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 2014 2015
CDC will support NGOs to implement evidence-based prevention programs, including STI services for MSMs and Mobile populations in areas where these services are currently weak or do not exist.
According to the 2008 UNAIDS report on the Dominican Republic, the HIV seroprevalence is an estimated 1.1% (.9%-1.2%), with 66,790 individuals (approximately 54,390 adults and 12,400 children) infected with HIV. Significant differences are found by geographic area and educational and socio-economic levels. Regions V (the east) and VII (northwest border) have the highest prevalence rates, as do women with four years or fewer of formal education and persons in the lowest socio-economic quintile. The 2007 DHS showed that HIV prevalence among the former was almost seven times higher than women with higher education (2.6% and 0.4%, respectively) and three times higher than the general population. Women in the bottom wealth quintile had an HIV prevalence rate almost five times higher than women in the top quintile (1.8% and 0.4%, respectively). Although men still account for the majority of HIV cases, the male to female ratio is decreasing. DIGECITSS 2005 statistics indicate that young women ages 14-24 account for 71% of all new HIV infections. A 2006 CDC assessment found that HIV incidence in young women ages 15-24 is almost twice that of males the same age.
Early sexual debut, multiple concurrent partners, cross-generational sex, MSM behavior and commercial/transactional sex all are driving forces of the DR's HIV epidemic. The 2007 DHS reports that 15% of females and 24% of males initiated sex before age 15, and 46% of women report having had sexual relations prior to age 18. Of these sexually-active adolescents, 45% reported having between two and four sexual partners in the previous 12 months. In two border cities, 28% of sexually-active adolescents reported having a first sexual relation before age ten. Such early sexual debut can be a characteristic of sexual abuse (not generally detected or considered, much less punished, in the DR), informal transactional sex and/or cross-generational sex, all of which put young people (especially young women) at greater risk of HIV/AIDS. Having a partner ten or more years older than oneself is a major risk factor for HIV/AIDS among young women: 23% of women ages 15-49 reported having had sex with partners at least ten years older than themselves; including 29% of women in the lowest economic quintile and over 30% of women living in Health Regions IV (southwest border) and VII.
MARPs in the DR include persons engaged in transactional sex, MSMs, Drug Users, prison inmates, persons living in and around bateyes, and mobile populations.
DR has an estimated 187,000 female sex workers and an undetermined number of male sex workers. In a 2005 study, 99% of female sex workers reported using a condom in the last sexual act with a new client and 95% with a regular client. However, only 58% used a condom the last time they had sex with a "trusted partner". According to the 2008 BSS, seroprevalence in CSWs was 3.3% (Santo Domingo) 8.4% (Barahona).
As in many Latin American countries, MSM behavior is stigmatized and therefore may be underreported. An estimated 6% of the adult male population engages in MSM behavior, although only 3% of adult males admit to having had a same-sex relation. According to the 2008 BSS, MSMs have an HIV prevalence between 5.1% (Santiago) and 7.6% (Higuey).
The DR has an estimated 600,000 to one million undocumented Haitian immigrants and residents, including those working in DR hotels, agricultural sector, construction and other industries. This population is considered to be at high risk of acquiring STIs and HIV: the 2007 DHS reported a HIV prevalence in the batey population of 3.2%, with 8.7% in men ages 40-44 and 8.9% in women ages 15-49.
While HIV prevalence rates in the Dominican Armed Forces (FFAA) are unknown, most of the military population is considered vulnerable or "at risk" for STIs and HIV. A recent study conducted by the FFAA among military personnel posted at the border revealed that this group engages in high-risk behavior.
Certain other segments of the general population also engage in high-risk behaviors. While data suggest that the general adult population knows the health benefits of reducing the number of sex partners, one in five men in union have outside partner(s), and in young couples aged 15-19, one in three men has outside partner(s). In one study, 2% of women of reproductive age and 27% of men aged 15-59 admitted having an average of two or more partners during the last twelve months. For men age 25-29, that number climbs to 50%. Men used condoms only 50% of the time with a casual partner and women of all ages did so only 3% of the time. According to 2006 Sentinel Surveillance Survey, approximately 4% of patients attending STI clinics are HIV+. The Population Services International (PSI) social marketing program, now funded by KfW, has distributed through NGOs more than 62 million USG-provided PANTE condoms through retail shops, brothels, and other sex sites throughout the country. Social marketing of condoms has targeted Bateyes, using NGOs supported by USAID and trained by PSI. GODR, through COPRESIDA and Dermatological Institute and its RCC GF grant, imports 2-3 million no-logo condoms for distribution in prisons, the Armed Forces and at VCT sites. Approximately 400,000 more condoms will be distributed through PROFAMILIA's social marketing family planning program. KfW has asked USAID to share costs in FYs 10, 11 and 12.
USAID originally funded the PSI condom social marketing program, which included condom distribution in non-traditional outlets and a successful "Trusted partner" mass media campaign. KfW took over the funding of this project in July 2007. With FY08 funds, USG/USAID will share costs with KfW. The GF grant will support prevention activities with MARPs and prevention with positives through the provision of funds to the network of persons living with HIV/AIDS.
Number of MARP reached with individual and/or small group level HIV preventive interventions that are based on evidence and/or meet the minimum standards required Target: 500
