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: 2008 2009
ACTIVITY UNCHANGED FROM FY 2008 COP.
This activity has been incorporated into NACP activity narrative.
TITLE: Biological and behavioural surveillance among commercial sex workers in Dar es Salaam
NEED and COMPARATIVE ADVANTAGE: The CDC/HHS in Tanzania has been collaborating with the
World Health Organization (WHO) in providing technical assistance to Tanzania Ministry of Health and
Social Welfare (MOHSW) AIDS Control Program (NACP) to conduct surveillance activities. Tanzania is
confronting a generalized HIV epidemic; the prevalence among pregnant women presenting for antenatal
care at sentinel surveillance sites is 8.7% (Ministry of Health and Social Welfare, 2005). Recent surveys
carried out by the University of Texas Health Sciences Center and the Muhimbili University, College of
Health Sciences, University of Dar es Salaam uncovered newly introduced high-risk behaviors among sex
workers and injection drug users (IDUs), which are overlapping populations.
The increase in heroin use among sex workers has led to an increased HIV prevalence in this population
(McCurdy 2006). As female heroin users' addiction increases, they are more likely to turn to sex work to
meet the financial needs of their habit. Anecdotal reports suggest that heroin use has spread throughout
Tanzania. This core group of potential HIV transmitters could lead to a wave of new infections in the
broader population through non-substance using sex partners, clients of sex workers, and regular sex
partners (spouses) of these clients. These developments warrant the consideration of increased attention
to sentinel surveillance of these most at-risk populations (MARPs), especially in Dar es Salaam.
ACCOMPLISHMENTS: Funds in FY 2007 were given to the National AIDS Control Program (NACP) to
convene a consultation meeting of key stakeholders to map the government strategy in the Health Sector
Strategic Framework (HSSF). There is currently a draft of the HSSF. Funds were also provided to pilot
behavioural and biological surveillance methodologies among bar workers in Morogoro (on the truck
routes).
ACTIVITIES: NACPs' Behavioral Surveillance Survey (BSS) protocols and tools have been used to develop
protocols for surveillance of AIDS cases, STI cases/syndromes, and antimicrobial susceptibility patterns for
STI pathogens. These activities were completed in collaboration with national sociological institutions, local
universities, the World Health Organization (WHO), the German Technical Corporation (GTZ), the joint U.N.
Programme for HIV/AIDS (UNAIDS), Muhimbili National Hospital (MNH), Muhimbili University College of
Health Sciences (MUCHS), Kilimanjaro Christian Medical Centre (KCMC), and the Infectious Disease Clinic
(IDC) of the Dar es Salaam City Council. These data have been compiled in different publications such as
the Tanzania HIV/AIDS Indicator Survey (THIS) and the Demographic and Health Survey (DHS) to provide
valuable information for planning, policy analysis and development. Second-generation HIV/AIDS
surveillance emphasizes monitoring of behavioral trends through BSS as systematic, repeated,
crosssectional
survey of HIV and STI-related behaviors thereby monitoring the level of risk and changes over
time in sub-populations such as commercial sex workers.
FY 2008 funds will support a BSS targeted among commercial sex workers (CSW) in Dar es Salaam and
the level of risk related to migration of seasonal workers, as well as drug and alcohol use. A presurveillance
assessment will be performed to estimate the size of the CSW population to be sampled
through respondent driven sampling (RDS). A drug and alcohol survey instrument developed by the Most
At-Risk Population (MARPS) Technical Working Group will be used, with training of local staff on its
utilization. Data will be collected in the three districts of Dar es Salaam (urban and rural areas) to produce
data for selected high risk areas - ports, trucking routes and brothels. Dissemination of data will include
printed reports and materials coupled to the implementation of HIV prevention interventions targeting the
identified high levels of risk for HIV transmission.
This will be done with a to-be-determined partner. Activities will include a) training of trainers in behavioral
surveillance methods including respondent driven sampling methodology (RDS), b) training field data
collectors on the survey methods, c) data collection, d) data management, analyses and report preparation,
and e) dissemination of study results.
CHECK BOXES: This is a strategic information activity which includes a survey and training. Through the
trainings and implementation of RDS and capture/recapture size estimation, capacity of local organizations
will be built to be able to conduct these surveys.
SUSTAINAIBLITY: Human capacity will be built to conduct these types of surveys in Tanzania. The linkage
of the survey results with development of prevention programs for MARPs will ensure that the data are
used, and programs are evidence-based.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16539
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16539 16539.08 HHS/Centers for To Be Determined 6481 4922.08 MARPS in DSM
Disease Control & - Interventions
Prevention
Table 3.3.17:
