(0:06-0:10) Sub-saharan African countries have some of the highest prevalence of HIV/AIDS. (0:10-0:14) Until recently, this included Ethiopia. (0:14-0:21) The 2011 demographic health survey indicated around 2.3 percent live with HIV. (0:21-0:24) As Ethiopia's health development sector has grown, (0:24-0:28) the country has seen a reduction in HIV prevalence. (0:28-0:31) According to the HIV AIDS Prevention and Control Office, (0:31-0:36) the prevalence rate has been reduced from 2.1 percent in 2011, (0:36-0:40) to 1.3 percent in 2013. (0:40-0:44) USAID initiated the TransACTION program in 2009... (0:44-0:47) to target most-at-risk populations... (0:47-0:50) who are at a higher risk of contracting HIV. (0:50-0:54) USAID TransACTION was a five-year... (0:54-0:57) $14 million flagship prevention program... (0:57-1:01) implemented in 119 towns with the goal... (1:01-1:05) of reducing new HIV and sexually transmitted infections... (1:05-1:08) among most-at-risk and vulnerable populations... (1:08-1:13) like commercial sex workers, daily laborers, and truck drivers. (1:13-1:17) The program was managed by a consortium of... (1:17-1:21) international organizations led by Save the Children... (1:21-1:24) and directly implemented by local NGOs. (1:24-1:29) The town level implementation was coordinated by a multi-sectoral committee... (1:29-1:32) represented from relevant government sector offices, (1:32-1:36) community-based organizations, and program beneficiaries... (1:36-1:38) for increasing quality of implementation... (1:38-1:41) and the likelihood of ownership and sustainability... (1:41-1:44) at a grass root level. (1:44-1:47) In order for TransACTION to achieve the intended objective, (1:47-1:51) significant focus was given to a comprehensive prevention approach... (1:51-1:52) which includes behavioural, (1:52-1:56) bio-medical, and structural intervention. (1:56-2:00) The behavioral program component of TransACTION has been... (2:00-2:02) designed to increase knowledge of HIV and STI... (2:02-2:05) and foster healthy attitudes and... (2:05-2:09) safe sex practices among the targeted populations... (2:09-2:13) involved in commercial and transactional sex. (2:13-2:17) TransACTION has developed five funded education programs... (2:17-2:21) for each target group under the umbrella 'addis mella', which means new strategy. (2:21-2:25) The bio-medical intervention of the program... (2:25-2:30) focused primarily on improving access to HIV and STI service... (2:30-2:33) and strengthening the referral for care and support. (2:33-2:37) A network model was designed to increase access to quality services... (2:37-2:42) which ultimately satisfy the needs of the targeted populations. (2:42-2:47) A voucher system was also introduced to build confidence... (2:47-2:50) and insure the linkage among different actors: (2:50-2:55) the beneficiaries, clinics, and the drug retail outlets. (2:55-2:58) Lay counselors assigned at the clinics strengthened... (2:58-3:02) the entry point for testing and the referral linkage... (3:02-3:04) for care and support services. (3:04-3:09) The economic empowerment initiative assist the targeted populations, (3:09-3:12) especially women, avoid risky behaviors... (3:12-3:15) and absorb economic shocks by engaging... (3:15-3:19) in saving groups and income-generating activities. (3:19-3:23) The structural intervention of the program focused on... (3:23-3:26) strengthening the organizational and technical capacity... (3:26-3:31) of local non-governmental organizations, HIV/AIDS committees, (3:31-3:35) and private health facilities to be actively involved in the... (3:35-3:40) day-to-day activities of the program implementation and coordination. (3:40-3:42) The community dialogue on gender... (3:42-3:45) has also increased the impact of the program... (3:45-3:49) by improving the enabling environment to work around... (3:49-3:53) transactional and commercial sex. (3:53-3:58) With the relentless and coordinated effort of all implementing partners, (3:58-4:01) over 1.1 million beneficiaries... (4:01-4:05) have directly received HIV and STI related services... (4:05-4:08) during the life of the program. (4:08-4:14) In general, there are changes that TransACTION brought in our city. (4:14-4:17) As I mentioned it earlier, it brought attitudinal change… (4:17-4:20) especially on the youth and also on the commercial sex workers… (4:20-4:24) that they can work by keeping themselves