Budget codes are specific areas of HIV programming. They represent the lowest level of planned spending data available from the COPs. The following definitions for the individual budget codes come from PEPFAR’s own data dashboard.
CIRC: Biomedical Prevention: Voluntary Medical Male Circumcision
UNAIDS/WHO issued normative guidance in March 2007, stating that VMMC should be implemented in specified countries as an important intervention to reduce the risk of male heterosexually-acquired HIV infection. In response to the normative guidance and under the leadership of partner country governments, PEPFAR funds can be utilized to support the implementation of VMMC, in accordance with national standards and international guidance. All VMMC services must include a minimum package of clinical and prevention services which includes: offer (and availability) of HIV testing and counseling for all men and, where possible, their partners attending MC services; active referral of clients determined to be HIV-positive to HIV care and treatment programs; age-appropriate sexual risk reduction counseling and counseling on the need for abstinence from any sexual activity during wound healing; pre-procedure clinical screening (focused physical examination and medical history) to detect STIs and contraindications to circumcision; treatment of STIs that are detected; circumcision by a medical method recognized by WHO (surgery or device); post-procedure follow-up, including systematic assessment of adverse events; and, promotion of correct and consistent use of condoms. Though clients are not forced to return for follow-up care, programs must recommend that all clients return post-MC for clinical assessment and care, and allocate resources to provide such follow-up services. VMMC programs must provide active linkages with other HIV prevention, treatment, care and support services. VMMC programs may encompass monitoring, evaluation, and reporting, policy efforts, training (task shifting/sharing), outreach, development of tools for communications, quality assurance, and equipment/commodities related to male circumcision, which focus on safe, efficient service delivery.
HBHC: Care: Adult Care and Support
Encompasses all facility-based and home/community-based activities for HIV-infected adults and their families. These activities aim to extend and optimize quality of life for HIV-infected clients and their families throughout the continuum of illness through provision of clinical, psychological, spiritual, social, and prevention services.
HKID: Care: Orphans and Vulnerable Children
Orphans and vulnerable children (OVC) are defined as children who have lost a parent to HIV/AIDS, who are otherwise directly affected by the disease, or who live in areas of high HIV prevalence and may be vulnerable to the disease or its socioeconomic effects, as stated in the Hyde-Lantos Act that reauthorized PEPFAR in 2008.
HLAB: Laboratory Infrastructure
Encompasses the development and strengthening of laboratory networks and facilities to support HIV/AIDS-related activities, including purchase of equipment (including Point-Of-Care), and commodities and provision of quality assurance, staff training and other technical assistance.
HMBL: Biomedical Prevention: Blood Safety
Activities support a nationally-coordinated blood program to ensure an accessible, safe, and adequate blood supply including: infrastructure and policies, donor-recruitment activities, blood collection, testing (transfusion-transmissible infections, group, and compatibility), component preparation, storage and distribution, appropriate clinical use of blood, transfusion procedures and hemovigilance, training and human resource development, monitoring and evaluation, and development of sustainable systems.
HMIN: Biomedical Prevention: Injection Safety
Injection safety includes the programs, policies, training, advocacy, and other activities to reduce medical transmission of HIV and other bloodborne pathogens, reduce unnecessary injections, and promote the safety of necessary medical injections and related procedures. Injection safety also encompasses infection prevention and control, standard precautions, supply chain management, health care waste management, needle stick management/occupational post-exposure prophylaxis (PEP), and safe phlebotomy.
HTXD: Treatment: ARV Drugs
Includes procurement, delivery, and in-freight of ARV drugs. HTXD encompasses funding for all ARVs, including ART costs for adult and pediatric treatment and PMTCT. All antiretroviral Post-Exposure Prophylaxis (PEP) procurement for rape victims and needlestick injuries is included within this program area.
HTXS: Treatment: Adult Treatment
Includes infrastructure, training for clinicians and other providers, clinical monitoring, related laboratory services, and community-adherence activities.
HVAB: Sexual Prevention: Abstinence/Be Faithful
Activities (including training) to promote abstinence (including delay of sexual activity or secondary abstinence), fidelity, reducing multiple and concurrent partners, and related social and community norms that influence these behaviors, fall under the HVAB budget code. These activities address programming for both youth and adults.
