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Prevention. STI Syndromic Management. V. Mass Awareness Campaigns. Education & Training included in all steps. HIV Screening. V. V. HIV Diagnostics. Infrastructure Development. HIV Care & Treatment Management Training. HIV Prevention in a Military Setting.

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hiv prevention in a military setting

Prevention

STI Syndromic Management

V

Mass Awareness Campaigns

Education & Training included in all steps

HIV Screening

V

V

HIV Diagnostics

Infrastructure Development

HIV Care & Treatment Management Training

HIV Prevention in a Military Setting

Department of Defense HIV/AIDS Prevention Program (DHAPP)

Naval Health Research Center

components of hiv prevention in a military setting
Develop plans with the military to achieve its HIV prevention goals

Mass awareness campaigns

Education and training (instructor training, peer education, workplace)

Behavioral change communication (BCC)

HIV screening [prevalence, voluntary counseling & testing (VCT)]

HIV/AIDS surveillance

Sexually transmitted infection (STI) syndromic management

Occupational exposure prevention

Policies and procedures for HIV-positive military

Long-term treatment and HIV management

Components of HIV Prevention in a Military Setting
develop plans with military to achieve their hiv prevention goals
Develop Plans With Military to Achieve Their HIV Prevention Goals
  • Make contact with appropriate personnel within the military
  • Create liaison with US in-country Embassy
  • Work with the individual country to identify its needs and potential solutions
  • Work with other programs such as Centers for Disease Control and Prevention, Global AIDS Program, Joint United Nations Programme on HIV/AIDS, and US Agency for International Development
hiv aids policies
HIV/AIDS Policies

Policies should encompass the following components:

  • Medical readiness
  • Social norms of community
  • Training
  • Prevention
  • Confidentiality
    • Human rights
  • Testing
  • Surveillance
  • Care
hiv aids prevention develop a strategic plan

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
hiv aids prevention develop a strategic plan1

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Safe blood supply
  • Occupational exposure intervention
hiv aids prevention develop a strategic plan2

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Safe blood supply
  • Occupational exposure intervention
  • Surveillance
  • Voluntary counseling & testing
hiv aids prevention develop a strategic plan3

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Safe blood supply
  • Occupational exposure intervention
  • Surveillance
  • Voluntary counseling & testing
  • CD4 counts
  • Viral load
  • Role of rapid tests
hiv aids prevention develop a strategic plan4

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Safe blood supply
  • Occupational exposure intervention
  • Surveillance
  • Voluntary counseling & testing
  • CD4 counts
  • Viral load
  • Role of rapid tests
  • Manage HIV
  • Treat endemic infectious disease
  • Treat OI, TB, malaria
hiv aids prevention develop a strategic plan5

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Safe blood supply
  • Occupational exposure intervention
  • Surveillance
  • Voluntary counseling & testing
  • CD4 counts
  • Viral load
  • Role of rapid tests
  • Communication & coordination
  • Treatment clinics
  • Laboratories
  • Blood banks
  • Training facilities
  • Pharmacies
  • Manage HIV
  • Treat endemic infectious disease
  • Treat OI, TB, malaria
hiv aids prevention develop a strategic plan6

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Safe blood supply
  • Occupational exposure intervention
  • Surveillance
  • Voluntary counseling & testing
  • Ambush Theater
  • Radio & TV programs
  • Billboards
  • Promotional materials
  • CD4 counts
  • Viral load
  • Role of rapid tests
  • Communication & coordination
  • Treatment clinics
  • Laboratories
  • Blood banks
  • Training facilities
  • pharmacies
  • Manage HIV
  • Treat endemic infectious disease
  • Treat OI, TB, malaria
hiv aids prevention develop a strategic plan7

Prevention

V

STI Syndromic Management

Mass Awareness Campaigns

HIV Screening

Education & Training included in all steps

V

HIV Diagnostics

Infrastructure Development

V

HIV Care & Treatment Management Training

HIV/AIDS Prevention Develop a Strategic Plan
  • Prophylactic medicine for sexual contacts
  • Follow-up to ensure effective drug regimen
  • Sexual health training for patients
  • Safe blood supply
  • Occupational exposure intervention
  • Surveillance
  • Voluntary counseling & testing
  • Ambush Theater
  • Radio & TV programs
  • Billboards
  • Promotional materials
  • CD4 counts
  • Viral load
  • Role of rapid tests
  • Communication & coordination
  • Treatment clinics
  • Laboratories
  • Blood banks
  • Training facilities
  • pharmacies
  • Manage HIV
  • Treat endemic infectious disease
  • OI, TB, Malaria
education
Education
  • Identify local social norms & customs
  • Provide:
    • Learning aids (flip charts/diagrams/fact sheets)
    • Visual aids (photographs/posters)
  • Encourage & facilitate:
    • Story-telling (sharing experiences)
    • Group discussions
    • Continuing education
provide training for
Master trainers

Peer educators

Drama troupes

Counselors

Nurses

Physicians

Laboratory personnel

Pharmacy personnel

Chaplains

Social workers

Senior military staff

Uniformed personnel

Provide Training for:
occupational exposure intervention prevention
Occupational Exposure Intervention & Prevention

