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1. Expanding Access to Critical HIV and Reproductive Health Services to Low Literacy Youth in Liberia R. Moorsmith (1), L. Hartenberger-Toby (2), R. Greifinger (3), C. Foti (4), M. Luke Urey (1), E. Bee-Barbu (1) (1) Population Services International, Monrovia, Liberia; (2) Education Development Center, Monrovia, Liberia; (3) Population Services International, Washington, United States; (4) Education Development Center, Washington, United States Lessons Learned Background Conclusions / Next Steps • In order to bridge the income and education inequalities in many contexts like Liberia, integration of HIV and FP services into non-traditional education can greatly improve health outcomes for women and youth. • Multi-sector programs in informal education, vocational training, and work-readiness should be a major focus for future FP-HIV expansion and scale-up. • PSI will pursue funding to continue and scale-up the project with EDC. • Physically bringing services to communities increases uptake and understanding of services available. Through May 2014, the program reached 108 AYP sites in Liberia and 2,769 HA participants (2,199 F; 570M). 50% of participant women accepted a modern FP method, much higher than CPR, and 68% received HTC. • Conducting the training in a setting where social ties already exist enhances the role of positive peer pressure to behave in healthier ways, rather than reinforcing fears and myths. • The program impacts the entire community, not just those who directly participate. 30% of community members who did not receive HA also got tested for HIV, far above the national average. 49,620condoms were distributed. • Learners had chance to actually see and touch the commodities, mitigating fear. This is something most would otherwise never have had the opportunity to do. • Classroom environment gave learners a safe environment to practice new skills. • * Currently there are only preliminary findings for the Liberia 2013 DHS. • Following a lengthy civil war and in a context of pervasive poverty, Liberian youth face major challenges in making healthy decisions. Lack of education is a significant factor in determining HIV protective behaviors and family planning (FP) use and intention. • With a population of 4.1 million, only 16% have tested for HIV in the preceding 12 months (DHS, 2013) • Overall contraceptive prevalence rate (CPR) is 20% • Substantial disparities: For those with no education, only 1% had ever tested for HIV and CPR was 15.3%; for those with secondary education or higher, 9.4% had tested for HIV and CPR was 28.6%. (DHS, 2007)* Description • HealthyActions(HA), a collaboration between PSI Liberia and EDC’s Advancing Youth Project (AYP), funded by USAID, launched in October 2012. • AYP provides access to Alternative Basic Education, social and leadership development, and livelihoods training for out-of-school youth, 13-35, who have no or marginal literacy and numeracy skills. • HA provides a five-day, 15-hour program covering HIV prevention and FP. The primary objective is to increase FP use and uptake of HIV testing and counseling (HTC). • Secondary aims are to improve assertiveness, communication skills, and gender-transformational attitudes. • Program culminates with an on-site “Clinic Celebration Day,” with HTC and FP counseling and services for HA participants and community members. PSI■■ 1120 19th Street, NW | Suite 600 Washington, DC 20036psi.org