G 2 hh;'\ luu4 WHO/WPRO LIBRARY MA NTLA, P}I!LJ?PINES (WP)HSI/ICP/HSI/3.5/001. Report series number: RS/2003/GE/21/(LAO) English only REPORT

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2 (WP)HSI/ICP/HSI/3.5/001 Report series number: RS/2003/GE/21/(LAO) English only REPORT MEETING ON 100% CONDOM USE PROGRAMME // FOR PREVENTION OF HIV/AIDS AND STI WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Vientiane, Lao People's Democratic Republic August 2003 ' Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines September 2003 WHO/WPRO LIBRARY MA NTLA, P}I!LJ?PINES G 2 hh;'\ luu4

3 NOTE The views expressed in this report are those of the participants in the Meeting on 100% Condom Use Programme for Prevention of HIV/AIDS and STI and do not necessarily reflect the policies of the Organization This report has been prepared by the World Health Organization Regional Office for the Western Pacific for governments of member states in the Region and for those who participated in the Meeting on 100% Condom Use Programme for Prevention of HIV/AIDS and STI, 18 to 21 August 2003.

4 CONTENTS SUMMARY I 1. INTRODUCTION Objectives: Patticipants and Resource Persons Organization of the Meeting Welcome Statement Opening of the Meeting PROCEEDINGS Introductory Presentations: Country Presentations Other Presentations , Group Work CONCLUSIONS AND RECOMMENDATIONS I. Conclusions Recommendations ANNEXES: ANNEX 1 - LIST OF PARTICIPANTS ANNEX 2 - DETAILED DAILY AGENDAS Keyw01 ds: Condoms-utilization I HIV infections-prevention and control, transmission I Acquired immunodeficiency syndrome-prevention and control, transmission I National Health programsorganization and administration I Health promotion-methods I Prostitution I Asia, Southeastern I Western Pacific

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6 SUMMARY The WHO Western Pacific Regional Office organized a four-day meeting in Vientiane, Lao People's Democratic Republic (from 18 to 21 August 2003) to share experiences about the 100% condom use programme (CUP) that is being implemented in many countries in Asia. The meeting was attended by 45 participants including country representatives working in the national 100% CUP from Cambodia, China, the Lao People's Democratic Republic, Mongolia, Myanmar, the Philippines, Thailand and VietNam and a broad range of professionals, WHO staff and technical advisers as well as representatives from sex worker support groups, international organizations and partners. Participants discussed the STI/HIV situation in their countries; the extent, types and evolution of sex work; the status of the 100% CUP including the policies in place, sites where the programme is ongoing, implementing strategies, lessons learnt, problems being encountered and future plans; and challenges. A broad range of conclusions were reached at the meeting including recognition that ( 1) HIV transmission associated with sex work remains a great concern for many countries in the Region; (2) all evaluations of the 100% CUP in countries have thus far given good evidence that the programme is effective, replicable across different settings and scalable; (3) countries must implement the 100% CUP within local and national contexts but that there are essential elements '. of the programme that must b~ given priority; ( 4)'politica:l commitment both nationally and locally are vital to the success of the 100% CUP; (5) all stakeholders including sex workers should participate in the planning and implementation of the 100% CUP; and (6) the 100% CUP plays a complementary role to other ongoing or evolving programmes that seek to promote condom use and address the problems of sex workers in their communities. Participants recommended to national governments and partners that they will continue to accord a high priority to the 100% CUP and to support national plans to strengthen and expand the programmes.

7 -2-1. INTRODUCTION ~ The "Regional Meeting on 100% Condom Use Programme for Prevention ofhiv/aids and STI" was held in Vientiane, Lao People's Democratic Republic from 18 to 21 August The meeting was organized by the Western Pacific Regional Office of WHO. 1.1 Objectives The objectives of the meeting were: (a) to share and discuss the experiences and lessons leamt from the 100% CUP and to obtain consensus on appropriate approaches or practices for the implementation of the 100% CUP; (b) to review the findings of assessments and evaluations conducted in the different countries; (c) to establish a support mechanism through partnership networks for the expansion of the 100% CUP; and (d) to increase political and financial support from member countries, partners and donor agencies for implementing and expanding the 100% CUP. 1.2 Participants and resource persons There were a total of fotty-five ( 45) persons who participated in the meeting (please refer to Annex 1 of this report) including: 1. eighteen (18) participants from six (6) selected countries ofthe WHO Western Pacific Region: Cambodia, China, the Lao People's Democratic Republic, Mongolia, the Philippines, and VietNam. Participants represented a broad range of officials involved in the design and management of the 100% CUP in their respective countries; 2. three (3) Tempormy Advisers from Myanmar, Thailand and Cambodia to assist with reports on 100% CUP activities in these countries; 3. four ( 4) Temporaty Advisers from associations of sex workers in Thailand and Cambodia; 4. thirteen (13) observers from agencies interested and involved in 100% CUP in the countries: Australian Agency for Intemational Development (AusAID), DKT Intemational, Family Health Intemational (FHI), Futures Group, Ministry of Health, Labour and Welfare of Japan, Program for Appropriate Technology, Policy Project, PSI, Joint United Nations Programme for HIV/AIDS (UNAIDS), United Nations Population Fund (UNFPA); and the United States Agency for Intemational Development (USAID); 5. two (2) consultants to assist with media and documentation; and 6. five (5) WHO staff from offices in Westem Pacific Region, Geneva, China, Mongolia and Myanmar.

