07-P0226: Botswana Defense Force.

This activity has USG Team Botswana Internal Reference Number P0226. This activity links to the following: P0210 & P0510.

The EP in Botswana also is supporting activities with the BDF in numerous other areas: CT C0905, Laboratory T1203, ARV Drugs T1110, and Strategic Information T1107.

This entry represents the AB prevention part of the program. The program's funding is split between the two program areas (AB and OP), at 55% and 45%, respectively. The reason for dividing the funding is to allow the program to address the HIV prevention needs of a wider range of beneficiaries than they would with funding from only one of the prevention program areas. The program's effort will reflect the funding proportions noted here.

For the past two years, PSI has carried out this activity and has built a core of peer counselors within the BDF who are reaching the vast majority of the troops. It has also run the only media campaign directed at military personnel.

This activity using FY07 funds will continue to support execution of the BDF five-year plan to combat HIV/AIDS within the military and will build upon a bilateral relationship which has been in existence for the last five years. The BDF's five year program is primarily focused on developing peer level educational programs to effect behavior change to reduce high risk behavior among soldiers serving in the BDF.

The primary implementing partner will be determined through the US Department of Defense (DOD) procurement and grant process. Specific focus for the FY07 behavior change program will build upon current efforts and will be focused on reaching the 18-24 year old age group. The program will include individual and group peer counseling sessions, community events, and mentoring by junior leaders in the BDF Sports program, and training of junior officers and non-commissioned officers serving at the platoon level in mentoring junior soldiers. Some activities will be conducted in the local language. A media campaign using both print and electronic media will be updated and continue as well.

The program will be continuously active at all permanent BDF camps, and will reach soldiers at deployment locations on a routine basis. The program will cover the following topics in order of emphasis: 1) partner reduction and fidelity, 2) correct and consistent condom use, and 3) HIV testing promotion. The program will include training or refresher training for 180 peer counselors, 50 platoon level leaders and leaders of 15 sports teams.

07-P0510: Botswana Defense Force.

This activity has USG Team Botswana Internal Reference Number P0510. This activity links to the following: P0226 & P0401 & P0511. The EP in Botswana also is supporting activities with the Botswana Defense Force (BDF) in numerous other areas: Counseling and Testing C0905, Laboratory T1203, ARV Drugs T1110, and Strategic Information T1107.

This entry represents the OP part of the program. The program's funding is split between the two program areas (AB and OP), at 55% and 45%, respectively. The reason for dividing the funding is to allow the program to address the HIV prevention needs of a wider range of beneficiaries than they would with funding from only one of the prevention program areas. The program's effort will reflect the funding proportions noted here.

For the past two years, PSI has carried out this activity and has built a core of peer counselors within the BDF who are reaching the vast majority of the troops. It has also run the only media campaign directed at military personnel.

This activity using FY07 funds will continue to support execution of the BDF five-year plan to combat HIV/AIDS within the military and will build upon a bilateral relationship which has been in existence for the last five years. The BDF's five year program is primarily focused on developing peer level educational programs to effect behavior change to reduce high risk behavior among soldiers serving in the BDF.

The primary implementing partner will be determined through the US Department of Defense (DOD) procurement and grant process. Specific focus for the FY07 behavior change program will build upon current efforts and will be focused on reaching the 18-24 year old age group. The program will include individual and group peer counseling sessions, community events, and mentoring by junior leaders in the BDF Sports program, and training of junior officers and non-commissioned officers serving at the platoon level in mentoring junior soldiers. Some activities will be conducted in the local language. A media campaign using both print and electronic media will be updated and continue as well.

The program will be continuously active at all permanent BDF camps, and will reach soldiers at deployment locations on a routine basis. The program will cover the following topics in order of emphasis: 1) partner reduction and fidelity, 2) correct and consistent condom use, and 3) HIV testing promotion. The program will include training or refresher training for 180 peer counselors, 50 platoon level leaders and leaders of 15 sports teams.

07-C0905 Botswana Defense Force.

This activity has USG Team Botswana Internal Reference Number C0905. This activity links to the following: P0401 & P0507 & T1110 & T1204.

Construction of a VCT Center This activity will target military personnel, their dependents, other government department employees, and the general public around the Botswana Defense Force's (BDF's) Eastern Military Garrison in the town of Selebi-Phikwe. This site was chosen based on the high prevalence rate in Selebi-Phikwe noted in the Botswana AIDS Impact Survey II (BAIS II, 2004) and the Antenatal consultation (ANC) sentinel surveillance surveys (2001, 2003, 2005).

The BDF Camp in Selebi-Phikwe is located some distance from town and this makes accessibility of services difficult for the military personnel and those residing near the camp. Currently, although minimal testing does occur in the garrison, the normal procedure is for Tebelopele Testing Center in Selebi-Phikwe to go and perform the testing. This is inadequate because Tebelopele staff itself is already overstretched. In response, this funding will support the construction of a new VCT center at the Eastern Military Garrison. Please refer to activity 07-T1204 (BDF Lab).

