The U.

S.

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

credit: John Hopkins Krieger School of Arts and Sciences Department of Economics

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 U.

S.

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 U.

S.

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 U.

S.

Department of Defense, U.

S.

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.

This BAA allows DHAPP to assist countries where militaries are not funded under PEPFAR.

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 members 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.

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