8 1.3 Organization of the meeting The meeting was held at the Lane-Xang Hotel, Fa ngum Road, Vientiane, Lao People's Democratic Republic from 18 to 21 August It incorporated (1) country presentations on status of their 100% CUP, (2) evaluation of three countries 100% CUP, (3) working groups and working group reports on selected issues, (4) technical presentations and (5) plenary discussions. Please refer to Annex 2 for the daily detailed agenda. 1.4 Welcome statement Dr Giovanni Deodato, WHO Representative in the Lao People's Democratic Republic delivered a welcoming statement to the meeting on behalf of Dr Shigeru Omi, Regional Director, WHO Regional Office for the Western Pacific. Dr Omi observed that there had been remarkable results with the 100% CUP in Thailand and Cambodia and that WHO is advocating this strategy elsewhere in the Region in view of the fact that the sex industry is widespread and growing in many countries. 1.5 Opening of the meeting H E Dr Ponmek Dalaloy, Minister of Health of the Lao People's Democratic Republic, formally opened the meeting with a statement observing that although Laos currently has a low prevalence ofhiv/aids, the country was wonied about the level ofsti and recognized the need to do more. He looked forward to sharing ideas about strategies needed to promote condom use and pledged support to the 100% CUP in the Lao People's Democratic Republic. 2. PROCEEDINGS 2.1 Introductory presentations Dr Bernard Fabre-Teste, WHO Regional Adviser, Sexually Transmitted Infections including HIV I AIDS, led an introduction of all participants and observers. A rotation of Chair and Co-chairpersons for the meeting was also agreed. Ms Gaik Gui Ong, WHO Technical Officer, WHO Sexually Transmitted Infections including HIV/AIDS, presented a brief history of the 100% CUP in the Asia region. Ms Ong also discussed the objectives of the meeting stressing the need to strengthen and indeed expand efforts through collaboration and sharing of experiences. Dr B. Fabre-Teste presented an overview of the HIV/AIDS and STI situation in the Western Pacific Region. Noting that it is the largest WHO Region, he stressed that the "high potentiality" ofhiv/aids was a source of great concern. Dr Wiwat Rojanapithayakorn, WHO Short Term Professional, currently working with the Ministry of Health in Mongolia, made a presentation on the principles of the 100% CUP observing that sexual transmission, most linked to sex work, was the principal mode of HIV spread in many Asian countries. He observed that general education on condom promotion has shown only limited results but that the 100% CUP had shown remarkable results in increasing

9 - 4- condom use and reducing STI when first implemented in Thailand in Dr Wiwat expressed confidence that the programme was one of the most effective and efficient ways to reduce HIV transmission linked to sex work that was applicable to a broad spectrum of countries in the Region. Dr Wiwat had added that there were some recent controversies about the programme which were the results of misunderstanding about the programme strategies. A document to clarify the controversies was distributed in the meeting. Mr Ichiro Kamoshita, Senior Vice-Minister of Health, Labour and Welfare, and leader of the Special Japanese Delegation to the Meeting, addressed the meeting, observing that HIV I AIDS is not only a health care problem, but also a great obstacle for social development. Expressing confidence that promoting condom use will also be useful in Japan, he thanked the Government of the Lao People's Democratic Republic and WHO for hosting this useful meeting. 2.2 Country presentations Representatives of the countries attending the meeting made presentations on the status of the 1 00% CUP in their respective countries. Special attention was given to lessons learnt and future challenges within the programmes Thailand Dr Anupong Chitwarakorn, Senior Expert in Preventive Medicine, Depatiment of Disease Control, Ministry of Public Health, reviewed data from Thailand's long experience with the 100% CUP, beginning first as a pilot project in 1989 in Ratchburi Province and then expanded nationwide from Evaluation of the programme showed almost immediate increases in reported regular condom use by sex workers and their clients and a corresponding reduction of STI and HIV in these two groups. More general indicators of the population burden of HIV (e.g. seroprevalence among military recruits and pregnant women) have also declined in Thailand, a result that stands in contrast to a continuing increase ofhiv seroprevalence among injecting drug users. Although 80% of men with STI are still a result of exposure to sex workers, there has been a noteworthy reduction in visits to STI clinics by both men and sex workers since Also noteworthy in Thailand has been a steady reduction in the number of men who report visiting sex workers (from almost 60% in 1993 to less than 5% in 1999). Looking to the challenges of the future, Dr Anupong observed that more sex workers in Thailand were shifting from direct to indirect types of employment (which required stronger efforts in working with indirect sex establishments) and that more persons were engaging in "casual" rather than commercial sex. Dr Anupong also worried about the impact that vaccines and Highly Active Antiretroviral Therapy (HAART) might have on encouraging more risky sexual practices Cambodia Dr Ly Penh Sun, Deputy Chief of Technical Bureau, National Center ofhiv/aids, STD and Dermatology, Ministry of Health, reviewed Cambodia's experience with the 100% CUP. Dr Ly reported that 90% of HIV transmission in Cambodia was the result of heterosexual exposure and that, according to 2002.data, 3.0% of direct sex workers were HIV positive.

