Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015

Details for Mechanism ID: 14400
Country/Region: Central America Region
Year: 2013
Main Partner: Population Services International
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USDOD
Total Funding: $0

With FY12 funds, PASMO will provide technical assistance to support the Guatemalan Armed Forces (GAF) to administer HIV program activities in Sexual Prevention, Testing and Counseling and Health System Strengthening for military members and their families. Similar activities using pipeline funds will be implemented to support the program in the Honduran Armed Forces (HAF).

The prevention emphasis will be on providing military members the necessary skills to engage in safe sex practices and reduce risk behaviors. By targeting military personnel, activities will support the Partnership Framework prevention goal of increasing healthy behaviors among at risk populations to reduce HIV transmission. Results from baseline bio-behavioral surveys obtained in 2012 will inform the future planning and direction of prevention activities in the HAF and the GAF.

The support of prevention programs leverages existing military institutional structures building the foundation for sustainable programs. The implementation of military HIV policies and strategic plans addressing issues related to HIV testing. Technical assistance for systems and institutional strengthening will encourage addressing issues related to access, availability and quality of prevention, care, treatment and support programs.

Cost efficiency and quality will be improved by increasing capacity of military healthcare workers to conduct trainings internally, leveraging partnerships with local organizations, and sharing best practices across militaries in the region. The program will incrementally increase the financial and human resource responsibility of the host country militaries. Program monitoring and evaluation will be carried out to inform program planning and efficacy.

Funding for Health Systems Strengthening (OHSS): $0

With FY12 funds, the institutional capacity of military health unit personnel in the Guatemalan Armed Forces (GAF) will be strengthened to implement comprehensive prevention strategies for HIV & STIs through the training of military health providers in the diagnosis and treatment of HIV, other STIs and OIs. Training will also include prevention with positives activities to improve health care providers abilities to effectively counsel military members on healthy living, reduction of risk behaviors, partner notification, adherence to ART and inquiry and linkages to family planning. Efforts will be made to address stigma and discrimination by promoting accepting attitudes toward people living with HIV/AIDS as well as strengthen service integration for HIV/STI care and treatment and referral networks. Strategic partnerships with other governmental organizations, NGOs, and private entities working on HIV and health for improved program quality will be emphasized. Similar activities in Health System Strengthening to be implemented in the Honduran Armed Forces (HAF) in FY12 will use pipeline funds.

Partnership Framework activities will support the development and implementation of military HIV policies and strategic plans addressing issues related to HIV testing (recruitment and periodic), retention and promotion of identified HIV-positive individuals. Technical assistance for systems and institutional strengthening will encourage addressing issues related to access, availability and quality of prevention, care, treatment and support programs.

Military leadership sensitization, endorsement and support of interventions addressing gender norms, substance abuse, and confidentiality among others will be sought to assure greater sustainability. Financial and program management mechanisms will be improved and training will be provided related to these areas. The development of mechanisms for leveraging resources and creating greater resource efficiencies will be encouraged.

Opportunities for military-to-military exchange training programs and professional exchanges to share program best practices and foster regional collaborations will be planned. Technical assistance will be provided for the development of strategies to encourage staff retention, performance and promotion for healthcare staff providing HIV/AIDS-related services. Service guidelines will be developed and/or disseminated and quality assurance mechanisms will be established. Military personnel will also be trained on HIV and other disease surveillance and strategic information.

Funding for Testing: HIV Testing and Counseling (HVCT): $0

Using FY 12 funds, activities will strengthen the capacity of the Guatemala Armed Forces (GAF) to provide accessible, confidential, and quality testing and counseling services. Activities will support the provision of HIV testing and counseling (HTC) services to the military members and their families. Funds for this activity will be used to train military health providers and technicians in provider-initiated HIV testing and counseling (PITC) and HTC and to support monitoring, evaluation and quality assurance programs to ensure quality service delivery through PASMO. Increasing PITC uptake in patients presenting with STIs will be also a focus. To strengthen the capacity of the GAF, training in STI syndromic management and referral mechanisms and sensitization trainings for military health providers to reduce stigma and discrimination will be conducted. Similar HIV testing and counseling activities to be implemented in Honduras in FY12 will use pipeline funds.

