Problem Analysis:

Afghanistan is considered to be a country of low HIV prevalence but at high-risk for spread of HIV infection. The reasons behind this are several: over two decades of armed conflicts, the extremely low socio-political and economic status of women, huge numbers of people displaced internally and externally, the extremely poor social and public health infrastructure, drug trafficking, use of injecting drugs and lack of blood safety practices. These risk factors denote that this is an urgent need for early interventions to prevent a potentially rapid spread of HIV in Afghanistan.

No data on the prevalence of HIV/AIDS or other sexually transmitted infections (STI) are available due to absence of surveillance in Afghanistan.

The two current sources of data on HIV/AIDS are the Central Blood Bank Kabul and the Voluntary Counseling and Testing Centre in Kabul city.

The data from the Central Blood Bank of Kabul indicates the detection of the first HIV positive case in Kabul in 1989. Between 1989 and 2005 the central blood bank reports a total of 67 HIV positive cases out of 125832 blood samples screened at central and provincial levels for HIV/AIDS through rapid testing kits. Out of 67 positive cases, 37 were living in Afghanistan and the rest were refugees/returnees from Pakistan, Iran, Saudi Arabia and Dubai. 35 HIV positive cases were reported from the Central Blood Bank Kabul and the remaining from the provinces of Nangarhar, Herat, Mazar, JozJan and Kunduz.

The VCT Centre at Kabul reports 15 HIV positive cases during 2005, confirmed through western blot. 12 HIV positive cases were from 338 Injecting drug users (IDUs) who came for VCT at the centre. The remaining 3 cases were from among 317 general population groups.

The analysis of these data shows that 46 of the 67 cases detected by the Central Blood Bank were during the last 2 years 2004-2005. The VCT Centre data of 12 cases out of 338 IDUs who came for voluntary testing is over 3 percent in this voluntary group. There is no information available on prevalence of HIV in other vulnerable groups.

Strategic Direction:

1. AFGA intends to create an enabling environment for reducing the vulnerability to HIV/AIDS through increased public awareness on HIV/AIDS and its integration into SRH services.

Goal:

1. To keep Afghanistan in low incidence of HIV/AIDS.

Objectives:

Objective 1:

• To reduce social and cultural barriers that makes people vulnerable to HIV/AIDS.

Objective 2:

• To increase access to interventions for the prevention of STIs and HIV/AIDS through integrated, gender-sensitive sexual and reproductive health programmes.

Activities:

Activities for objective 1:

• Conduct a baseline on existing attitudes on HIV/AIDS among staff and volunteers

1. Build partnerships with Ministries of Youth’s Affairs, Women’s Affairs and MOPH on coordination of HIV/AIDS related programs and activities.
   
   
2. Build partnerships with other NGOs working in the field of HIV/AIDS at national level.
   
   
3. Create strategic linkages between AFGA and networks of PLWHA in the region
   
   
4. Conduct orientation, training and capacity building programs for AFGA staff and volunteers on HIV/AIDS, the gender construction of sexuality and rights-based perspectives.
   
   
5. Organize and conduct awareness workshops on HIV/AIDS and Sexuality and Rights, for vulnerable groups, especially young people.
   
   
6. Collate, develop and disseminate awareness raising materials and posters on HIV/AIDS and rights.
   
   
7. Sensitization of media on using accurate, up-to-date and rights-based information and terminology on HIV/AIDS/STIs.

Activities for objective 2:
   

• Build capacity of AFGA staff on diagnosis and treatment of STIs.
  
  
• Follow standard protocol for STI treatment in AFGA clinics.
  
  
• Ensure availability of medicine for treatment of STIs in AFGA clinics.
  
  
• Conduct orientation training for youth and vulnerable groups on STI/HIV/AIDS and prevention.
  
  
• Publish and distribute awareness rising materials on prevention of STI.

Outcomes:

1. Improved coordination and collaboration of AFGA with different agencies for working on HIV/AIDS programs at national level.
   
   
2. Increased understanding and rights-based perspectives of AFGA staff and volunteers on HIV/AIDS related issues.
   
   
3. Increased public awareness on HIV/AIDS and STI prevention especially women and young people.
   
4. Increased community commitment to support HIV/AIDS related programs at national level.

Indicators:

Indicator for objective 1:

1. Number of training and capacity building programs conducted for AFGA staff and volunteers on HIV/AIDS.
   
   
2. Number of MoUs signed between AFGA and line ministries for collaboration on HIV/AIDS programs.
   
   
3. Number of linkages between AFGA and networks of PLWHA.
   
   
4. Number of HIV/AIDS awareness workshops conducted for vulnerable groups, especially young people.
   
   
5. Number of people trained in these workshops.
   
   
6. Number of fact sheets and awareness raising materials and posters distributed by AFGA on HIV/AIDS to youth and general population.
   
   
7. Number of media stories / programs having accurate and rights-based information related to HIV/AIDS/STIs

Indicator for objective 2;

• Number of capacity building programs conducted for service providers on diagnosis and treatment of STIs.
  
  
• AFGA clinics where staff used approved protocol for treatment of STIs.
  
  
• Medicine for treatment of STIs available in all AFGA clinics.
  
  
• Number of orientation training conducted for vulnerable groups, especially young people on STI/HIV/AIDS and prevention.