Members of the PCS staff designed a training of trainers curriculum for HIV/AIDS hotline counselors in five African countries. Bérengère de Negri and Liz Thomas worked in South Africa and later in Burkina Faso, Cote d'Ivoire and Togo. Lucia Kramer and Chamberlain Diala adapted the training curricula for Nigeria. The staff implemented these activities under the PCS and Family Health and AIDS Prevention (FHA) Projects with funds from USAID.

As regular and cellular telephone service becomes increasingly available and cheaper in African countries, the PCS staff expects that demand for hotline services will increase. In the interim, team members may return to the field to observe the hotline counselors that they trained in recent months and to follow up TOT activities.

The Curriculum: The two-week counselor training curriculum, which is available in both English and French, consists of two modules: 1) HIV/AIDS Information; and 2) Counseling Skills. Participatory learning techniques such as small group work and role plays are extensively utilized. Local experts, including doctors, legal specialists and home-based care providers, co-facilitate selected sessions and complement the knowledge of the trainers.

Due to the high turnover of counselors, it is essential that local hotline staff be able to train new counselors. AED has developed a 3-1/2 day Training of Trainers (TOT) module that can be added on to the beginning or the end of the counselor training. Doing the TOT before the counselor training has proven to be very effective, since it has allowed the TOT participants to co-facilitate sessions during the larger workshop.

Local Partners: The AIDS hotlines are being implemented by local NGOs in each of the five countries. The largest hotline is the AIDS Helpline in South Africa, which receives over 20,000 calls per month and has 75 paid counselors. The hotlines in the other countries are much smaller and staffed primarily by volunteers. The NGOs running these hotlines include the Youth Empowerment Foundation in Nigeria, AFAFSI/SWAA in Burkina Faso, Ruban Rouge in Côte d'Ivoire (not operational yet) and Pais Sans Frontières in Togo (not operational yet).

Lessons Learned: Following are some lessons that AED has learned during the process of developing and implementing the training curriculum in various countries:

· An effective hotline can be launched with a single telephone line and limited resources if the NGO has a corps of dedicated and well-trained counselors.

· Counselor trainees need to be provided with resource materials, but they can be easily overwhelmed with information and statistics. It is important to emphasize basic HIV/AIDS information and ensure that the counselors know it well.

· The majority of AIDS hotline calls are for basic information and do not require extensive counseling. This should be taken into account during the training of counselors.

· Trainers should be prepared to manage strong emotions among counselors who are HIV positive or affected by HIV in other ways.

· Call data forms, evaluation tools and referral resources should be developed in collaboration with trainees in order to ensure their effective utilization.

· Call volume is directly related to the intensity of promotional activities. Sharp increases or decreases in call volume can alternately overwhelm or discourage counselors. Therefore, it is important to 1) Train counselors before the hotline is extensively promoted; and 2) Ensure continuous promotion of the hotline after it is launched.