evaluationJanuary-Feb. 2011 Disseminate the findingsMarch 2011 Draw lessons learned and scale upApril 2011

12. 12 Budget Using existing resources from various sources Integrating with the national plan

13. 13 Thank You