Lesotho-Military Specific HIV/AIDS Prevention, Care, and Treatment Program for PEPFAR funded Countries
Abstract
Population Services International (PSI) is pleased to submit the following concept paper to the Department of Defense (DoD) HIV/AIDS Prevention Program (DHAPP) under Funding Opportunity Announcement N00244-17-S-FO02, for continued collaboration with the Government of Lesotho (GoL). The proposed activities build on PSI’s previous experiences working with the military in Lesotho, and complement other President s Emergency Plan for AIDS Relief (PEPFAR) programs currently being implemented in Lesotho. Despite substantial progress towards the 90-90-90 UNAIDS targets (Lesotho: 77-90-88), incidence of HIV in Lesotho is one of the highest in the world at 1.47% among adults 15-59 (1.75% among women and 1.22% among men), representing approximately 13,000 new cases annually.1 Although no literature is available on the incidence or prevalence of HIV among the uniformed forces, they are estimated to closely mirror that of the general population. Military personnel and their partners are particularly vulnerable to HIV/AIDS due to high mobility, multiple concurrent partnerships and being away from norms that regulate behavior in stable communities.2 To achieve epidemic control, the GoL emphasizes the continued expansion of HIV testing and treatment.3 The proposed project will contribute to the goal of reducing incidence of HIV and other sexually transmitted infections (STIs) among military personnel, their families, and the surrounding civilian communities served by the Lesotho Defense Force (LDF). The project will build on successes of ongoing interventions under the current, DoD-funded, joint PSI/LDF project to accelerate the achievement of the 90-90-90 UNAIDS fast track targets in line with national objectives. The Lesotho Population-based HIV Impact Assessment found that case finding is higher among women (85%) than among men (71%).4 Therefore, PSI will boost HIV testing services (HTS) by optimizing the index testing model through introduction of partner notification services (PNS) and leveraging PSI’s leadership in the Self-Testing Africa (STAR) initiative to accelerate uptake of HIV self-testing (HIVST). The project will also incorporate recent success linking PLHIV to care and treatment. In Q1 of Phase 4 of the current project, 92% of identified PLHIV were linked to HIV treatment initiation through physical accompaniment to treatment and by targeting services to the needs of clients through differentiated models of care, reducing waiting periods and default between diagnosis and clinical services. PSI will build capacity of clinical and managerial LDF personnel through various models, such as national and district level trainings, and will further engage LDF leadership to ensure a gradual transfer of ownership of project activities after the project has ended. Data collected through the implementation of an electronic management record (EMR) system, aligning with MOH plans, and District Health Information Software 2 (DHIS2), will improve client follow-up and facilitate data-driven decision making. PSI will work in close collaboration with the LDF, Ministry of Health (MOH) and relevant nongovernmental organization (NGO) partners to achieve the following objectives: • Contribute to identifying 90% of military personnel and their families living with HIV; • Contribute to initiating 90% of PLHIV among military personnel and their families on HIV care and treatment; • Contribute to 90% of PLHIV among military personnel and their families on antiretroviral therapy (ART) achieving viral suppression; • Scale-up HIV combination prevention services through provision of quality voluntary medical male circumcision (VMMC) services, condoms and pre-exposure prophylaxis (PrEP); • Scale-up TB case detection and treatment services among military personnel; • Improve capacity of HIV/TB laboratory services via capacity building and technical support
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jul 07, 2020
- Source ID
- N002441910004
Entities
People
- Albert Machinda
Organizations
- United States Navy