Dr. Freda Vaughan, CAPT, USN, Ret Country Program Manager DoD HIV/AIDS Prevention Program 19 April 2012

1. Central Asia Regional Health Security WorkshopGeorge C. Marshall European Center for Security Studies 17-19 April 2012, Garmisch-Partenkirchen, Germany Prevention Strategies for HIV/AIDS in Military Populations Dr. Freda Vaughan, CAPT, USN, Ret Country Program Manager DoD HIV/AIDS Prevention Program 19 April 2012

2. Introduction Content of Presentation Strategies for military HIV programs US DoD assistance to foreign militaries Types of assistance in CAR Process for DHAPP collaboration

3. Strategies for Military HIV Programs • Strategic Information • “Know your epidemic” • Data-driven programs • Use outcome indicators • HIV Policy • Align with national policy • Implemented by command leadership • Protect individual rights • Key elements: stigma, discrimination, retention, testing

4. Strategies for Military HIV Programs • Combination Prevention • Behavioral • Peer education integrated into military training requirements • Targeted content – gender, rank, new recruits, risk factors, alcohol/drug abuse, deployment sites • Biomedical interventions • Male circumcision • STD treatment • Structural (change in context or environment) • Access to condoms • Law enforcement – gender-based violence, alcohol, drugs

5. Strategies for Military HIV Programs • Testing & Counseling • Dedicated centers vs. integrated services • Mobile services • Couples • Care & Treatment • ART • Adherence to treatment support • TB/HIV diagnostic and treatment capacity • Prevention with positives

6. US DoD Assistance toForeign Militaries - DHAPP Objectives • Assist in development and implementation of military-specific, culturally focused HIV prevention, care, and treatment programs • Collaborate with other US Government agencies (USAID, CDC), and international organizations (UN, Global Fund), on HIV/AIDS programs for uniformed services • Support HIV/AIDS programs as a Security Cooperation Activity

7. DHAPP – Europe & Central Asia Russia: Military HIV Prevention Conference Estonia: HIV Rapid test kits and training for lab personnel Ukraine: Renovated and equipped VCTs Serbia: Study on HIV prevalence in Armed Forces Tajikistan: HIV/AIDS training for healthcare workers Albania: Equipped lab for HIV testing and blood safety Georgia: HIV prevention training course for recruits

8. Types of Assistance in CAR • Military International Training Program (MIHTP) • 30 day clinical course for physicians in San Diego, CA • Laboratory support • Laboratory equipment • Training for technicians • Support for prevention programs • Counseling & Testing • Educational/training course development

9. DHAPP Collaboration Kyrgyzstan • Medical supplies & equipment, HIV seminar, educational material, multimedia equip • Equipped information center, equipped diagnostic lab, medical equipment, international training • Educational material for training 2009 Training program for trainers, educational material, seminars, 2 MIHTP attendees, sterilization equipment

10. DHAPP Collaboration Tajikistan 2004 2 MIHTP attendees 2005 4 MIHTP attendees 2006 Lab equipment, installation and training 2008 OSI (NGO) contracted to conduct prevention activities • 2 MIHTP attendees

11. DHAPP Collaboration Kazakhstan 2005 2 MIHTP attendees 2008 2 MIHTP attendees

12. Process for DHAPP Collaboration • Host military and designated U.S. DoD representative at U.S. Embassy develop plan for proposed activities • Proposal for activities and requested funding is submitted to DHAPP by U.S. Embassy or NGO • Proposal is reviewed at DHAPP • Decision is made about funding • DHAPP staff is available for technical support through out this process

13. Questions Questions?

14. Dr. Freda Vaughan, CAPT, USN, Ret Country Program Manager, DHAPP Freda.Vaughan@med.navy.mil 619.553.8396