We aim to improve the sexual and reproductive health and rights (SRHR) of one million young people affected by HIV across five countries in Africa and Asia. Link Up consortium

Partnership and Practical Impact 3 years, 5 counties, with opportunities for scale-up 3 years: 2013 - 2016, funded by the Dutch Foreign Ministry (BUZA) $43.8 million reaching more than 1 million young key population groups 5 countries: Bangladesh, Burundi, Ethiopia, Myanmar, Uganda Diverse contexts - different challenges - definite opportunities! Partnership and Practical Impact AIDS Alliance: Lead organisation MSI: SRH service delivery and commodity procurement in Bangladesh, Myanmar & Uganda Stop AIDS Now!, Athena Network and Global Youth Coalition on AIDS: Global policy partners Population Council: Research (evaluative & operational)

Overview: purpose, focus, contexts Purpose: To increase health seeking behaviours and uptake of quality integrated maternal health, family planning and HIV information, services and commodities amongst young people affected by HIV and uphold their sexual and reproductive rights. Focus:Young people (10-24 years), Key populations including young people living with HIV, young people who sell sex, young MSM, young transgender people and young people who use drugs. Context specific: The project is adapted to fit each country’s specific context and HIV epidemic and is based on four key essential elements Community mobilisation and demand creation for integrated HIV & SRHR information, services and commodities Provision of quality HIV & SRHR integrated services for young people Strengthening community and clinical capacity to delivery integrated services Increased participation of young people affected by HIV in advocacy for their SRHR.

What is Link Up about? Young people Key populations Community-based peer outreach Policy advocacy Integration of HIV and SRHR Stigma Gender Two points: -We talk about Link Up as being an integration project -We know that in addition to just focussing on integrating services, we need to tackle a lot of other essential issues Human rights What is Link Up about?

Link Up Outcome Core indicators 1 Community Young people affected by HIV reporting improved self efficacy to make healthier choices through a supportive environment at peer, family and community level (431,231) 3 Capacity building Service providers and civil society organisations demonstrate increased capacity and deliver improved SRH/HIV services (2,298) 2 Clinical Services Percentage increase of Young women affected by HIV with unmet need for family planning met. (With access to HIV/SRH commodities (116,552) 4 Policy & Advocacy Young people affected by HIV participating in local, national, and global SRH/HIV advocacy activities SW MSM Could we put pictures of real young people (maybe from Burundi/Ethiopia/Myanmar pics from documentation trips) to the left and right of the table, rather than the icons? It would bring the presentation alive from the outset. Not sure what VY is. I would talk about reaching 1 million young people with community based services; 140,000 with clinical services; training 1629 service providers and supporting policy and advocacy VY PLHIV

Education & services in communities Access 2 clinical services Model Peer educators Service providers Demand Creation Community spots Clinics Capacity Building Education & services in communities Advocacy Access 2 clinical services I would suggest we delete this slide as it repeats slide 3. The triangle doesn’t quite work for me in terms of conceptualising the four areas. I think the diagram on slide 3 works better. The table describing links between community mobilisation and clinical services – perhaps it would be better described through the two country examples.

Education and services Capacity building of service Providers Access to services Young People Advocacy and Policy Education and services in community

Programme Models In generalised HIV epidemics (Burundi, Ethiopia, Uganda) Link Up will work with young men and women aged from 10-24 who are most at risk and/or are living with HIV to integrate SRH into existing HIV services, and vice versa. In these settings, the majority of young people aged 10-24 are highly vulnerable to HIV - especially girls with HIV prevalence between 3-4% and high rates of unintended pregnancies and unsafe abortions. Link Up will work with youth as a way to reach young people most in need i.e. adolescent girls and boys and young women and men living with HIV, young married women, adolescents and young men and women with multiple concurrent partners, adolescents and young women in intergenerational relationships, girls and boys who are sexually exploited, young people who sell sex and young men who have sex with men (MSM). In concentrated epidemics (Bangladesh and Burma) Link Up will work with people living with HIV and key population groups such as sex workers and MSM to integrate SRH into existing programmes as an entry point to reach young people affected by HIV.

link up research: learning and evaluating Eileen Yam, Population Council, Washington, DC, USA

What is the Link Up research agenda? Conduct exploratory research? Evaluate Link Up activities?? Generate evidence for policy advocacy? Test HIV-SRHR integration strategies? Conduct community-based participatory research?

Four broad categories of research activities Evaluate the “Link Up model” in three countries Bangladesh, Myanmar, Uganda Test strategies to address operational issues Conduct exploratory research to fill critical global knowledge gaps Engage community members in participatory assessment activities

Evaluating the Link Up model: generating demand in communities Peer outreach in communities Strengthened facilities Active referrals VOUCHER VOUCHER VOUCHER VOUCHER Bangladesh female sex workers (FSWs) Myanmar men who have sex with men (MSM) Uganda young people living with HIV (PLHIV)

Link Up research: testing strategies, filling knowledge gaps Country Population Study overview Bangladesh Health care providers Testing a two-part stigma reduction training Uganda Males and females, ages 10 to 24 Household survey examining gender attitudes Ethiopia Female sex workers ages 18+ who have been pregnant Qualitative study examining their experiences with pregnancy Male pavement dwellers ages 15 to 24 Qualitative and quantitative study examining their SRHR needs, service access

Link Up research: engaging communities Country Population Activities Myanmar Myanmar Youth Stars (MYS) participants Participatory capacity-assessment activities Burundi Link Up partners, community members, and other local stakeholders Year 2 and Year 2 program evaluation workshops

Timelines Baseline data collection completed for three Link Up model evaluations and the Bangladesh provider stigma reduction trainings Endline data collection planned for Q2, 2015 Year 3 Burundi workshop planning under way MYS capacity assessment planning under way Exploratory studies planned for Q2-Q3, 2015 Ethiopia FSW pregnancy study data collection completed in Q3, 2014

Lessons learned for Project and Partnership Diversity: Young people from key population groups have different and specific needs between groups, as well as within the groups according to age, literacy levels, family circumstances etc Coordination: Link Up has many partners, incorporating many different departments within the consortium partners, and we have learnt programming lessons from some of the challenges of collaborative working. Due diligence: safety and security, safeguarding guidelines, and due diligence in terms of program management Context specific: working within existing legislative boundaries while trying to transform them Youth leadership: takes investment and innovation, as well as to create opportunities and spaces to expand opportunities to more and more young people through the life of the project. Scaling-up Link Up? Other countries - building on lessons learnt Other key population groups within existing countries Expand to more partners (such as public sector health care facilities) in each of the existing countries

THANK YOU Lucy Stackpool-Moore Senior Advisor: Sexual and Reproductive Health International HIV and AIDS Alliance lstackpoolmoore@aidsalliance.org Eileen Yam Associate, HIV/AIDS Population Council eyam@popcouncil.org

Thank You