from HIV. (4:24-4:26) This is one big change. (4:27-4:30) And people’s attitude toward HIV is changing. (4:30-4:35) There was discrimination and stigma. (4:35-4:39) There was a time when they wouldn’t even let me peel onions. (4:39-4:45) But now they choose me for my cooking skill. (4:47-4:50) When the clients come here from the clinic with the coupon, (4:50-4:56) we explain it to them very well with the language that they understand… (4:56-4:58) and give them the TransACTION kit. (4:58-5:01) And in addition, we not only give them the kit… (5:01-5:05) but we also counsel them. We give them counseling service. (5:05-5:07) We tell them not to discontinue taking the medicine and that if it is discontinued, (5:07-5:09) the medicine will not work. (5:09-5:12) And also, for example, if only a male or female comes, (5:12-5:17) if she has a husband, we tell her to bring her husband. (5:17-5:21) If it is a man, we tell him to bring his wife or his friend. (5:21-5:27) Therefore, this is how we counsel them separately to prevent the disease. (5:27-5:31) When they have sexually transmitted disease, (5:31-5:35) they come and tell us their symptoms so that we give them the medicine. (5:35-5:37) But what I do is, if I give them the medicine, (5:37-5:42) I will get a benefit, but the main objective is to save the community. (5:42-5:45) Because the main objective is to save the community, (5:45-5:50) what I do is, I will persuade them to go to the member clinic. (5:50-5:52) And there is a back referral coupon. (5:52-5:56) So I give them the back referral coupon and take them to the clinic. (5:57-6:00) I was studying at Arba Minch University. (6:00-6:03) Because my result was not good enough to pass… (6:03-6:05) I came back home. (6:05-6:07) But my parents were unable to pay for my college. (6:07-6:09) So I became a commercial sex worker. (6:12-6:14) I got drunk myself. (6:14-6:17) At that time I couldn’t remember whether we used condom. (6:17-6:20) I was always hiding from my relatives. (6:20-6:23) It is like hide and seek. (6:23-6:26) I cover my face and walk at night like a hyena to hide myself… (6:26-6:29) for fear of being caught. (6:29-6:33) I was doing a very disgusting job. (6:33-6:37) Because I had no choice. (6:37-6:40) I was not really living life, I was stagnated. (6:40-6:45) It was a life of apprehension. Now I feel like I am reborn. (6:45-6:49) A commercial sex worker doesn’t have a vision. (6:49-6:04) We think only for the day and we could die tomorrow. (6:52-6:58) I have a vision now, got married and a mother of this child. (7:00-7:04) TransACTION won’t give you money. (7:04-7:07) It gives you a wealth of knowledge. (7:07-7:13) Even if TransACTION leaves we are TransACTION ourselves. (7:13-7:16) We can teach others beyond ourselves. (7:17-7:21) Parents (mother and father) support you to start your own life. (7:21-7:24) No child then should return home. (7:24-7:26) They should live on their own. (7:28-7:32) Now our organization has moved from implementing partner… (7:32-7:37) to serve granting other implementing local organizations. (7:37-7:41) This is because of the capacity-building training… (7:41-7:44) and the capacity-building assistance… (7:44-7:49) that you have got from the USAID-Save the Children TransACTION program… (7:49-7:51) in the last two years. (7:53-7:56) Anecdotal evidences in the preliminary result of the online evaluation… (7:56-8:00) suggested that the targeted populations have significantly… (8:00-8:03) improved their knowledge on HIV and STI… (8:03-8:06) which led to correct and consistent condom use… (8:06-8:09) and access to HIV counseling and testing… (8:09-8:12) and sexually transmitted infection services. (8:13-8:17) Even though the direct impact of TransACTION cannot be measured at this stage, (8:17-8:21) it is believed that it has contributed significantly… (8:21-8:26) to reducing new HIV and STI infections among the targeted groups… (8:26-8:30) in and around the 119 towns served by the program. (8:32-8:39) I am thankful for the day TransACTION came here. (8:39-8:42) It was a lucky day, I celebrate that day every year. (8:42-8:45) Because it brought me TransACTION. (8:45-8:47) I celebrate that day with candles. (8:47-8:52) Appreciation and many thanks go to all involved directly or indirectly… (8:52-8:55) in the implementation of TransACTION program, (8:55-8:58) more so, to the United States Government and people… (8:58-9:00) for funding TransACTION program.