1. Implementing HIV/AIDS Standard Bidding Clauses Christopher R. Bennett Lead Transport Specialist, GTIDR

2. Some Context: HIV/AIDS and Transport

3. 3  People at high risk (and their families) include  Construction workers away from home  Employees in long-distance transport  People living along transport routes  Commercial sex workers 42% of truck drivers report indulging in commercial sex while traveling; 33% of those who have casual sex don’t use condoms Survey results, Poland and Lithuania border areas (World Bank, 2003) Who is at Risk With Transport?

4. 4 Migrant Workers  Up to 50 weeks away from families  Working in hard conditions  Staying in same sex dormitories/camp sites  Little access to HIV/AIDS prevention information and services  Easy targets for drug sellers  Have ample opportunities to interact with commercial sex workers Thus, they may become a “bridge” for spreading the HIV from high-prevalence to low-prevalence areas

5. Standard Clauses

6. Standard Bidding Documents

7. Revised Version http://tinyurl.com/pcc-clauses

8.  Include clauses as part of bidding document as particular condition of contract  Provide a link to resources  Provide bidders with a list of pre-approved HIV/AIDS providers  Include provisional sum in Bill of Quantity to fund program Implementing

9. Regular Reporting

10. Resources: The Road to Good Health (RTGH) Toolkit www.theroadtogoodhealth.org

11.  Includes specific short-term, intermediate and long- term outcomes  The long-term goals for the campaign are to  reduce the incidence of HIV  reduce stigma and discrimination associated with HIV or AIDS,  increase the protection of human rights for people living with HIV and AIDS, and  increase gender equity RTGH Toolkit

12.  Knowledgeable use of:  good, quality condoms,  voluntary and confidential counseling and testing, and  treatment and care services Need to Ensure

13.  Managers and Supervisors  Workers  Local Community Residents  Commercial Sex Workers Focus on Different Audiences

14. RTGH Contents

15. RTGH Contents (Cont.)

16. RTGH (Cont.)

17. Experience from China

18. 18 Three Phases  Develop Program  Co-ordinate with other agencies  Appropriate materials  Deliver Program  Develop effective intervention plan  Train Educators  Set up VCTs for consultation and testing  Conduct field visits  Evaluate Results

19. 19 HIV/AIDS Intervention Activities  Awareness Raising  AIDS-related posters, booklet and playing cards, educational board, movies, etc.  Text messages to all cell phone users  Face to face education to construction workers

20. 20 HIV/AIDS Intervention Activities  Behavior Change  Set up condom distribution sites & training on proper usage  Activities & trainings at local recreational centers  100% condom use pilot program  Local VCTs & onsite - consultation and testing

21. 21  Covered 100% of the project area  Trained  4,214 construction workers and administrative personnel  4,860 village people in 47/57 villages  Set up 7 VCT sites along the expressway, tested 2,084 persons for HIV and STDs  Set up 83 condom sites and educational material sites Shiman Highway Project (end 2006)

22. 22  Distributed  45,061 copies of handouts  17,286 brochures  2,624 posters  1,237 AIDS playing cards  366 banners and slogan  173 copies of VCDs  25,452 condoms  80,000 text messages to all cell phone users Coverage (continued)

23. 23 100% Condom Use Program initiative at Liupuo  Baseline study of the “recreational places” shows: Liupuo township has 39 “recreational places”, 15 of them provides CSWs (about 60 persons).  Gain the cooperation of the owner of the “recreational places”; train the hotel service staff about HIV/AIDS.

24. 24 Testing Results HIV/AIDSTested6,211 Positive1 STDsTested7,101 Positive1,692

25. 25 Program Outcomes Year: 2004 20052006 STD cases: 2344 1901 1172 Decease(%): 19% 38%

26. 26 Program Outcomes (cont’)  Increased general awareness among the workers and local residents – by 71.4% in 2005 and 52.2% in 2006  Condom sales up 10.4% in 2006 over 2005  No significant change in stigmatized attitude

27. 27 Lessons Learned  Must include local health department  Project must complement existing activities  Target both workers and residents  Means of intervention do matter – innovations (eg cards, text messaging)  Window of opportunity is brief, get the timing and location right

28. 28 Lessons Learned (cont’)  Focus on behavior change  Train ‘peer educators’ among highly mobile workers  Get government and contractor’s buy-in early  Set practical monitoring indicators – stigmatized attitude will not change overnight

29. Questions