Strengthening Public Health Systems and Services - Prevention
Preventing new infections represents the only long-term, sustainable means to stem the global HIV/AIDS pandemic. Through the President's Emergency Plan for AIDS Relief (PEPFAR), CDC assists resource-poor countries to identify, develop, implement and evaluate evidence-based HIV prevention interventions.
Building self-reliant HIV prevention programs
CDC collaborates with U.S. government PEPFAR partners, host governments, ministries of health, non-governmental organizations, international organizations, U.S.-based universities, and the private sector to:
- Develop comprehensive, evidence-based programs to prevent the spread of HIV through sexual and non-sexual transmission. These programs include counseling and testing, interventions for people living with HIV/AIDS and other high risk populations, interventions to prevent medical transmission of HIV including blood and injection safety, and new bio-medical interventions including male circumcision.
- Develop HIV prevention guidelines, policies, and implementation strategies.
- Develop protocols and training curricula to facilitate the implementation of HIV Prevention programs.
- Assist with monitoring and evaluating new and existing prevention programs.
- Develop and implement research protocols to improve the effectiveness of HIV prevention strategies used by CDC and its partners in the field.
- Disseminate the results of research to partners and the scientific community through presentations at meetings and conferences and through reports and scientific publications.
CDC
has expanded HIV prevention efforts to include people living with HIV/AIDS (PLWHA),
having spearheaded the development of a comprehensive HIV prevention package for
HIV-infected individuals in sub-Saharan Africa, HIV Prevention for People Living
with HIV/AIDS: An Intervention Toolkit for HIV Care and Treatment Settings. This
evidence-based, field-tested package integrates HIV prevention into the routine
care of PLWHA in HIV care and treatment settings. Healthcare providers deliver
brief prevention messages and provide other prevention services (e.g. STI
management) during routine clinic visits. Lay counselors, most of whom are PLWHA,
are trained to reinforce prevention messages and assist PLWHA in addressing key
prevention issues through supportive counseling. They are also trained to
counsel and test partners in the clinic setting.
Cote d'Ivoire, Haiti, Kenya, Namibia, Nigeria, and Rwanda are currently planning
for national implementation. The package will be evaluated in Kenya, Namibia,
and Tanzania in 2009.
CDC provides technical support to the national blood
transfusion services in 14 countries for needs assessments; strategic
planning; development of guidelines and training materials; procurement; and
the management of agreements with national blood services and with technical
assistance providers. CDC contributes technical input to WHO for the
development of a global blood safety policy.
Ensuring that medical injections are safe for patients, health workers, and
communities is also a critical HIV prevention intervention. CDC manages the
PEPFAR Safe Injection program in seven countries. This program provides
training to healthcare workers, as well as injection equipment and supplies
such as safety boxes to healthcare systems.
HIV
Testing and Counseling (HTC) services provide an entry point into treatment and
care, as well as a crucial opportunity for prevention education, counseling, and
support. Through PEPFAR partners, CDC is pioneering multiple HIV testing and
counseling interventions:
- Provider-initiated counseling and testing (PICT) in medical facilities through training and training curriculum development and, in collaboration with WHO, development of normative guidance on PITC.
- Home based testing and community outreach testing, working with local partners, by developing a standardized training package on door-to-door HTC so that counselors are trained not only in testing but also in prevention counseling.
- Couple HIV Counseling and Testing (CHCT), working with local and international partners, CDC developed a training manual in response to the growing demand for training in CHCT and is supporting cross-country exchange so that experienced countries can assist other countries with CHCT expansion.
Evidence
from Africa-based research funded by the HHS National Institutes of Health has
now shown that medically provided adult male circumcision (MC) can decrease the
rate of heterosexual HIV acquisition in men.
CDC provides providing technical assistance to Ministries of Health to develop
national MC policies and strategic plans; conduct situational assessments;
implement and evaluate MC service delivery programs; and develop technical
guidance, tools, and monitoring and evaluation systems. Further, CDC is working
with UNAIDS and WHO to develop guidance on the key service components,
communication strategies, quality assurance, and operational research priorities
for MC programs.
In Kenya, CDC worked closely with the Kenya government, providing technical assistance on policy and strategic plan development, design of service delivery models, and development of a monitoring and evaluation system. Kenya is now preparing for an innovative method of service delivery-portable MC services to reach men in rural areas. CDC is also jointly supporting, with the Gates Foundation, a center to train public and private sector providers in MC. It has already trained 115 medical and clinical officers, nurses, and counselors.
Last reviewed: August 27, 2008
Content Source:
Global AIDS Program (GAP)
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention