Umbutfo Lophilile ngulonqoba iHIV Project: HIV epidemic control for a healthy military
Abstract
Offeror: University Research Co., LLC (URC) is an international public health firm with demonstrated technical capacity in strengthening health systems and expanding access to quality health services in Swaziland and globally. Objectives of the project: This PEPFAR-funded program will collaborate with the Department of Defense HIV/AIDS Prevention Program (DHAPP) to provide support to the Angola to reduce the number of new HIV infections and other sexually transmitted diseases among members of the Angola military or Forças Armadas Angolanas (FAA), their families, and the civilian communities served by the Angola military health directorate. The project objectives are to i) aggressively scale-up the military ART program to achieve 90-90-90 goals for HIV epidemic control within the military ii) aggressively scale up HIV testing services in order to achieve the first 90 for military personnel; iii) Improve the Clinical Laboratory Services in the military hospitals for HIV care; iv) Improve Clinical Monitoring Systems in the FAA HIV/AIDS program; and v) scale up of comprehensive HIV prevention interventions in the Angolan military, their families and hotspots. Assessed needs: The Forças Armadas Angolanas (FAA) is comprised of approximately 100,000 service members. Despite the Angola military leadership’s prioritization of HIV testing to achieve established 90-90-90 targets, the FAA faces many challenges in controlling the HIV epidemic. Knowledge of HIV among FAA members remains low, access to mobile testing units is limited, HIV Testing Services (HTS) uptake is low, and linkages to care and treatment remains problematic. FAA staff are often deployed in areas with high numbers of female sex workers, creating hotspots for HIV infection close to military barracks. Although the military provides comprehensive HIV diagnosis and treatment services in all military hospitals, it is not reaching the entire military target population. Mobile outreach for HIV testing services to the brigades’ services are not consistent due to human resource shortages and competing demands for outreach transport. HIV treatment coverage in the military is 50%, with nearly to 2,000 clients currently on treatment to date. 40% of military members with HIV are retained in care at 12 months due to late presentation, weak defaulter tracking and follow up systems, and slow implementation of TEST and START within the military. HIV treatment initiation is provided in the five health facilities, yet access issues remain. Decentralization of services could increase access and equity, while capacity building of military health staff is needed to improve provision and monitoring of quality services. HIV laboratory monitoring is being transitioned to routine viral load (VL). Military VL capacity must be increased by setting up VL equipment at the two remaining sites or through an optimized specimen transport and results delivery system. Supply chain management remains an issue for medicines and laboratory commodities. Patient level data is not routinely used for clinical and programmatic planning due to challenges with the M&E system. Anticipated Impact and Results: The project aims to reduce new HIV infections and other sexually transmitted diseases among members of the Angola military, their families, and surrounding civilian communities. URC will work directly with the Angolan military health directorate to aggressively scale up combination prevention and the military ART program to achieve 90-90-90 goals for HIV epidemic control within the military over the life of this project. The project aims to achieve 650 new ART initiations, increase the number of patients on ART to 1,750 under HIV/AIDS Care and Treatment (HTXS), test and provide results to 16,975 people under the HTS; strengthen HIV Clinical Monitoring Systems; and provide HIV prevention interventions to 20,497 individuals (PP-PREV).
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- May 11, 2018
- Source ID
- N002441810005
Entities
People
- Neeraj Kak
Organizations
- United States Navy