FY19-FY20 Department of Defense HIV/AIDS Prevention Program: Military Specific HIV/AIDS Prevention, Care, and Treatment Program for PEPFAR (President's Emergency Plan for AIDS Relief) Funded Countries

DHAPP's goal is to maximize program impact by focusing on the drivers of the HIV epidemic specific to the military and to support the development of interventions and programs that address these issues. DHAPP works with militaries of foreign countries to devise plans based on the following process: Meet with key partners in country to determine provisional major program areas and other technical assistance needs.Adapt DHAPP support to a country’s need for prevention, care and/or treatment of its HIV/AIDS situation based on an assessment of the country’s epidemic, and more specifically, in that country’s military.Strengthen the military capacity for ownership and behavioral changes over the long term.Consider program design by leveraging assets with other country partners who have/had successful prevention, care, and/or treatment efforts.Focus on prevention, care and/or treatment impact aligned with national implementation plans.Implement and monitor programs to ensure accountability and sustainability. Countries and their militaries need strong evidenced based HIV programs with measurable courses of action that demonstrate the following specific objectives. Priorities for DHAPP include the following but are subject to change based on O/GAC guidance. Visible support and ownership from the military sector.Development of plans of action and support for military policies that further epidemic control.Alignment with PEPFAR and national strategies and priorities.Testing and treatment expansion to meet 2020 goals of 90-90-90 and 2030 goals of 95-95-95 for people living with HIV. The first goal is identifying 90/95 percent of all HIV-positive individuals in the population; the second goal is linking 90/95 percent of all those identified HIV positive people to consistent antiretroviral treatment; and the last goal is reaching 90/95 percent of all those on antiretroviral treatment to attain viral suppression.Care and treatment plans should use the “Treat All” approach with differentiated models of care. Special attention should be given to TB and other opportunistic infections and address care for those with advance HIV disease.Reduction of mother-to-child transmission of HIVCombination prevention using biomedical, behavioral and structural support for sexual transmission of HIV and other sexually transmitted infections (STI). Interventions include male and female condoms, voluntary medical male circumcision (VMMC), HIV testing and counseling (HTC), diagnosis and treatment of sexually transmitted infections (STIs), antiretroviral drug (ARV)-based prevention, standalone behavioral interventions to minimize sexual risk or increase protection, supportive behavioral interventions to optimize biomedical prevention, and legal and policy reform.Prevention packages for specific populations including a comprehensive package for Key Populations (KP), Priority Populations, Positive Health, Dignity and Prevention (PHDP): prevention for people living with HIV, and prevention interventions for young people.Pre-Exposure Prophylaxis (PrEP) of HIV in specific high risk HIV-negative populations in whom annual HIV incidence is greater than 3%.Prevention of cervical cancer progression and mortality among HIV-positive women as directed by PEPFAR.Stigma and discrimination reduction associated with HIV infection.Monitoring should be strengthened to collect and report on PEPFAR indicators, ensure quality of service delivery using clinical and laboratory monitoring tools and to take rapid corrective action based on results.Promoting sustainability through capacity building of the partner military.