10 - 5 - The 100% CUP was piloted in the harbour town of Sihanouk Ville in Data presented from Sihanouk Ville showed a dramatic reduction in STI between 1996 and 2000 with continuing downward trends since then. It was concluded that the decline was the result of a "combination" of interventions (including both the 100% CUP and improved STI care) and it was decided to expand both services nationwide. Based on initial results of Sihanouk Ville, the Cambodian Prime Minister endorsed the nationwide expansion of the programme in Twelve provinces were selected for priority expansion because of their HIV prevalence among direct or brothel-based sex workers and their clients. The programme was further expanded to cover the rest of the country throughout 2001 and Cambodia is looking forward to the challenges of ( 1) ensuring proper monitoring and supervision; (2) extending services to both direct and indirect sex workers; and (3) providing for a greater involvement of sex workers in the programmes Myanmar Dr Tun Myint, Assistant Director/Medical Epidemiologist, National AIDS Programme, reported on Myanmar's 100% Targeted Condom Promotion (100% TCP) programme launched in Currently being implemented in 58 townships, the 100% TCP started initially in four pilot townships and expanded to 11 additional townships in 2002, and an additional 43 townships in Dr Tun explained that six agencies (UNAIDS, WHO, UNFPA, United Nations Development Programme, Fund for HIV/AIDS in Myanmar and Japanese Intemational Cooperation Agency) have been providing financial assistance to this expansion. Early evaluations ofthe 100% TCP programme have demonstrated an ongoing and consistent increase in the condom use rate among sex workers and a concurrent decrease in the STI rates in this same population in one area (Tachileik) as well as a general conclusion that the 100% TCP programme is feasible, culturally acceptable and sustainable in the Myanmar context. Myanmar is now looking towards enhancing its cooperation with donors and UN agencies so as to expand this programme nationwide, to expand the availability and distribution of condoms and to translate information, education and communications materials into national languages China Dr Wang Xiaochun, Director, Department oflntemational Cooperation ofnational AIDS Centre (NCAIDS), presented a review of the 100% CUP in China. Beginning with a pilot project at two sites (Wuhan and Jiangsu) in 2000, the programme expanded to Hainan and Hunan in Despite the problems confronted in the initial phase of the pilot programme (including the high mobility of sex workers and difficulties in verifying condom use), Dr Wang presented 2003 evaluation data which clearly demonstrated an increase in condom use and decrease in STI among sex workers in Wuhan, Jingjiang of Jiangsu and Lixian of Hunan. Data collection from Danzhou of Hainan was interrupted by the severe acute respiratory syndrome epidemic. The focus at the pilot sites was on fostering the 100% CUP policy, especially at the local level, and in drafting national strategies. Dr Wang also recognized that the four project sites are attempting to institute finn policies to ensure the achievement of the final stage of implementation of "No Condom- No Sex."

11 - 6- Chinese programme staff are cuuently looking toward the potential of expanding and integrating its 100% CUP with the National HIV/AIDS Comprehensive Care and Prevention Project targeting 100 counties (China CARES). Other international partners such as UNFPA (one site in Guangxi) and Future's Group under project funded by Depa1tment for International Development (four sites in Sichuan and Yunnan) have started or are under planning for the replication of the CUP. NCAIDS is also putting on agenda to mobilize sufficient resources from both central and provincial levels to support scaling up in the current four provinces VietNam Dr Nguyen Van Kinh, Programme Officer, Administration for Preventive Medicine and HIV I AIDS Control, Ministry of Health, discussed VietNam's nascent, but growing efforts, with the 100% CUP strategy. With support of WHO, Luxembourg, FHI, Asian Development Bank and the World Bank, VietNam now has 100% CUPs in 17 sites around the country, beginning first in Thus far, VietNam's 100% CUP is being built around advocacy and IEC, condom social marketing and cooperation with STI services. Baseline data on HIV, STI and condom use have been established and, in data presented by Dr Nguyen, there has been initial indication that HIV and STI declined among sex workers between 2001 and Challenges for the future of VietNam's 100% CUP include strong anti-prostitution laws in the country, unavailability of condoms in some places and maintaining quality STI services Mongolia Dr Bavuu Enkhjin, Officer in Charge ofhiv/aids and STJ, Ministry of Health, reported on Mongolia's initial experience with the 100% CUP in its pilot site in Darkhan aimag which began with WHO assistance in July Noting that Mongolia has only four repmted cases ofhiv between 1992 and 2003, Dr Bavuu observed that all were linked to heterosexual exposure. The pilot site in Darkhan was selected because STI rates in the area were above national averages, local authorities were cooperative; STI services and condom social marketing were already in place and it was estimated that there were at least 300 freelance sex workers. Mongolia's 100% CUP has the distinction of working with freelance sex workers through a registration process (issuance of "green cards") which renders them immune from arrest by police as long as they continue to collaborate with the programme. Between 2002 and 2003, Dr Bavuu presented evaluation data that showed a reduction of STI rates among sex workers. 0 0 Mongolia has plans to expand the 100% CUP to an initial two sites (aimags) in 2004 with support from the WHO and Global Fund. There is also hope that four more aimags can be included in the programme in 2004 and an additional five aimags" a year can be initiated each year between 2005 and Lao People's Democratic Republic Dr Chansy Phimphachanh, Director, National Committee for the Control of AIDS Bureau, Ministry of Health, reported on Laos initial plans for the 100% CUP. A pilot site in Savannakhet Province was initiated several weeks before the meeting.

12 - 7 - Observing that prostitution is illegal and that there are no brothels in the Lao People's Democratic Republic, it was nonetheless recognized that sex is negotiated in a variety of places (night clubs, guesthouses, bars, etc.) and by street workers. Baseline data on sites and number of sex workers has been documented for the pilot site. The future challenges and plans for the Lao People's Democratic Republic revolve around effectively implementing their pilot project within a context of the distinctive cultural and legal climate of the country Philippines Dr Roderick Poblete, Medical Specialist II, Philippine National AIDS Council, discussed the 100% CUP in the Philippines. Building on a long history of routine STI screening of females working in registered entertainment establishments, and a sentinel surveillance system that has been in place since 1997, authorities launched a 100% CUP in three pilot sites in January The 100% CUP in the Philippines will include a comprehensive package of STI/IEC services and condoms will be promoted and distributed largely through the country's ongoing system for condom social marketing. The greatest problems confronting the programme in the Philippines include the low level of public visibility of HIV in the country, opposition from important conservative groups and the general political unattractiveness of working with sex workers. Despite these constraints, authorities have plans to expand the 100% CUP into additional towns and areas. 2.3 Other presentations Research on the 100% CUP in the Dominican Republic Dr Gilles Poumerol, Department ofhiv/aids, WHO Geneva, reported on the results from a recent academic investigation to detetmine the "Impact and Cost-Effectiveness of Two '100% Condom Use' Models in Dominican Republic". Investigating the impact of the programme using a voluntary "community-and solidarity-based" approach and a programme that used also a 100% CUP "policy", investigators concluded that there was a "more intense impact and better cost-effectiveness when government policy is added." Investigators also concluded that the 100% CUP policy had relevance in non-asian countries Sex worker support groups Representatives of sex worker support organizations from Thailand (Ms Chantawipa Apisuk, Ms Phenjan Khamkhanan and Ms Siriporn Sriphen from Empower Foundation) and Cambodia (Ms Mang Chrep from the Cambodian Women for Peace and Development with assistance from Ms Nith Sopha of Family Health International) presented their views and concerns about sex work in their national context. Both groups were concerned with the illegal status of sex work and the discrimination they often endure in the hands of governmental authorities. They look forward both to being recognized as a legitimate "entertainment professionals" and also to programmes that will give sex workers training to expand their vocational opportunities.

13 POLICY Project Mr David Lowe, Senior Technical Adviser, POLICY Project, presented the results of a study this organization conducted on the Cambodian 100% CUP based on the perceptions of sex workers. While the POLICY Project was overall supportive of the programme's efforts to help sex workers to protect their own and the public health, they were concerned that the 100% CUP in Cambodia had both conceptual and implementation problems that handicapped its effectiveness and compromised the human rights of sex workers % CUP partners Participating agencies from UNFP A, UN AIDS, USAID, FHI, PSI, DKT, Policy Project, Empower and Futures Group shared their experiences, mid the possible support to the 1 00% CUP. 2.4 Group Work At two junctures of the meeting, the plenary was divided into working groups. The first group work considered some cross-cutting problems in implementing the 100% CUP that were revealed in the country reports. The second group work brought counhy representatives together to elaborate on the next steps and resource needs for expanding the 100% CUP in their respective countries. The active plenary discussions that followed the group presentations contributed directly to the conclusions and recommendations. 3. CONCLUSIONS AND RECOMMENDATIONS 3.1 Conclusions Participants at the meeting reached the following conclusions regarding the status and future of the 1 00% CUP in the Asian region: The meeting recognized that: (1) HIV transmission associated with sex work remains a great concern 'for countries in the Asian region that have both widespread as well as local concentrations of entertainment establishments and sex work; (2) the experience of countries that have been implementing the 100% Condom Use Programme ( 100% CUP) in the Asian region, supported also by a recent academic study in the Dominican Republic, continues to offer good and growing evidence that the 100% CUP is:

14 - 9 - (a) effective in increasing consistent condom use and decreasing the transmission of STI and HIV associated with establishment-based sex workers; (b) a prevention strategy that is feasible across a diverse spectrum of both localities and countries when tailored lo the local political, cultural and epidemiological needs; and (c) capable of expanding rapidly to a large scale; (3) the successful experience with the 100% CUP in Thailand and Cambodia has served as an effective model appropriate for use in other countries seeking to address HIV transmission associated with establishment-based sex work; the Asian experience with designing and implementing the 100% CUP has grown substantially in the last two years to include China, the Lao People's Democratic Republic, Mongolia, Myanmar, the Philippines and VietNam; (4) most countries implementing the 100% CUP have noteworthy achievements in condom promotion in sex establishments, and recognize the need for more intensive work to achieve the final policy goal of"no Condom- No Sex." (5) all countries with 100% CUP activities were encouraged by the results of efforts to date, and are exploring actively the potential to strengthen and expand their programmes while recognizing that: (a) strong commitments of political support from local, provincial and national leaders is critical for the success of programmes; and (b) additional human and financial resources will be required from local and national levels as well as from bilateral and international partners and NGOs; (6) in areas where there is establishment-based sex work, it is critical to assure that essential policy and strategic components of the 100% CUP is given priority, attention; (7) in the implementation of the 100% CUP, attention should be paid to assure that programme activities are directed only at public health objective and: (a) do not compromise the rights and safety of sex workers and clients; and (b) do not become misconstrued as efforts to legalize or promote prostitution or to encourage promiscuity; (8) the 100% CUP is focusing primarily at establishment-based sex work and there is a need to complement and support other strategies addressing the prevention of HIV/AIDS and STI; and, encourages what efforts governments and partners can undertake especially to: a. assure access of sex workers and clients to high quality STI care; b. promote condoms generally; and, c. reduce stigmatisation and discrimination of sex workers that serve to increase their vulnerability to HIV/AIDS and STI transmission and care.

15 Recommendations All countries confronting a significant level of STI and/or HIV transmission associated with establishment-based sex work should consider the potentials for implementing a 100% CUP in the context of the local situation and needs Govermnents, with the support of national and international partners should: (1) recognize the need to accord a high level of political support for the 100% CUP that is vital to its implementation and expansion; (2) assure a good balance of resources between prevention and care activities; (3) assure the coordinated multi-sectoral involvement in the I 00% CUP; ( 4) ensure that there is participation of all stakeholders, including sex workers, in the planning and implementation of the 100% CUP at all levels (local, provincial and national.); and (5) seek out opportunities to encourage and support sound scientific research and evaluation with regard to: WHO should: a. the changing dynamics of sex work; b. public he~lth interventions essential to preventing STI/HIV transmission through sex work; and, c. the perceptions and needs of sex workers and clients relating to the protection of health and prevention of disease transmission. (1) increase efforts to assist countries to identify and implement those components that are essential to the most efficient implementation of 100% CUP; (2) work more broadly to assure that there is good understanding among some sectors that the 100% CUP is not an effort to promote or legalise prostitution or to encourage promiscuity; and (3) continue to place a priority on HIV/AIDS and STI prevention programmes.

16 ANNEX 1 WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL MEETING ON 100% CONDOM USE PROGRAMME FOR THE PREVENTION OF HIV/AIDS AND STI Vientiane, Lao People's Democratic Republic August 2003 WPR!ICP /HSI/3.5/001/HSI(3)/2003/IB/2 1 August 2003 ENGLISH ONLY LIST OF PARTICIPANTS, TEMPORARY ADVISERS, OBSERVERS, REPRESENTATIVES AND SECRETARIAT 1. PARTICIPANTS CAMBODIA Dr Kilin Pisey Supervisor-! 00% Condom Use Programme Bantay Mean Chey Provincial Hospital Ministry of Health A venue Kampuchea Krom PlmomPenh Tel: (855 12) Fax: (855 54) ; Dr Ly Penh Sun Deputy Chief of Technical Bureau National Center for HIV I AIDS, STD and Dennatology Ministry of Health No. 170 Preah Sihanouk Avenue Phnom Penh Tel: (855 12) Fax: (855 23) penhsun@online.com.kl1 Mr Kim Sitha HIV/AIDS Program Manager-AIDS/STD Office Sihanouk Ville Health Department Sangkat 4 Khan Metapheap Sihanoukville Tel: (85512) Fax: (855-34)

17 - 12- Annex 1 CHINA Dr Wang Wenjie Deputy Director Division II Department of Disease Control Ministry of Health 1 Xiwai Nanlu Beijing Tel: (8610) Fax: (8610) wangwj@moh.gov.cn Dr Wang Xiaochun Director Office of International Cooperation and Program Management National Center for AIDS/STD Prevention and Control No. 27 Nanwei Road Beijing Tel: (8610) Fax: (8610) wangxc@ 163. net Mr Chen Xi Chief, AIDS/STI Prevention Division Hunan Provincial Center for Disease Prevention and Control 50 Furongzhong Road, Changsha Hunan Tel: (86731) Fax: (86731) bsichan@hotmail.com LAO, PDR Dr Chansy Phimphachanh Director National Committee for the Control of AIDS Bureau Ministry of Health Vientiane Tel: (856-21) ; Mobile: (856-20) Fax: (856-21) or ncca@laotel.com Dr Panom Phongmany Deputy Director of Health Department Savannillchet Province Tel: (856-41) ; Mobile: (856-20) Fax: (856-41) pphongmany@yahoo.com Dr Phengphet Phetvixay Head ofiec Unit National Committee for the Control of AIDS Bureau Ministry of Health Vientiane Tel: (856-21) ; Mobile: (856-20) Fax: (856-21) phetvixay@hotmail. com