HTC activities will link with prevention sensitization activities to educate participants and encourage testing especially during time periods around pre- and post-deployment. Expansion of mobile and outreach services will be explored as a means to reach military personnel working in geographic areas away from military hospitals and urban testing sites. Focus will also be on strengthening collaboration & partnerships with the Ministry of Health (MoH), and surrounding MoH treatment sites for maximum patient retention and adherence.

Technical assistance in the provision of quality HTC services will be provided to military health providers. Counseling will be performed in accordance with national guidelines and will include targeted prevention messages, emphasizing the reduction of risk behaviors, and address issues surrounding stigma and discrimination.

Soldiers who test positive will be referred for care and treatment. At all levels, attention will be given to increasing the gender equity in accessing HIV/AIDS programs and addressing stigma and discrimination as well as positive living. In collaboration with Sanidad Militar, HTC IEC materials will be developed and disseminated to all HTC centers in the military. The program will also work closely with the Supply Chain Management System (SCMS) in procuring test kits and other medical consumables.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $0

Partnership Framework activities will build on previously established sexual prevention initiatives with the Guatemalan Armed Forces (GAF) and the Honduran Armed Forces (HAF). With FY12 funds, PASMO will support partner militaries in Guatemala in the expansion and integration of focused HIV prevention activities for military members and their families. Similar activities to be implemented in Honduras will use pipeline funds. The overall goal is to focus on the drivers of the epidemic specific to the military and address knowledge, attitudes and practices related to HIV prevention. Technical assistance will build internal capacity of partner militaries to direct and maintain HIV prevention efforts.

FY12 BCC activities for HIV prevention and risk reduction will target recruits, enlisted soldiers, officer groups and their dependents. Technical assistance will be provided for the provision of evidence based interventions in areas such as increasing correct and consistent condom use (including minimizing the stigma surrounding accessing condoms), promoting condom negotiation skills with partners, decreasing sexual risk behaviors, mitigating the influence of alcohol on sexual risk taking behaviors, HIV testing and counseling (HTC), improving knowledge and attitudes about testing, decreasing HIV-related stigma, addressing gender and male norms, and the influence of mental health factors on risk behaviors. Prevention activities will promote partner reduction by communicating the risks associated with overlapping or concurrent sexual partnerships. Condoms will be provided in collaboration with the Global Fund and PASMO will establish new condom retail outlets at the military bases in addition to ensuring free distribution of condoms. Prevention counseling will be integrated into testing and counseling services and will link with HIV testing and care and treatment services. Health seeking behaviors and access to services will be promoted. Analysis of structural changes that may decrease vulnerability to HIV and other STIs will be conducted with community participation to promote their adoption.

Interventions will be delivered through individual one-on-one and small group sessions, campaigns, and through trainings integrated into military institutions. Specific education workshops for military officers will be implemented, in addition to troop-level education sessions will be implemented by peer educators trained in risk reduction counseling and equipped with risk reduction supplies (i.e. penile models, condoms). Master trainers will train others on how to implement educational outreach and community mobilization activities and provide supportive supervision of peer educators. Selection criteria will be established for peer educators, and retention and incentive strategies will be developed with militaries to encourage sustainable programs. Refresher trainings for peer educators will also be provided.

Efforts will be made to integrate STI screening and treatment into existing medical health services and routine medical care for military personnel. Technical assistance for the diagnosis and treatment of STIs with STI awareness and incorporation into educational outreach and other prevention activities will be conducted. STI services will link with HIV testing, care and treatment services.

Militaries require strong HIV prevention programs and evidence based programming is fundamental for effective interventions.

Key Issues Identified in Mechanism
Implement activities to change harmful gender norms & promote positive gender norms
Military Populations