Part II The AMTP IV Strategic Plan

A. GUIDING PRICIPLES

The formulation of the AMTP IV aws guided by the following principles:

1. The formulation anf implementation of socio-economis development policies and programs should include consideration of the impact of HIV/AIDS infection. Responses to STI/HIV/AIDS should be mainstreamed in national and local development plans. Resources should be equitabl;y allocated taking into consideration the needs of different populations;

2. Multi-sectoral involvement is essential to the planning, execution and monitoring of the national and local responses to HIV infection. People should be empowered to prevent further STI/HIV transmission in all settings and situations;

3. Mainstreaming of treament,care and support services for the infected and affected into existing health and social services should likewise be pursued;

4. The dignity and rights of persons infected and affected by HIV/AIDS and that of health care providers must, at all times, be promoted and respected;

5. All efforts should be harnessed to ensure the genuine and meaningful involvement of the persons infected and affected by HIV/AIDS at all levels of policy-making, project design, implementation, monitoring and evaluation;

6. HIV interventions should be voluntary with quality information and guaranteed with utmost confidentiality; and,

7. Efforts should be constantly improve HIV-related programs and adopt gender-responsive and rights-based approaches.

B. POLICY DIRECTIONS

The directions of AMTP IV for 2005-2010 will be geared towards the following:

1. Efforts must be geared towards the prevention of the further spread of HIV infection and to reduce the impact of the disease on individuals, families and communities;

2. It must ensure that measures and programs undertaken are responsive to the identified needs of concerned sectors, individuals and groups;

3. Priority must be given to the infected and affected as well as to existing and emergent highly-vulnerable groups, especially those not covered in the AMTP III, which include OFWs, youth, infected and affected children;

4. Quality improvement in the design and implementation of STI/HIV/AIDS interventions must be given due attention. Systems to monitor and measure quality of every intervention must be put in place;

5. Scaling-up and expansion of effective intervention measures must be pursued and given ample resource support;

6. It shall embody all on-going assisted projects and programs on HIV/AIDS to ensure integration, harmony of purpose and direction and avoid overlaps;

7. It must include mechanisms to ensure a protected level of funding support to pursue its goals and objectives;

8. The implementation, coordination, monitoring and evaluation mechanisms of the AMTP IV should build on existing structures and systems, particularly those provided by the Local Government Code; and

9. The directions and goals shall be aligned with the vision, goals and purposes of the Medium Term Philippine Development Plan (MTPDP), the Millennium Development Goals (MDGs), UNGASS Declaration of Committment on HIV/AIDS, and the ASEAN Joint Ministerial Statement and other international commitments that are considered relevant to the country.

C. VISION

HIV/AIDS 2010: Greater access to holistic response

D. GOAL

To prevent the further spread of HIV/AIDS infection and reduce the impact of the disease on individuals, families and communities

E. OBJECTIVES

1. To increase the proportion of the population with risk-free practices;

2. To increase the access of people infected and affected by HIV/AIDS to quality information, treatment, care and support services;

3. To improve accepting attitudes towards people infected and affected by HIV/AIDS; and,

4. To improve the efficiency and quality of management systems in support of HIV/AIDS programs and services.

F. TARGET GROUPS & SECTORS

The AMTP IV shall take into consideration the different population groups and sectors in mounting the national response against HIV/AIDS in the next six years. It will continue to focus interventions on: (a) the sex workers, both registered and non-registered, including their clients, (b) the IDUs and (c) MSMs. Equal consideration will be provided to PLWHAs and those affected b7y the disease. Providing HIV prevention information and services will continue among the workforce, in-school youth and the general public. The AMTP IV will give ample attention to emerging population groups becoming more vulnerable to STI/HIV/AIDS - the OFWs, young people and children.

Considering that everyone is susceptible to HIV/AIDS and differs in their degree of vulnerability to the infection, the various sectors of women, men, youth, children and the workforce must be equally mobilized to take into account the vulnerability of their respective local sector(s) to HIV infection.