18 - 13- Annex 1 MONGOLIA Dr Bavuu Enkhjin Officer in Charge of HIV I AIDS and STI Ministry of Health 2 Olympic Street Room 212 Ulaanbaatar-48 Tel: (976) Fax: (976) ebavuu@aids.nm; ebavuu@huuhed.com Dr Khalzan Davaajav Head Department of AIDS/STI National Centre for Communicable Diseases Ulaanbaatar -48 Tel: (976) Fax: (976) Dr Lkhagvajav Zolboot Head, Department of Health Darkhan uul 165 Tel: (976) Fax: (976) PHILIPPINES Dr Roderick Poblete Medical Specialist II Philippine National AIDS Council 3'd Floor Building 12 Department of Health Manila Tel. No.: (63 2) Fax No.: (63 2) or pnacsec@yahoo.com Dr Urrninico Baronda Jr. City Health Officer 11 City Heallh Office Ortiz St Iloilo City Tel. No.: (63 33) Fax No.: (63 33) Ms Gloria Peralta City Administrator City Hall Laoag City Tel. No.: (63 77) Fax No.: (63 77) or lapeso@laoag.net

19 - 14- Annex 1 VIETNAM Dr Nguyen Van Kinh Program Officer Administration for Preventive Medicine and HIV I AIDS Control Ministry of Health 138 A Giang Vo Street Ba dinh District HaNoi Tel: (844) Fax: (844) kinhbyt@hotmail.com Dr Hoang Due Hanh Director Ratay Preventive Medicine Center No 23 Nguyen viet xuan street Ha Dong Town Ha Tay Province Tel. No.: Fax: hoangduchanh@hotmail.com Dr Nguyen Van Huan Director Dennatology and Venereology Center Quang Ninh Province Tel: Fax: TEMPORARY ADVISERS Ms Chantawipa Apisuk, Noi Foundation Director Empower Foundation 57/60 Tivanond Road Nonthaburi Thailand Tel. No. (662) Fax No: (662) badqirls@empowerfoundation.org Capisuk@access.inet.co.th Dr Anupong Chitwarakom Senior Expert in Preventive Medicine Depa1tment of Disease Control Ministry of Public Health Nonthaburi Thailand Tel. No.: (662) Fax No.: (662) anupongc@health.moph.go.th

20 Annex 1 Ms Mang Chrep Peer Educator Cambodian Women for Peace and Development # Snakat Beoeng Keng Kang I Phnom Penh Cambodia Tel. No.: (855) Fax No.: (855) Ms Phenjan Khamkhanan Office Manager Empower Foundation 57/60 Tivanond Road Nonthaburi Thailand Tel. No. (662) Fax No: (662) badgirls@empowerfoundation.org Dr Tun Myint Assistant Director (AIDS/STD) Director-Disease Control Department of Health 91 Upper Pansodan Street Mingalartaungnyunt township Yangoon Myanmar Tel. No.: Fax No.: 95-l hhlwin@cybertech.net.mm Dr Tia Phalla Secretary General National AIDS Authority #33 R 360 Boeing KengKang Phnom Penh Cambodia Tel: (855-23) Fax: naa02@bigpond.com.kh Ms Siripom Sriphen Project Coordinator Empower Foundation 57/60 Tivanond Road Nonthaburi Thailand Tel. No. (662) Fax No: (662) badgirls@empowerfoundation.org

21 - 16- Annex 1 3. OBSERVERS/REPRESENTATIVES Australian Agency for International Development DKT International Family Health International Futut es Group Rakounna Sisaleumsak AusAID Australian Embassy Rue J. Nehru, Quartier Phone Xay Vientiane Lao People's Democratic Republic Tel. No. (856 21) Fax No.: (856 21) rakouna.sisaleumsak@dfat.gov.au Mr Larry Holzman Country Director DKT International-VietNam Unit 504, Floor 30 Nguyen Du, Hai Ba Trung HaNoi VietNam Tel. No.: (844) (Ext 102) Fax No.: (844) Mobile: HolzmanLC@aol.com larrv@dktintemational.org Mrs Nith Sopha Women's Health Officer FHI/IMPACT- Cambodia #11, St. 302 Sangkat Boen Keng Kang 1, Chamcarmom Phnom Penh Cambodia Tel: (855) Fax: (855) sopha@fl1i.org.kh Mr Wang Zhenxiu Deputy Program Manager Futures Group Europe-Beijing Office C12 Guanghua Road, Chaoyang District Beijing China Tel. No.: (86 10) Fax No.: (86 10) Mobile: Wangzx@51condom.com

