1. Session 4: Applying Combination Prevention Approaches

2. Session learning objectives
Participant individually practice locating three additional technical resources on specific HIV prevention topics
Participants name three elements of successful HIV prevention activities based on PCV experience
Participants name two appropriate activities and one inappropriate activity for PCVs in priority HIV prevention interventions

3. Have a goal
List goals and objectives from HIV/health sector plan/framework (include national prevention targets)
Include PEPFAR country-specific prevention goals, prevention goals from PEPFAR partnership framework
Refer back to health sector plan/framework. Remind participants that this was designed in consultation with local counterparts, other US Government agencies, and development partners. Include national prevention targets

4. What is effective Target those at highest risk
Address specific risk factors and drivers
Evidence-based interventions have been rigorously evaluated and demonstrated significant prevention effect. They are:
PMTCT
Condoms
ART for people living with HIV
Voluntary medical male circumcision
Prevention programs are more effective when carefully targeting those who are at highest risk (key and vulnerable populations) and addressing risk factors and drivers.
Risk factors and drivers change over time. Messages lose their effectiveness, external changes impact factors and drivers. Ask participants if they can think of examples of how drivers change. Examples may include how the expansion of technology has changed the way people get information and communicate with each other, or the impact of infrastructure like roads increases mobility and people’s social networks. How might HIV prevention needs change for an individual? Give the example of a 16 year old girl who a PCV meets their first week at post. What changes might she go through in the 2 years of your service?
We have worked to better understand the dynamics of risk factors and risk drivers in country. Exercises like Know your Epidemic & Know your Response and Modes of Transmission studies are designed to better forecast where new HIV infections are coming from and collect information about which actors are involved in HIV activities. Those documents are available for review, but national prevention plan should reflect these exercises provide. Provide hyperlinks in handout 1or include these documents on a resource CD ROM.

5. What is effective
Activities that meet minimum standards means activities are “promising” based on sound theory and demonstrated effectiveness.
These include
YSRH programs
Programs to combat stigma and discrimination