G. KEY STRATEGIES

The AMTP IV will pursue the following key strategies:

Strategy 1: Scaling-up and quality improvement of preventive interventions, targeted to identified highly vulnerable groups (sex workers and their clients, IDUs, MSMs and OFWs)

Strategy 2: Strengthening intitutional and general public preventive interventions

Strategy 3: Scaling-up and quality improvement of treatment, care and support (TCS) services for people infected and affected with HIV/AIDS

Strategy 4: Integrate stigma reduction measures in the preventive treatment, care and support services and in the design of management systems

Strategy 5: Strengthening and intitutionalization of management systems in support of the delivery of HIV/AIDS information and preventive services

H. OPERATIONAL STRATEGIES, KEY RESULT AREAS & MAJOR ACTIVITIES

Strategy 1

Scaling-up and quality improvement of preventive interventions targeted at population segments with risk beahviors and those identified as highly vulnerable.

Epidemiological studies have identified risk behaviors and vulnerability factors that facilitate the transmission of HIV/AIDS like unprotected sex as frequently practiced by MSMs, sex workers and their clients and the use of infected needles among IDUs. Specific population groups like OFWs are also identified as vulnerable to infection. These groups are rendered highly vulnerable to HIV infection because of the socio-economic and occupational contexsts they are in. Though the country lacks solid data on the number of highly vulnerable populations, studies show an increased prevalence of unprotected sex among them, and some occupational groups are emerging as more vulnerable than others.

OPERATIONAL STRATEGIES

Improving the quality of prevention interventions among HRGs and expanding coverage would contribute significantly to halting the further spread of HIV. There is an urgent need to assess existing interventions in terms of their responsiveness and quality. Due attention will be given to the promotion of 100% CUP while BCC will be made inherent in every prevention effort. The Harm Reduction Program will be expanded to other areas where the number of IDUs is increasing. Aside from strenthening the existing health facilities as providers of STI/HIV/AIDS information and service, efforts weill be undertaken to widen the outreach network that will proactively reach and serve the vulnerable groups. This would require intensive mobilization and organization of the target groups as well as capacity building of outreach workers and other stakeholders.

In support, the criteria and process for identifying high-risk areas (See Annex1) will be refined and reapplied. The AMTP IV aims to cover all the 43 identified areas, phasing coverage from 2005 to 2010. Partnerships between the local governments and NGOs will be strongly advocated while the establishment of LACs will be fully encouraged. Efforts will be undertaken to mobilize resources to support local response in the identified high-risk areas. Particular attention will be devoted to enhancing existing programs for OFWs while establishing new measures to facilitate their access to services abroad.

KEY RESULT AREAS

KRA 1: All migrant workers are provided with STI/HIV/AIDS preventive information and services

KRA 2: PIPs are provided with focused STI/HIV/AIDS preventive education, skills and services

KRA 3: Clients of PIPs are provided with STI/HIV/AIDS preventive information and services

KRA 4: MSMs are provided with focused preventive information, skills and services

KRA 5: IDUs are provided with focused STI/HIV/AIDS preventive education and skills and services

Key Result Area 1: All migrant wokers are provided with STI/HIV/AIDS preventive information and services
Activity	2005	2006	2007	2008	2009	2010
1. expand and improve PDOS/PEOS for departing migrant workers
2. develop institutional policies and programs to ensure provision of STI/HIV/AIDS service for migrant workers
3. establish HIV/AIDS information and referral sites abroad
4. explore regional initiatives to address HIV/AIDS, migration and cross-border issues
5. develop comprehensive reintegration strategy for HIV+ OFWs
6. quality assurance of testing centers through quality monitoring visits and regular conduct of client feedback survey
7. expand network of STI/HIV/AIDS service providers in both the public and private sectors
8. implement community=based HIV/AIDS education and BCC activities with families of migrant workers