HVCT: Testing: HIV Testing and Counseling
Covers the provision of HIV testing and counseling across the range of community and facility-based settings including client- and provider-initiated approaches. Mobilization to support HTC as well as activities linking HTC users to appropriate follow-on services and tracking linkages are also covered under this budget code.
HVMS: Management and Operations
Encompasses the cost of supporting the U.S. government mission staff to manage, support, and administer HIV/AIDS programs including related training, salaries, travel, housing and other personnel related costs.
HVOP: Sexual Prevention: Other Sexual Prevention
Activities (including training) are aimed at preventing HIV transmission through means other than promoting abstinence and fidelity. All sexual prevention programs for key populations fall within this budget code. Other activities funded within HVOP include: procurement, promotion, distribution, and social marketing of male and female condoms and lubricants beyond key populations; STI management for people living with HIV (PLHIV) outside of care settings (STI treatment for PLHIV within care settings are coded under adult care: HBHC); comprehensive care for survivors of sexual violence including provision of post-exposure prophylaxis (PEP); and activities to reduce alcohol-related sexual disinhibition.
HVSI: Strategic Information
Activities in this budget area aim to establish and/or strengthen national systems and to build in-country individual, institutional, and organizational capacity for HIV/AIDS behavioral and biological surveillance, facility surveys, monitoring program results, reporting results, health information systems, and related data analytic and data dissemination activities. HIV drug resistance surveillance activities also fall under strategic information.
HVTB: Care: TB/HIV
Includes exams, clinical monitoring, related laboratory services, treatment and prevention of tuberculosis (including isoniazid and drugs for treating active TB), as well as screening and referral of TB clinic clients for HIV testing and clinical care. The location of HIV/TB activities can include general medical settings, HIV/AIDS clinics, home-based care, and traditional TB clinics and hospitals.
IDUP: Prevention: Injecting and Non-Injecting Drug Use
Activities encompass policy reform, training, capacity building, community mobilization, and comprehensive approaches including needle and syringe access programs and medication assistance therapy to reduce injecting drug use. Comprehensive programs for People Who Inject Drugs (PWID) that also address non-injection drug use (e.g. methamphetamine) should be included under this budget code. This budget code does not include non-injection drug use interventions (e.g. alcohol), unless they are part of a larger and comprehensive PWID program. Procurement of methadone and other medical-assisted therapy drugs as well as programs for prevention of sexual transmission among PWIDs are included in this.
MTCT: Biomedical Prevention: Prevention of Mother to Child Transmission
Includes activities aimed at preventing mother-to-child HIV transmission, such as HIV testing for pregnant women, antiretroviral treatment (ART) for HIV-infected pregnant women and ARV prophylaxis for newborns, counseling and support for maternal nutrition and exclusive breastfeeding, and related training for clinical and other personnel.
OHSS: Health Systems Strengthening
Includes activities that contribute to improvements in national-, regional- or district-level health systems. Activities may be focused on health systems building blocks themselves as well as on institutions and processes that strengthen the building blocks and their interactions. Prior to 2009, the budget code was called OHPS (Other/Policy Analysis and System Strengthening).
PDCS: Care: Pediatric Care and Support
Includes all health facility-based care aimed at extending and optimizing quality of life for HIV-infected children, adolescents, and their families throughout the care continuum through provision of clinical, psychological, spiritual, social, and prevention services. Clinical care includes early infant diagnosis, prevention, and treatment of OIs and other HIV/AIDS-related complications including malaria and diarrhea (providing access to commodities such as pharmaceuticals, insecticide treated nets, safe water interventions, and related laboratory services), pain and symptom relief, and nutritional assessment and support including food.
PDTX: Treatment: Pediatric Treatment
Includes support to the government to roll out updated pediatric treatment guidelines; infrastructure development; training clinicians and other providers; clinical and laboratory monitoring of children and adolescents on treatment; adherence support and strategies to improve retention in the pediatric and adolescent population; development of capacity to provide laboratory services that escalate case finding for children/adolescents and detect treatment failure; building capacity to monitor, supervise and implement uninterrupted HIV treatment services from infancy to adolescents (including transition to adult services); and promoting integrated approaches to improve outcomes.