PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2010 2011 2012 2013
UVG is one of CDC's primary partners. The Center for Health Studies is an academic unit within the Institute for Research at UVG. Its vision and mission is to become a center of excellence by conducting science and training contributing to the improvement of health in Guatemala and the region, in collaboration with strategic partners. During the last 29 years, CHS has developed the capacity to conduct studies in response to public health needs and to translate results into public health programs and policies. Some new areas that have been developed in the last five years include: HIV/AIDS, Tuberculosis and sexually transmitted diseases surveillance and operational research carried out in collaboration with CDC. The UVG has had the ability to integrate laboratory science into field studies. The UVG laboratory capacity includes modern equipment and personnel for entomological, parasitological, bacteriological, virological, immunological and molecular biology activities.
The STI control for HIV prevention intervention (VICITS) among MARPs in Guatemala and Nicaragua is a strategy that has been gradually being transferred to each local MOH. The countries have already started to assume the payment of salaries for some of the clinicians and lab staff, and it is expected that MOH covers 100% of personnel by the end of FY2013. Also, diagnostic reagents & supplies are already being purchased by host countries. UVG consistently shares information with each MOH, and the prevention services, surveillance, and M&E are already integrated into the national health systems of Guatemala, Nicaragua and Costa Rica. UVG is working to establish an expert team as a part of the BSS+ implementation to monitor the epidemic in each country & develop a long term surveillance strategy.
Global Fund / Programmatic Engagement Questions
1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Neither3. What activities does this partner undertake to support global fund implementation or governance?
Budget Code Recipient(s) of Support Approximate Budget Brief Description of ActivitiesHVCT CEPRESI in Nicaragua 4000 Coordination with VICITS and BSS studyHVOP Guatemala PRs: Programa Nacional de VIH SIDA in Guatemala & HIVOS Guatemala 36000 National AIDS Program - Coordination with VICITSHIVOS Guatemala - Coordination with Special Studies
VICITS (Vigilancia y control de VIH, ITS y comportamiento sexual en poblaciones vulnerables HIV/STI/ surveillance and control among most at risk populations) is a comprehensive HIV and STI prevention program linked to the analysis of surveillance data in Central America. VICITS is an HIV prevention strategy that combines sexually transmitted infections (STI) diagnosis and treatment among most at risk populations, condom promotion, behavioural change and an information system to monitor the impact of the project. Due to high infection rates and a high number of sexual partners, sex workers (SW) and men who have sex with men (MSM) have been identified as a core group in HIV transmission in Central America. The presence of sexually transmitted diseases and difficulty of safe-sex negotiation makes this group more sensitive to acquire, and more prone to transmit, HIV. Evidence supports that timely treatment of STIs may reduce HIV transmission, especially in concentrated epidemics and in groups with a high rate of bacterial infection - such SW and MSM. UVG will continue supporting VICITS in Guatemala, Nicaragua and Costa Rica.
M&E for MSM Prevention: It is essential to monitor and evaluate the impact of the interventions being implemented in the region for the groups at highest risk of infection. The UVG will support the implementation of programmatic evaluation of coverage and impact of interventions and costing of strategies. This programmatic evaluation will improve the programs and the heath of the participants covered by the strategies.
Health systems strengthening is a cross-cutting issue for all UVG activities. Prevention services are provided through public facilities and staff is trained, equipment provided, and infrastructure development is provided through this mechanism. Information systems developed either to monitor the impact of prevention interventions or to support surveillance, monitoring, and evaluation are integrated into the national health systems. Health services-- in general-- are mainly tailored to serve the needs of women and children. UVG will work towards equalizing access for men, and especially MSM. Prevention programs will document levels of gender-based violence and include counseling and referral services to address these problems. Data from BSS+ and other special studies will help design strategies to reduce discrimination towards MSM, male and female sex workers.
Training & Communications- CDC, through UVG, will strengthen human resources for health in the areas of HIV, STI, surveillance and reproductive health. The UVG will also support curriculum development, training materials, and technical assistance through the FELTP (Field Epidemiology and Laboratory Training Program). The Center's mission will be to expand human capacity in the region for the implementation of effective, sustainable and context-specific HIV strategic information processes which enable evidence-based development of HIV prevention, care and treatment in the region. CDC and UVG will also support the development and implementation of a communications strategy to assist in dissemination of lessons learned and best practices in the region.CDC through its implementing partner will also train health care personnel to reduce stigma and discrimination towards different groups of men who have sex with men, trans population and female sex workers under the VICITS strategy. UVG will also promote SW and MSM attendance through peer educators and health promoters and will train staff providing services to MSM and SW in data analysis.
Governments in the region have varying levels of service for sex workers. Often these services include medical history and behavioral risk factors interviews, physical exam, basic and sporadic laboratory screening tests, treatment and condoms. STI services are not standardized, supplies are not always available and data on services and STI prevalence has never been systematically gathered and analyzed. Currently there are no STI or Voluntary Counseling and Testing (VCT) services offered methodically for the MSM population.
Through VICITS, access and quality will be improved for STI, VCT, and referral for HIV care and risk reduction counseling at public health facilities for the MSM community in Guatemala, Nicaragua and Costa Rica. The intervention will include strengthening STI etiologic and syndromic management through strenghthening counseling for risk reduction and condom promotion, improving laboratory STI and HIV diagnostic capacity through training and provision of equipment and reagents. An information system to monitor HIV, STI and condom use trends will allow to evaluate the projects impact. The strategy is designed with the participation of the Ministry of Health and implemented in government facilities and selected NGOs.
Early identification of HIV positives and early referral for ART: CDC in conjunction with UVG and based on the recent findings of the study HPTN 052 will be implementing a pilot study in MSM and transgender HIV-positives and their discordant couples, in Guatemala, with the aim of evaluating the feasibility of providing early treatment with ART in countries with limited resources such as Central America. The study by Dr. Mynor Cohen of the University of North Carolina found that "HIV-infected people treated with antiretroviral therapy (ART) when immune systems are still healthy led to a 96 percent reduction in HIV transmission to their partners."