Key Result Area 2: PIPs are provided with focused STI/HIV/AIDS preventive education, skills and servcies
Activity	2005	2006	2007	2008	2009	2010
1. assessment of current prevention initiatives for the PIPs and other HRGs
2. improve criteria and process in mapping and identifying needs of PIPs/other HRGs
3. enhance existing training modules to be gender sensitive
4. enhance IEC/advocacy support materials
5. orientation/advocacy among local officials/influentials on STI/HIV/AIDS prevention
6. establish and expand community outreach and peer education programs
7. sustain and expand 100% condom use
a) advocacy among local officials and program stakeholders to adopt/support CPU
b) meetings/orientation/training on condom use among involved implementers
c) procurement/making available condoms through social marketing of condoms
8. sustain/improve provision of STI/HIV/AIDS information and services by SHCs
9. strengthen referral of PIPs for other needs
10. assist LGUs establish Local AIDS Council

Key Result Area 3: Clients of PIPs are provided with STI/HIV/AIDS preventive informationa nd services.
Activity	2005	2006	2007	2008	2009	2010
1. expand community outreach (in red light districts and entertainment establishments)
2. dialogue/advocacy among owners and managers of commercial sex establishments
3. strengthen partnership and linkage among NGOs, PNP and DSWD at the local level
4. promote condom use and training on negotiation skills for condom use

Key Result Area 4: MSMs are provided with focused preventive education, skills and services
Activity	2005	2006	2007	2008	2009	2010
1. continuous dialogue/conferences to evolve best mechanisms to reach MSMs
2. design and establish measures to creatively reach the MSMs for HIV preventive information and services
Target No: high risk areas	18	5	5	5	5	5
3. mapping and need identification of MSMs
4. organize outreach service network
5. promote condom use

Key Result Area 5: IDUs are provided with focused STI/HIV/AIDS preventive education and skills and services
Activity	2005	2006	2007	2008	2009	2010
1. develop and adopt risk assessment response system
2. explore policy support for harm reduction program - exchange needle
3. sustain harm reduction program in identified high risk areas
a) advocacy among local officials and program stakeholders to support harm reduction program
b) identify and capacitate NGOs to assist LGUs implement the program
c) training of program implementers and service providers/outreach workers
d) dialogues with local police, PDEA officials and other concerned agencies
e) procurement or making available needles and syringes for exchange
4. strengthen partnership among agencies at the local level (PNP, LGUs, NGOs, PDEA)
5. strengthen referral mechanisms for IDUs requiring special care and services

Strategy 2

Strengthening institutional and general general public reventive interventions.

Prevention interventions apply not only to HRGs but to everyone since every individual is vulnerable to the infection. Unsafe sexual behavior, particularly unprotected sex, is reportedly increasing especially among young people. Substance and sexual abuse among children and youth is also on the rise. Majority of HIV recorded infections were among the age group 20-49, considered the most economically productive segment of the population. Awareness of the correct ways of preventing HIV transmission among the general public remains low. The extent of coverage of STI/HIV/AIDS preventive interventions, given the large population size of target groups, is still limited. Quality of service requires further improvement.

OPERATIONAL STRATEGIES

Prevention interventions among general public is an integral part of the national response in line with the thrust of laying a strong foundation for long-term impact. It complements the thrust to engender a non-discriminatory environment for persons living with HIV/AIDS. The AMTP IV will support the scaling up of STI/HIV/AIDS prevention information and service delivery in the workplace. It will be expanded to cater to those employed in the public or government service and to those working in the informal sector. This would entail mobilizing the Civil Service Commission for government workers and other stakeholders for the informal sector.

The extent and quality of previous interventions will be assessed, the results of which will serve as basis in developing an integrated approach in reaching young people, both in-and-out-of-school. Efforts to reach young people in schools will be doubled and partnership with community-based organizations involved in out-of-school youth programs will be established. Existing networks of young people (e.g. SK) and other youth-oriented organizations will be tapped to integrate STI/HIV/AIDS prevention information and services.