22 - 17- Annex 1 Ministry of Health, Labour and Welfare, Japan Programme for Appropriate Technology Policy Project PSI Joint United Nations Programme for HIV/AIDS Dr Ichiro Kamoshita Senior Vice Minister of Health Labour and Welfare Ministry of Health, Labour and Welfare lntemational Affairs Division Minister's Secretariat Government of Japan 1-2-2, Kasumigaseki, Chiyoda-ku Tokyo Japan Tel. No.: (81-3) Fax No.: (81-3) Mr Stephen Croll Cambodia Country Program Leader PATH-Cambodia 22 Street 184 Sangkat Phsar Khan Daun Penh PnomPenh Cambodia Tel: (855 23) Fax: (622 23) Mr David Lowe Senior Technical Advisor POLICY Project Sri pat Court Apartment 9 A 7 Phaholyothin Soi 4, Samsen-Nai Phyathai Bangkok Thailand Tel: (66 0) Mobile: (66 0) Fax: (66 0) davidbkkth@yahoo.com Sihamano Bannavong Communications Manager PSI-Lao P.O. Box 8723 Vientiane L1l:o People's Democratic Republic Tel: (856-21) Fax: (856-21) bsihamano@hotmail.com Khamlay Manivong Country Programme Adviser UNAIDS - Lao PDR P.O. Box 345 Vientiane Lao People's Democratic Republic Tel: (856-21) Fax: (856-21) khamlay.manivong@undp.org

23 - 18- Annex 1 Ms Geeta Sethi Country Programme Advisor UNAIDS,P.O. Box 877 Phnom Penh Cambodia Tel: Fax: unaidscmb@bigpond.com.kh United Nations Population Fund United States Agency for International Development WHO, Myanmar Dr Chaiyos Kunanusont CST Adviser on HIV/AIDS and STI UNFPA-CST Bangkok 14th Floor, U.N. Building Raj damn ern A venue Bangkok Thailand Tel: Fax: kunanusont. unescap@un.org Dr Chantha Chak Development Assistance Specialist for HIV I AIDS/ID Office of Public Health US Agency for International Development-Cambodia No. 18 Mongkul Earn Street #288 Phnom Penh Cambodia Tel: (855) ext. 324 Fax: (855) Mobile: (855) cchak@usaid.gov Dr Jamie Uhrig World Health Organization, Myanmar 7 1 h Floor, 330 Ahlone Road Yangon Myanmar Tel: (951) Fax: (951) uhrigj.whomm@undp.org 3. CONSULTANTS Dr Robert Darrell Fischer Consultant 9000 New Delhi Pl. Dulles, VA USA Tel: (503) Fax: (503) fischer@ie-eg.com; fischer@internetegypt.com

24 - 19- Annex 1 Ms Mangai Balasegaram Media Consultant-Freelance Journalist No. 30 Jalan 5/40 Petaling Jaya Selangor, Malaysia Tel: (6) Fax: (603) mangai@wildmail.com 4. SECRETARIAT WHO/WPRO WHO/HQ Dr Bernard Fabre-Teste Regional Adviser, Sexually Transmitted Infections, including HIV/AIDS World Health Organization Regional Office for the Western Pacific United Nations Avenue 1000 Manila Philippines Tel. No.: (632) Fax No.: (632) fabretesteb@wpro.who.int Dr Gilles Poumerol Department ofhiv/aids World Health Organization CH Geneva 27 Switzerland Tel. No.: (41) Fax No.: (41) poumerolg@who.int Ms Gaik Gui Ong Technical Officer Sexually Transmitted Infections, including HIV/AIDS World Health Organization Regional Office for the Western Pacific United Nations Avenue Manila Philippines Tel. No.: (632) Fax No.: (632) ongg@wpro.who.int

25 -20- Annex 1 WHO/China WHO/Mongolia Dr Zhao Pengfei Project Coordinator, HSI WHO, China 401, Dongwai Diplomatic Office Building 23, Dongzhimenwai Dajie Chaoyang District Beijing China Tel: (8610) to 92 Fax: (8610) zhaopf@chn.wpro.who.int Dr Wiwat Rojanapithayakorn WHO, Mongolia Ministry of Health Building Ulaanbaatar Mongolia Tel: (976) Fax: (976) Wiwatr@mog. wpro. who.int

