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
These funds will be used to support technical area staff.
The overall goal of this activity is to decrease new HIV infections through male circumcision (MC) among Rwanda Defense Forces (RDF) personnel. The program will be presented as part of an expanded approach to reduce HIV infections, and will be promoted in conjunction with other prevention programs, including HIV testing and counseling, treatment for other sexually transmitted infections, promotion of safer-sex practices and condom distribution. MC will not replace other known methods of HIV prevention and will be considered as part of a comprehensive HIV prevention package.
The World Health Organization (WHO) and UNAIDS recommended that MC be made available in countries highly affected by HIV/AIDS to help reduce transmission of the virus through heterosexual sex. According to data from two NIH-funded studies conducted in Uganda and Kenya routine MC could reduce a man's risk of HIV infection through heterosexual sex by up to 65%. According to WHO, implementing MC programs in sub-Saharan Africa could prevent about 5.7 million new HIV cases and three million deaths during the next two decades if combined with other factors such as condom usage, responsible behavior and knowing the HIV status of one's partner. WHO is encouraging countries to provide access to no-cost MC to countries in Southern and East Africa, where HIV rates are high and circumcision rates are low to consider adopting male circumcision as an important and urgent health priority, with the target group being boys and men ages 13 to 30 years. In addition, DoD recognizes that
it is critical for men to know that even if they are circumcised, they can still contract HIV and transmit it to their partners. Therefore, circumcised men should continue to practice abstinence, have fewer sex partners and use condoms. It is important that MC is provided to men who are HIV-negative, emphasizing that it is important to know one's HIV status prior to receiving MC.
In FY 2009, communication and messaging targeting Rwandan military personnel emphasized the many benefits of MC but also reiterated that MC does not provide complete protection against HIV. Communication campaigns occurred at the national level through mass media outlets, which encouraged safe MC as part of a complete approach to prevention. Local and inter-personal communication strategies also employed.
Conducting MC in the Rwanda military is considered vital since the military is predominately male, young, and highly mobile, characteristics which put this group at high risk of infections. In FY 2010 MC will be conducted on a voluntary basis on HIV-negative soldiers, as studies have demonstrated that HIV- positive men who have undergone circumcision may be more likely to transmit the virus to their female partners if they have sex before the circumcision wounds have healed. Attention will be paid to the socio-cultural context, human rights and ethical principles, health services strengthening, training, gender implications, service delivery and evaluation. In the coming year DoD will provide TA to the Rwandan military so it may conduct a research study on the "Circumcision status of military recruits".
These activities address the key programmatic issues of gender (particularly male norms) and stigma reduction. Furthermore, these programs reinforce the PEPFAR strategy of strong collaborating with the GOR, as well as the Partnership Framework and the National Strategic Plan for HIV/AIDS, both of which prioritize prevention efforts among military personnel.
Under the Rwanda Defense Force (RDF), there are a total of three military hospitals and five brigade clinics throughout the country. DoD and the Directorate of Military Services (DMS) works together to promote HIV prevention, care and treatment among members of the Rwanda Defense Forces (RDF). While many soldiers practice sexual abstinence and fidelity, their living situation, mobility and age increase their vulnerability to contracting HIV. The estimated HIV prevalence in the RDF is 4.5% (from where) and, consequently, the PEPFAR five-year strategy highlights the military as a high-risk group.
In FY 2009, DoD worked with DMS to strengthen the capacity of the RDF through periodic TA visits from the Department of HIV/AIDS Prevention Program (DHAPP) and through collaboration with clinical partners and the RDF (Rwanda Defense Forces). The first component of this activity involved providing three short-term TA visits from DHAPP headquarters prevention specialists who supported the RDF health providers with prevention, clinical management, diagnosis and treatment of HIV/AIDS. More
specifically, DoD provided TA to reinforce referral mechanisms between military VCT sites and prevention, care and treatment services. TA also helped improve the integration and linkages between facility based and community based services. Through periodic TA, DoD provided technical and institutional expertise to Drew University and to the RDF to strengthen their capacity to manage and improve clinical activities in PMTCT, TB/HIV, basic care and support, TC, and ART. In addition, TA enabled the RDF and Drew University to improve their performance and promotion of professional medical staff providing HIV/AIDS care and treatment.
DoD is working to ensure that Rwandan Defense Forces (RDF), their family members and communities surrounding the military installations have equitable access to a high quality, sustainable continuum of care through HIV and AIDS services. In FY 2010, TA will help military health providers improve treatment of OIs, STI and TB among HIV-positive military personnel and civilians receiving care at military facilities. In addition, this targeted TA will strive to increase treatment adherence. To address mental health issues related to HIV infection this TA will also improve the quality of psychosocial support services and build capacity treatment of mental ill-health in PLWHA receiving treatment and care at military health sites.
This activity contributes to the Partnership Framework and the National Strategic Plan for improving prevention and treatment services, building on existing services and ensuring quality and equitable access to HIV treatment in an expanded number of sites/districts.