On the other hand, STI/HIV/AIDS prevention for children will be given equal attention, with focus on thsoe whoe are in high-risk situations. A more specific program for preventing mother to child transmission will eb developed. Startegic key messgaes will be communicated to the general public through the mobilization of media practitioners, media network and conduct of tri-media campaigns and other information/promotional activities. These will be based on the enhanced Communications Plan. Coverage will follow the priority areas of the concerned institutions but will consider realigning with the targets of the other strategic interventions for convergence of efforts and impact.

KEY RESULT AREAS

KRA 1:	Children in rsiky situations are provided with appropriate STI/HIV/AIDS preventive information, life skills and services
KRA 2:	Children and young people in school (formal, non-formal, alternative learning systems) are provided with appropriate STI/HIV/AIDS preventive information, life skills and services
KRA 3:	Children and young people out of school provided with appropriate information and services on STI/HIV/AIDS
KRA 4:	Local (public, private and informal) employees provided with appropriate information and services on STI/HIV/AIDS
KRA 5:	Other relevant sectors/groups (outside identified sectors) provided with basic HIV/AIDS information on prevention and control

Key Result Area 1: Children in risky situations are provided with appropriate STI/HIV/AIDS preventive information, life skills and services
Activity	2005	2006	2007	2008	2009	2010
1. develop guidelines in communicating, reporting and monitoring children regarding HIV
2. build capacity and gender sensitivity of GO-NGO child-focused institutions on provisions of STI/HIV/AIDS preventive information/services
3. develop training and advocacy modules for service providers
4. capacitate children in risky situations through counseling and life skills training
5. formulate policy on HIV/AIDS for children
6. advocate and integrate STI/HIV/AIDS information and services into existing policy and program framework on children
7. strengthen referral network system for other needs

Key Result Area 2: Children and young people in school (formal, non-formal, alternative learning systems) are provided with appropriate STI/HIV/AIDS preventive information, life skills and services
Activity	2005	2006	2007	2008	2009	2010
1. assess quality and scope of intervention coverage for in school and out of school youth
2. Integrate life skills approach in STI/HIV/AIDS modules of DepEd, CHED, TESDA and NGOs with similar activites for children and/or parents
3. build capacity in STI/HIV/AIDS life skills education of school-based service providers
4. expand the implementation of school-based HIV/AIDS instruction and information
5. ensure accessibility of school youths to quality STI counseling and services

Key Result Area 3: Children and young people out of school provided with appropriate information and services on STI/HIV/AIDS
Activity	2005	2006	2007	2008	2009	2010
1. develop capacity of civil society organizations and youth organizations (e.g. SK) to provide information and education services
2. integrate STI/HIV/AIDS information and services into the local government's and existing community-based programs
3. establish community outreach and peer education programs for out-of-school youth

Key Result Area 4: Local (public, private and informal) employees provided with appropriate information and services on STI/HIV/AIDS
Activity	2005	2006	2007	2008	2009	2010
1. expand the implementation of STI/HIV/AIDS program in the workplace in the private sector
2. enforce the mandate of the Civil Service Commission to implement STI/HIV/AIDS program in the government sector
3. establish LGU-NGO-PO-informal sector network at the community level for STI/HIV/AIDS prevention

Key Result Area 5: Other relevant sectors/groups (outside identified sectors) provided with basic HIV/AIDS information on prevention and control
Activity	2005	2006	2007	2008	2009	2010
1. enhance the national STI/HIV/AIDS Communications Plan for AMTP IV (key messages, channels and information materials)
2. undertake sustainable campaign with evaluation to check on the impact and effect
3. sustain and build on national mobilization activities and special events like AIDS Day celebration and Candle Light Memorial
4. continue development of capacities of media practitioners in handling STI/HIV/AIDS reporting and as advocates for HIV/AIDS prevention