DEPARTMENT OF DEFENSE HIV/AIDS PREVENTION PROGRAM

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The US Government has a long history and extensive network of international collaboration and partnerships in the fight against HIV/AIDS, providing funding, technical assistance, and program support. These collaborations increase the fundamental understanding of HIV transmission and provide an evaluative basis for prevention and intervention success. The current HIV/AIDS epidemic is devastating. Militaries, in particular, have been identified as a high-risk population. In order to target this population, the Naval Health Research Center (NHRC), San Diego, California, under the oversight of the Navy Surgeon General, has been tasked to serve as the US Department of Defense (DoD) Executive Agent for the DoD HIV/AIDS Prevention Program (DHAPP). DHAPP has successfully engaged over 80 countries in efforts to combat HIV/AIDS among their respective military services. DHAPP is a partner U. S. Government (USG) organization collaborating with the US State Department, Health and Human Services, US Agency for International Development, and Centers for Disease Control and Prevention, in the President’s Emergency Plan for AIDS Relief (PEPFAR). Working closely with US Department of Defense, US Unified Combatant Commanders, Joint United Nations Programme on HIV/AIDS, university collaborators, and other nongovernmental organizations, DHAPP assists countries in establishing HIV/AIDS prevention, care and treatment programs and/or strengthening their capabilities to combat HIV. The new Partnership Framework within PEPFAR is a 5-year HIV/AIDS national strategy which will work in concert with and support the host country’s national HIV/AIDS strategy. The Partnership Framework will delineate USG’s and host country’s roles and contributions to achieving stated goals and objectives. The Phase I Partnership Framework countries are Ghana, Lesotho, Swaziland, Dominican Republic, Democratic Republic of Congo, Malawi, Nigeria, Rwanda, Tanzania, Namibia, and Ukraine. In addition, there is 1 regional Partnership Framework. The Caribbean Regional Partnership Framework includes the following countries: Barbados, Bahamas, Belize, Jamaica, Trinidad and Tobago, Suriname, Antigua and Barbuda, Dominica, Grenada, St Kitts and Nevis, Saint Lucia, St Vincent and the Grenadines. For most of the Partnership Frameworks, the Ministry of Defense and US DoD will have a vital role in designing and implementing the strategy. Most of the Partnership Frameworks were be finalized by the end of 2009. It is important for offerors receiving an award who work in one of the aforementioned Partnership Framework countries to connect with the military Partnership Framework point of contact. Offerors receiving an award should be aware of the military’s PEPFAR activities and work in concert with these activities without duplicating efforts, creating parallel systems, or conflicting activities. DHAPP's goal is to maximize program impact by focusing on the drivers of the epidemic specific to the military, and to support the development of interventions and programs that address these issues. DHAPP works with countries’ militaries to devise plans based on the following process: • Meet with key partners in country to determine provisional major program areas and other technical assistance needs. • Adapt DHAPP support to a country’s need for prevention, care and/or treatment of their HIV/AIDS situation based on an assessment of the country’s epidemic, and more specifically, in that country’s military. • Strengthen the military capacity for ownership and behavioral changes over the long term. • Consider program design by leveraging assets with other country partners who have/had successful prevention, care, and/or treatment efforts. • Focus on prevention, care and/or treatment impact aligned with national implementation plans. • Implement and monitor programs to ensure accountability and sustainability. Countries and their militaries need strong programs with courses of action that demonstrate: • Visible support from the military sector. • Development of plans of action and policies. • Alignment with PEPFAR, as well as national, strategies and priorities. • Increasing awareness within the military sector. • Country military ownership of its activities. • Prevention plans focusing on prevention of sexual transmission through voluntary counseling and testing, sexually transmitted infection (STI) prevention and management, behavioral interventions, reduction of concurrent partnerships, prevention and care of opportunistic infections, male circumcision, changing male normative behaviors, and prevention campaigns. • Reduction of mother-to-child transmission, (The primary focus of these interventions is on behavior change to reduce the risks of sexual transmission, counseling, testing, diagnosis and proper linkages to care and support). • Stigma reduction associated with HIV infection. • Surveillance and infrastructure development through programs focusing on HIV/STI/tuberculosis surveillance, prevalence surveys, laboratory support, monitoring and evaluation, training and strategic information management. • Increasing capacity building. • Promoting sustainability by the partner country. The DoD HIV/AIDS Prevention Program (DHAPP), based at the Naval Health Research Center (NHRC) in San Diego, California, provides technical assistance, management, and administrative support of the global HIV/AIDS prevention, care, and treatment for foreign militaries. DHAPP administers funding, conducts training, and provides technical assistance to participating militaries. In addition, DHAPP staff serve on most of the PEPFAR Technical Working Groups and Core Teams through the Office of the U.S. Global AIDS Coordinator. DHAPP provides HIV program execution and monitors outcomes, with staff that includes active duty military, civil service, and contract personnel. More information about countries in which DHAPP currently operates and existing DHAPP programs can be found on the DHAPP website: http://www.med.navy.mil/sites/nhrc/dhapp/background/Pages/default.aspx

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