Department of Defense HIV/AIDS Prevention Program [DHAPP] 2012 ANNUAL REPORT

Richard A. Shaffer, Ph.D. Executive Director

Colleagues,

This 2012 Annual DoD HIV/AIDS Prevention Program Report represents a

continued escalation of HIV/AIDS prevention, care, and treatment support to the

countries that need it most. There are many examples of successful

partnerships between US Government (USG) agencies, partner militaries,

nongovernmental organizations (NGOs), universities, community-based

organizations, faith-based organizations, and civilian society. Inside this report

are the results of the work of thousands of dedicated military and civilian

personnel from around the world who are working tirelessly to fight the HIV/

AIDS epidemic occurring among military personnel, their families, and civilian

communities surrounding military bases. This report also documents the role of

the US DoD in the US President’s Emergency Plan for AIDS Relief (PEPFAR), the

largest international health initiative dedicated to a single disease in USG

history. Through PEPFAR and DoD resources, the DoD provides the world’s

largest source of HIV assistance to militaries and works with a worldwide cadre

of military HIV experts to combat the harm and devastation that HIV inflicts on

the health and readiness of the world’s military populations.

One of the activities I am most proud of from this past year was the 2012

International Military HIV/AIDS Conference: Re-Energizing HIV Campaigns

(IMilHAC) co-hosted by the Forças Armadas de Defesa de Moçambique, held in

Maputo, Mozambique, last May. The conference was attended by 417

participants and represented one of the most inclusive international military

gatherings of the year with representatives from 75 militaries, 21 NGOs, the

Office of the US Global AIDS Coordinator, every US DoD Combatant Command,

and numerous USG agencies and multilateral organizations, including the

Global Task Force on HIV Among Uniformed Services and the United Nation's

Department of Peacekeeping Operations. The conference objectives were to (1)

highlight the role of leadership in successful military HIV/AIDS programs; (2)

emphasize the best military health system practices in HIV prevention, care,

treatment, and strategic information; (3) facilitate military-to-military technical

assistance, networking, and partnerships; and (4) consolidate advances in

military medical HIV programs to support an agile, effective, and sustainable

response to the epidemic. Results from the evaluation of the 2012 IMilHAC

indicate that the conference was a huge success and equipped attendees

with the tools to re-energize and encourage greater sustainability for their

military HIV programs.

DHAPP, headquartered at the Naval Health Research Center in San Diego,

California, currently supports military HIV prevention, care, and treatment

activities in 66 countries where programs impact 4.8 million military

members and at least as many dependent family members. We continue to

see growing evidence that this support is also reaching many civilian

communities that surround military bases and depend on these bases for

health care services. The entire health care systems of many militaries

around the world have benefited from the health education, health worker

training, laboratory capacity building, facilities construction, surveillance

tools, clinical treatment, and testing services provided through the collective

efforts of everyone involved in reaching military populations with HIV

services.

During the period from October 2011 to September 2012, 3,377 health

care workers were trained to provide HIV clinical services, and 115,501 HIVpositive

adults and children received a minimum of one clinical service. To

promote early and more effective treatment of HIV-infected persons, and to

encourage individuals to take preventive measures against new infections,

473,328 military and family members were counseled and tested for HIV

infection and received their test results, and 665,785 military and family

members were reached with comprehensive prevention messages.

Encouraging sustainability through the development of local capacity and

expansion of facilities remains an important priority for our program. During

this period, 243 new laboratories were equipped and supported for HIV

testing and diagnostics. New services were supported for the prevention of

mother-to-child transmission, 48,628 pregnant women knew their HIV

status based on testing and counseling services provided to them, and

3,430 HIV-positive pregnant women received antiretroviral drugs to reduce

their risk of mother-to-child transmission. This report also documents that

49,402 men were circumcised as part of an HIV prevention program, and

72,520 people living with HIV/AIDS were reached with a minimum package

of Prevention with Positives interventions.

Reducing the incidence of gender-based violence (GBV) and addressing

gender norms and inequities is essential to reducing HIV risk. PEPFAR has

committed to incorporating gender issues in HIV programming and has

invested in special gender initiatives to order to expand evidence-based

gender programming to all countries. Our partner militaries in Mozambique,

Tanzania, and the Democratic Republic of Congo are part of the PEPFAR

GBV Response Initiative and have been reporting on pilot GBV indicators. In

FY12, these military GBV programs created women’s groups that conduct

debates and presentations for both men and women to address GBV in the

military, developed a module for peer education training on GBV, and used

behavior change communication strategies to engage men and improve

negative power dynamics around sexual practices such as condom use and

the ability to negotiate sex.