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: 2011 2012 2013 2014
Since 1986, Emory Universitys Project San Francisco (PSF) has been Rwandas national leader in the effort to identify & respond to the HIV/AIDS epidemic through Couples HIV Counseling and Testing (CHCT). The great majority of new HIV infections in Rwanda are acquired from an HIV-positive spouse or cohabitating sexual partner. In these "discordant couples (where one partner is HIV-positive and the other is HIV-negative), CHCT reduces HIV transmission from 12-20% per annum (for un-counseled couples that do not know their sero-status) to 3-8% per annum (for those couples that are counseled and observed following joint testing). PSF has developed curricula and trained health professionals in the most effective techniques of this intervention. PSF proposes to continue to provide technical assistance (TA) to the Institute of HIV/AIDS, Disease Prevention and Control (IHDPC), implementing partners, and health care facilities in CHCT and follow-up of discordant couples.
PSF will continue to partner with the HIV Prevention Team at IHDPC to provide TA for implementation of CHCT. In COP12 PSF will provide mentorship to health centers in the city of Kigali for the follow-up & monitoring of the discordant couples follow-up program. In addition, PSF proposes to provide direct TA and mentoring to an additional 15 high volume clinics in Kigali to document incident infection. The selected health centers will provide data on the incidence of HIV infection among discordant couples. PSF will also provide TA to IHDPC and stakeholders to implement CHCT indicators developed in COP11, & train supervisors at the district-level on the monitoring & evaluation of CHCT services and follow-up of discordant couples in clinics throughout Rwanda.
The project does not plan to purchase or leas
More than ninety percent (90%) of new HIV infections in Rwanda are acquired from an HIV-positive spouse or cohabitating sexual partner. PSF will continue to partner with IHDPC and other HIV implementers to provide technical assistance for implementation of CHCT and follow-up of discordant couples in at least 15 health centers. A technical support will also be provided for training and deploying 60 Trainer-of-Trainers (TOT) who are equipped to conduct additional CHCT trainings and provide TRAC-Plus with Monitoring and Evaluation of CHCT operations in clinics.
In COP12, PSF will support the National Program to develop, institutionalize and ensure data collection and use related to outcome indicators on the Discordant Couples Services in accordance with the Guidelines for Discordant Couples. PSF will also support the National Program in documenting HIV incidence in cohorts of discordant couples in the National Program.
Evidence suggests that the majority of new HIV infections in Sub-Saharan Africa occur within stable cohabiting relationships, and that there are high rates of sero-discordance among heterosexual couples. In Rwanda, it is estimated that about 55% of new infections or ~6000 new infections (27 92%) occur in stable, cohabiting sero-discordant couples.
Couples HIV counseling and testing (CHCT) is one HIV prevention initiative addressing this gap whereby couples receive joint HIV counseling and testing (HCT) and supported mutual disclosure of their HIV status. CHCT is associated with increased condom use and reduced HIV transmission among discordant couples receiving the intervention. Through the USG support, a Couples HIV Counseling and Testing (CHCT) Intervention and Training Curriculum was developed in response to increased demand for interventions and training that would help address the complex issues related to HIV counseling and testing with couples.
Family planning is viewed by the GOR as a key intervention to reduce poverty and maternal and infant mortality. The Ministry of Health aims to increase the prevalence of modern contraceptive use by increasing the demand in the population, and by increasing and improving the supply of services offered by health care institutions. Using Couples HIV Counseling and Testing (CHCT) CDC approved curriculum, PSF will integrate HIV couples counseling and testing with family planning services presents an important opportunity to involve men in family planning decisions, and it has been shown to reduce the incidence of unplanned pregnancies by fifty percent (50%). The combination of family planning and couples HIV counseling and testing services is also an important strategy for prevention of mother-to-child transmission of HIV.
PSF will assist health centers to integrate family planning services in CHCT services. The training for nurse/counselors will emphasize the voluntary nature of family planning, the importance of informed choice, the reasons for family planning, the full range of methods available and the advantages and disadvantages of each.
