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The goal of the assistance is to halt and begin to reverse the spread of HIV/AIDS in the Pacific by 2015. The purpose is to have an effective response to HIV/AIDS in place in Pacific Developing Member Countries in regard to government and community capacity to address HIV/AIDS, through the implementation of the ADB Pacific region roadmap on HIV/AIDS.

The Project has four components: (i) Strengthening surveillance. This component focuses on developing national HIV/AIDS surveillance capacity, with a focus on developing methodologies and skills for conducting second-generation surveys to better understand the status of and risk factors governing HIV infection and prevention among high-risk subpopulations across the region. The activities will focus mainly on building capacity so that the countries and the region can mobilize and target resources to curb growing rates of

infection.

(ii) Community-based interventions for HIV/AIDS prevention. This component will provide support for a regional condom social marketing program, including the design and delivery of mass media and targeted communication programs promoting condom use and the supply of male and female condoms; for behavior change communication (BCC) programs, including the development of tailored BCC materials and the design and delivery of BCC programs; and for sexually transmitted infection (STI) treatment and care programs, including the provision of training for local health care workers and of equipment and materials for STI treatment facilities.

(iii) Targeted interventions for vulnerable groups. This component focuses on supporting targeted interventions for vulnerable populations in the project Pacific developing member countries (PDMCs), including (a) establishing five drop-in centers for seafarers and their communities with information about HIV/AIDS, STIs, and safe sex and referrals to appropriate services; (b) developing and distributing information, education, and communication materials for vulnerable groups; (c) providing targeted training for nongovernment organizations working with vulnerable groups; (d) providing support for regional maritime schools in training on HIV/AIDS and STIs; (e) providing training in enhancing livelihood skills for HIVpositive people; and (f) providing antiretroviral drugs for HIV-positive people.

(iv) Project management. This component will manage the Project and includes project planning, monitoring, and evaluation.

The potential for the spread of HIV/AIDS in the Pacific is high. All PDMCs have detected HIV infections and also have unreported and unidentified cases because of the lack of testing facilities and generally low levels of surveillance. Significant risk factors for HIV exist, including high prevalence of STIs, low condom use, high levels of interregional and intraregional mobility, prevalence of multiple sex partners, and high rates of transactional sex. The region has experienced highly disparate levels of development, resulting in variable levels of access to information and services. Some Pacific countries have poorly functioning health systems with weak capacity to operate safe blood supplies, treat STIs, provide counseling and testing, and prevent mother-to-child transmission.

The socioeconomic impacts of the HIV/AIDS epidemic are potentially significant. Social impacts include the pain and suffering of individuals and communities affected by the illness

and the death of family members. At the household and individual levels, economic impacts include decreased discretionary spending by households affected by loss of income together with increased expenditure on care, treatment, and funerals. Economic impacts arise from productive sector losses and from the added burden on the health sector. HIV/AIDS exacerbates poverty by limiting the opportunities of the poor to lift themselves out of poverty and by driving economically vulnerable people below the

poverty line.

The current response to HIV/AIDS in the Pacific is underfunded. Pacific governments have committed to a comprehensive regional strategy and various programs are under way. Existing efforts urgently need to be scaled up and extended.