26 ANNEX2 Meeting on 100% condom use programme for prevention ofhiv/aids and STis Monday 18 August 2003.une. ~ ~~i ~,r ~ " ~'.)e ~_e_~~ iol\ I ~l~ ~[~,( reseiife"r 'J:.C! ;f;_ :FaaH~ tuf,. ~ ~ 4:"1 ~ l:! 1_._.,.k I" ~ - ~ 08:00 Registration - Lao Office 08:30-09:00 Opening remarks (WHO/MoH) Dr Deodato Giovanni, WR Dr Bounly Dr Ponmek, MOH 09:00-09:10 Photo session 09: 10-09:25 Introduction of participants and - Dr Bemard F.T. selection of daily Chairs 09:25-09:30 Meeting objectives and expected MsG.G.Ong Chairperson outcomes 09:30-09:45 Overview ofhiv/sti epidemic Dr Bernard Fabre-Teste Chairperson status 09:45-10:00 Coffee/tea break 10:00-10:30 Principles of the 100% CUP Dr Wiwat Rojanapithayakorn Chairperson Speech H.E. Dr Ichiro Kamoshita, Chairperson Vice Minister, Japan I 0:30-12:00 Country presentations and Chairperson discussions on implementation of 100% CUP 10:30 -Thailand Dr Anupong Chitwarakorn 11:00 -Cambodia Dr Ly Penh Sun 11 :30 -Myanmar Dr Tun Myint 12:00-13 :30 Lunch break (Payment ofperdiem) 13 :30-15:00 Continuation of country Chairperson presentations and discussions 13 :30 -China Dr Wang Wenjie 14:00 -VietNam Dr Nguyen Van Kinh 14:30 -Mongolia Dr Bavuu Enkhjin 15 :00-15:30 Coffee/tea break 15:30 -Lao PDR Dr Chansy Phimphachanh Chairperson 16:00 - Philippines Dr.Roderick Poblete 16:30-17:00 Experience from Dominican Dr Gilles Poumerol Republic Output of day 1: Update ofhiv/sti epidemic in Asia Understanding the principles of the 100% condom use programme Experience sharing including lessons learned from all countries implementing the 100% CUP

27 ,...Facllit!Ho/") -22- Annex 2 Meeting on 100% condom use programme for prevention ofhiv/aids and STis Tuesday 19 August 2003,... > Tim ~. r, ' Session ;': ~;: ::;j J~resenter.~ it1 ~> 1 -.h ~ ~-.. '~":li l ' ~!.-1 I''."'-;.:.M... 08:15-08:30 Summary of presentation from Dr Robert Fischer Chairperson Day 1 followed by introduction to group work 08:30-10:00 Group work - Secretariat 10:00-10:30 Coffee/tea break 10:30-12:00 Continuation of group work - Secretariat 12:00-13:30 Lunch break 13:30-15:00 Presentation and discussion of Rapporteur Chairperson group work 15:00-15:30 Coffee/tea break 15:30 Continuation of group Rapporteur Chairperson presentation and discussion How to effectively involve sex Chairperson workers in the planning and implementation of programmes - EMPOWER/Peer educator Ms C. Apisuk I 16:20 (Thailand) P. Khamkhanan/ S. Sriphen - Peer educator Ms Chin Srey Mao/ 16:40 (Cambodia) Mrs Nith Sopha Output of day 2: Report of discussions with suggested options Strategies to effectively involve sex workers in planning and implementation of programmes

28 -23-. ~ ~~ - Meeting onloo% condom use programme for prevention ofhiv/aids and STis Wednesday 20 August 2003 tim ~~;.. ;1';~... "' ). ~... 0 S~si f:lo I.,, -ol ~~:!! se.,. r.,...{ ~ '.. &~:~: - ' Annex 2 ~. 'FaHlH:ifiar. " /~~r t ~,~ -.:. tt1,:r. ; -,l,}.: 1 ' ~, I"",;\,.- IPf. " ~'Si. ~~ J''~~ ~ ~~i ~~~~. lji'i ~. ' - ' 08:15-08:30 Summary of Day 2 Dr Robert Fischer Chairperson 08:30-09:15 Case study on assessment and Chairperson evaluation of the 100% CUP 08:30 - Thailand Dr Anupong Chitwarakom 08:45 - Myanmar DrTunMyint 09:00 - Cambodia Dr Tia Phalla 09: 15-09:30 Experience from POLICY Mr David Lowe Chairperson PROJECT 09:30-10:00 Coffee/tea break 10:00-12:00 Questions and answers and - Dr Tia Phalla discussions on future challenges 12:00-13:30 Lunch break ~ 13:30-15:00 Group work on next steps for - Chairperson implementation and expansion of the 100% CUP in the countries 15:00-15:30 Coffee/tea break 15:30-17:00 Presentation of group work Rapporteur Chairperson Outputs of day 3: Report on future challenges Country work-plan on implementation and expansion of the 100% CUP with identification of support needed

29 -24- Annex 2 Meeting on 100% condom use programme for prevention of HIV/AIDS and STis Thursday 21 August 2003 Tim \,.. ~ Session : Presenter! ~t ~)?!~;f ifatilihtt?11 r. :: <~f r.' J (~.~- 08: I 5-08:30 Summary of Day 3 Dr Robert Fischer Chairperson 08:30-09:30 Experience sharing from Representative from Chairperson Participating agencies Participatil1g agencies 09:30- I 0:15 Future development and next - Dr Robert Fischer steps I 0:15-10:30 Coffee/tea break I0:30-12:00 Discussions on conclusion and Dr Robert Fischer Chairperson recommendations 12:00-13:30 Lunch break 13:30-14:45 Consensus on conclusions and Dr Bemard Fabre- Chairperson recommendations Teste!4:45-15:00 Closing ~ NCCAB I5:00-15:30 Coffee/tea break Outputs of day 4: Activities for future development and next steps Conclusion and recommendation of the meeting