Hospital staff and patients are at high risk for HIV infection, therefore:

  • Assess:
    • Infection control practices
    • Facilities for tuberculosis (TB) isolation and ventilation
  • Provide mandatory training of health care personnel
  • Consider logistics:
    • Design efficient patient care areas (e.g., where to place sharps disposal containers)
    • Identify solutions for sharps and hazardous waste disposal (such as syringes, scalpels)
      • What kind of disposal container is most appropriate to contain waste/sharp
      • Where to place sharps (clean & dirty) so personnel are least likely to incur occupational exposures
    • Maintain ample stock of protective supplies (gloves, biohazard waste, sharps disposal)
  • Decrease multiple uses of sharps
  • Increase hand washing
  • Develop & schedule regular equipment maintenance & waste disposal routines
hiv screening prevalence surveillance active duty recruits
HIV Screening(prevalence, surveillance: active duty & recruits)
  • Requires personnel who are properly trained and educated
  • Consider logistics: test kits, locations, building, clinics that will ensure confidentially
  • Develop policy to standardize and ensure quality of:
    • Laboratory testing
    • Counseling guidelines
    • Personnel training
  • Offer & encourage counseling upon screening
  • Testing options for HIV positives:
    • HIV rapid testing
    • ELISA testing
    • CD4 counts
    • Behavioral risk surveys to understand risk behavior
  • Provide follow-up for positives
surveillance
Surveillance

Develop surveillance tools:

  • Conduct seroprevalence survey
  • Use data to:
    • Estimate HIV infection prevalence in each military
    • Map prevalence trends over time
    • Estimate resource burden
    • Create annual reports
    • Set up a sentinel population
voluntary counseling testing vct
Voluntary Counseling & Testing (VCT)
  • Ensure privacy of information/confidentially
  • Be sensitive & aware of the potential discrimination & stigmatization the patient may encounter
  • Ensure patient receives test results
  • Provide & encourage counseling
behavior change communication bcc
Behavior Change Communication (BCC)

Multi-level tool to promote and sustain risk-reducing behavior change in individuals and communities via tailored health messages in a variety of communication channels

BCC can help:

  • Increase safe sex practices
  • Reduce stigma
  • Increase demand for VCT, mother-to-child transmission
  • Increase clinic visits for STIs, opportunistic infections (OIs), TB
safe blood supply
Safe Blood Supply
  • Provide personnel training
  • Develop screening algorithm for blood supply usage
  • Develop infrastructure capabilities
mass awareness campaigns
Provide media such as “Ambush Theater” that are more likely to be accepted in the community

Develop mass media programming to include military-specific characters and themes

Consider culture-specific language, behaviors, and perceptions when designing campaigns

Identify myths and misconceptions

Communication tools that can be utilized for mass awareness include:

Radio

Films/video

Posters

Newspapers

Bulletin boards

Training events

Mass Awareness Campaigns
communication coordination
Communication & Coordination
  • Establish phone and e-mail communication
  • Improve Internet technology support
  • Establish office so that information can be updated and communicated to all members of the organization
  • Specify job descriptions and tasks for which each staff member/organization is responsible
  • Limit number of levels of management
department of defense executed hiv aids rudimentary civilian construction refurbishment projects
Department of Defense-Executed HIV/AIDS Rudimentary Civilian Construction/Refurbishment Projects
  • Design & construct:
    • HIV/AIDS education & training facilities
    • Clinics, especially VCT centers
    • HIV/AIDS diagnostic laboratories
    • Blood banks & blood collection centers
    • Supply warehouses solely supporting HIV/AIDS programs (e.g., climate-controlled, secure storage for antiretroviral pharmaceuticals)
    • Small AIDS treatment and care hospitals
    • Other (considered on a case-by-case basis)
laboratory equipment procedures
Laboratory Equipment & Procedures
  • Laboratory tests & equipment may include:
    • Rapid test kits
    • ELISA machine
    • CD4 counter
    • Microscope
    • Magnetic bead CD4 cell separation materials
  • Develop testing algorithm to ensure accuracy of positive HIV test results
hiv diagnostics staging capability
HIV Diagnostics & Staging Capability
  • Provide laboratory infrastructure and equipment
  • Provide personnel training
  • Conduct HIV disease monitoring (CD4 lymphocyte count, viral load, consider alternative options in resource-poor settings)
  • Consider role of rapid tests (evaluation of rapid tests as available)
sti syndromic management
STI Syndromic Management

Coinfection of STI increases likelihood of HIV transmission & acquisition:

  • Syndromic management reduces HIV infection rates & provides an opportunity for HIV prevention education

Provide preventive medicine:

  • Establish programs to contact and test past sexual contacts of known STI patients
  • Know current pharmacological data, sensitivities, most-effective drug regimens
  • Set up clinics where patients may be followed up for progress
  • Provide intensive sexual health training for STI patients
hiv care and treatment management training
HIV Care and Treatment Management Training
  • Provide:
    • Management of HIV
    • Treatment of endemic infectious diseases in HIV seropositives
    • Treatment for OIs, TB, and malaria
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