The BDF offers care, treatment, and monitoring of patients on ARV treatment to its personnel and family, and to people living around their various camps. The new VCT center will therefore provide ARV treatment and counseling to HIV positive individuals who are identified at the center, as part of their integrated CT, care and treatment services. In FY07, funding will also be provided to procure one additional porta cabin to strengthen laboratory services for care and treatment in the BDF camp in Selebi Phikwe. This additional VCT center will be the fifth permanent VCT operated by the BDF. In conjunction with the existing centers at Francistown, Gaborone, Thebepatswa and Maun, this new center will mean that all of the BDF's major permanent camps will be covered.

Training Additional counselors need training to operate this facility, and the counselors at the existing facilities require retraining in new protocols. This training will be conducted by the IDM as described below.

Procurement of rapid HIV test kits

The current rate of HIV testing in BDF is about 4,000 per year, and it is anticipated that when VCT services are made more accessible throughout the BDF, the rate may be increased to 6,000 per year. We program that 5,000 test kits need to be procured for FY07. These test kits will be used in all BDF camps and in operational areas for testing of deployed soldiers. Although procurement is done through the Government's CMS, its procurement program currently cannot meet the BDF's needs in a timely manner. The purchase of kits specifically for the BDF is necessary until the training and management program for CMS staff is completed. The USDOD will work with BDF to procure and distribute the HIV test kits through local agents like the Eagle Systems.

Sub-partner: IDM As described above, using FY07 funds, the US Department of Defense (DOD) and the BDF will sub-contract with the IIDM to train additional counselors to operate the new VCT center that will be constructed BDF's Eastern Military Garrison in Selebi-Phikwe. The counselors at the existing facilities also require retraining in new protocols. These include training in the VCT protocol for same-day results, training in performing the rapid tests, training in couples counseling and adherence counseling.

The IDM is the key counselor training institution in Botswana. IDM uses the curriculum approved by the MOH for training in basic HIV counseling and the CDC protocol for VCT and couples counseling. Most institutions in Botswana, including the government, use the IDM for counselor training.

07-T1110: Botswana Defense Force.

This activity has USG Team Botswana Internal Reference Number T1110. This activity links to the following: C0905 & P0507 & T1201 & T1203 & T1204.

The National ARV program began in 2002, and the BDF launched its first ARV treatment site in September 2003 at Thebephatshwa Air Base (TAB). The second site was launched a year later at Francistown, and a third was launched in Sir Seretse Khama Barracks (SSKB) in 2004. Note that SSKB has four satellite areas, including Glen Valley, Village, Lobatse and Pitsane.

Currently, data in all of the sites is captured manually, which has a negative impact on follow-up, particularly where treatment modification is necessary. In 2005 and 2006, EP funds supported the initiation of computerization of the BDF sites. This has strengthened the registration process and facilitated follow-up and treatment monitoring for patients. The long-term plan is to network all of the BDF ARV treatment sites to allow easy follow up as troops move around the country. In 2007, emphasis will be placed on the Francistown clinic, as data at this site are still being captured manually.

The BDF is significantly expanding its VCT and laboratory capabilities, but the expansion has overstepped the BDF's information management capabilities. Most notably, the expanded VCT center at the BDF Headquarters, the VCT center at Silebe Phikwe, and the clinic at Francistown have not yet been integrated into the wide area network.

FY07 funds will be used to integrate these locations into the BDF network, thus making it possible to track the testing and patient data, and permitting soldiers from other locations to receive assistance and treatment at these facilities when on temporary duty.

07-T1204: Botswana Defense Force Lab.

This activity has USG Team Botswana Internal Reference Number T1204. This activity links to the following: C0905 & T1110 & T1201.

The Botswana Defense Force (BDF) offers care, treatment, and monitoring to its personnel and the family of personnel, as well as people living around the different camps. In FY06 a prefab lab was built in Francistown to support the ARV treatment program. There is a desperate need to strengthen the existing labs, the QA program, and provide additional equipment and training.

QA and training FY07 funds are requested to support the enrollment of 3 BDF labs in a QA program, and to provide quality management training to three lab techs. The funds will support annual equipment maintenance for the existing lab equipment, and assist in developing a linkage with the existing mechanism at MOH for equipment maintenance and calibration.

Renovation In FY06, a porta cabin was provided to the Francistown BDF clinic to support the ARV treatment monitoring of VL and CD4. Efforts will continue in FY07 by providing one additional porta cabin to strengthen the care and treatment in the BDF camp at Selibe Phikwe. The laboratory will support the satellite clinic at Selibe Phikwe as well as the PMTCT and TB program.

Procurement of reagent and equipment In FY06, CD4 and VL equipment was provided by US Department of Defense (DOD) to the Francistown laboratory. In FY07, additional equipment for hematology and chemistry, as well as laboratory supplies will be provided to the laboratories in Francistown and Selibe Pikwe. A prefab lab with adequate equipment will be needed to strengthen the care and treatment in the BDF camp at Selibe Phikwe. Reagents for CD4 and VL will also be provided to support the ARV treatment program. FY07 funds will help develop a laboratory information and management network system to strengthen the monitoring system of the patients under ARVs in the different BDF ARV clinics and laboratories.