Technical Brief Series
With new prevention strategies on the horizon and HIV incidence stabilizing or declining in many parts of the world, the tides are beginning to turn on the HIV epidemic. Between 2002 and 2010, new HIV infections globally declined from 3.1 million to 2.7 million. However, 33.3 million people globally are still estimated to be living with HIV, including 2.5 million children. Approximately 40 percent of all women living with HIV are in sub-Saharan Africa. This technical brief discusses barriers to and outlines current and developing strategies to scale up traditionally vertical programs that work towards achieving the millennium development goals that focus on maternal, newborn and child health, HIV and AIDS, and malaria.
In sub-Saharan Africa, HIV has negatively impacted both natural resource management (NRM) and economic growth (EG). This technical brief is a resource for NRM/EG and HIV donors, program managers, and implementers. It introduces the concept of mainstreaming HIV programming into NRM/EG activities; describes how four NRM/EG organizations in Tanzania have implemented HIV mainstreaming; documents the successes, challenges, and lessons learned of these four organizations; and provides recommendations for future programming.
As the number of adolescents living with HIV (ALHIV) continues to grow, the need to improve services, policies, and programs intensifies. This technical brief provides guidance for program managers and policymakers in order to develop services for ALHIV and their families/caregivers as they transition toward HIV self-management and adult clinical care. Highlighting key principles and recommendations, this brief offers guidance to countries and programs on how to provide the multidisciplinary care, support, and treatment services these adolescents need.
A promising development approach for addressing food and nutrition insecurity for orphans and vulnerable children (OVC) is permaculture. In the context of OVC programming, permaculture helps guide communities toward permanent solutions for food and nutrition security, while ensuring that these options exist harmoniously within their environment. The purpose of this technical brief is to provide an overview of permaculture programming as a sustainable, non-donor-dependent tool for improving the health, food, and nutrition security and livelihoods of OVC and their families.
This technical brief provides a systematic global review and synthesis of practical approaches, program examples, and resources to support human rights as a core element of HIV programming for MSM. This document gives an overview of U.S. policies on and commitments to MSM and human rights, and outlines recommended approaches, including program examples in various countries, for linking health and human rights to address HIV among MSM. It also offers a synthesis of questions for developing and monitoring HIV programs for MSM, and a list of program resources.
This technical brief documents promising practices in critical services related to the psychological and social wellbeing of perinatally-infected children in Africa. These include the identification, testing, and counseling of children so that they are linked to appropriate care as early as possible, as well as on-going support to help children and their families manage disclosure, stigma, grief and bereavement processes.
The purpose of this technical brief is to highlight the common elements of successfully transitioned programs, their approaches, and lessons learned to help PEPFAR program managers transition their programs to greater host country management.
In April 2008, the WHO Technical Reference Group for Pediatric HIV/ART and Care released a series of nine updated recommendations for diagnostic testing, initiation of treatment, and appropriate treatment regimens for HIV-exposed and infected infants. This technical brief outlines practical implementation considerations for program planners and policymakers working to incorporate these recommendations into their local efforts.
Many countries have begun to decentralize HIV treatment to primary health care (PHC) centers to decrease the burden of providing HIV services at existing facilities while increasing access to treatment. The purpose of this technical brief is to assist national program planners, stakeholders, and implementers in designing, planning, and implementing the decentralization process and in providing ART services at PHC facilities, with the ultimate goal of achieving universal access to treatment and care in generalized HIV epidemic settings.
Adherence to treatment (particularly ART) and retention in care are necessary to optimize clinical outcomes in people living with HIV. Most of the studies conducted in resource-limited settings, however, have focused solely on adherence to treatment and have provided limited information on effective and practical approaches to improve both adherence to treatment and retention in care. This brief addresses both aspects of adherence in adult patients and 1) explores barriers associated with poor adherence to ART and retention in care; 2) outlines current methods to measure and monitor adherence; 3) reviews program strategies to retain individuals on effective treatment for life while discussing the applicability of these interventions for integration into ART programs; and 4) provides programmers with guidance on key steps to strengthen efforts to promote adherence to ART and retention in care.
Gender-based violence (GBV) is a major problem throughout the world, and the intersection between HIV and GBV is widely acknowledged. Because of the association between these two topics, reducing GBV is one of the five gender strategies promoted through the U.S. President’s Emergency Plan for AIDS Relief.
The purpose of this technical brief is to assist HIV program planners and implementers in designing, planning, and implementing activities that integrate GBV and HIV prevention, treatment and care, and support programs.
Highlights the key mental health issues in the continuum of HIV care and reviews promising programmatic practices for addressing these issues in resource-constrained settings. This tool provides links to important resources and tools for program planners and health care providers concerned about mental health issues in HIV care and support.
Research shows that early childhood development (ECD) is critical to both mental and physical health later in life. However, programming targeting orphans and vulnerable children (OVC) is almost exclusively focused on school-aged OVC, and only rarely are very young children included in program activities. This technical brief, aimed at program planners and implementers, highlights the benefits of ECD interventions and outlines essential elements of ECD programming targeted towards OVC.
HIV serodiscordant couples, in which one partner is HIV-positive and the other is HIV-negative, are increasingly recognized as a priority for HIV prevention in developing countries. Recent studies have estimated that, in several sub-Saharan African countries, approximately two-thirds of infected couples are serodiscordant. Written to assist program planners and implementers, this technical brief provides a summary of effective and promising prevention interventions for serodiscordant heterosexual couples.
Although only 4 of the 12 Anglophone Caribbean countries publicly collect HIV prevalence data among men who have sex with men (MSM), in Jamaica, Guyana, and Trinidad and Tobago, researchers report an HIV prevalence of more than 20 percent among MSM. Moreover, a notable lack of human rights protection in the Anglophone Caribbean impedes efforts to improve the health of MSM. This technical brief provides basic information about HIV programming for MSM in the Anglophone Caribbean and reviews programming opportunities and resources for regional and local organizations involved.
Increasing demand for HIV/AIDS prevention, treatment, care and support in developing countries necessitates a renewed focus on models that increase capacity and resources to expand services. There is immense potential in leveraging the private sector to alleviate the overburdened public sector in HIV/AIDS service and resource provision. This report presents different models of promising or effective public-private partnerships that expand HIV/AIDS care. Following the presentation of models is a discussion of implementation factors that program planners should carefully consider when designing a public-private partnership.
HIV presents an increasing risk to pregnant women, their infants, and their families. In response, governments are looking to the integration of two services traditionally provided separately: maternal, newborn, and child health (MNCH) and prevention of mother-to-child transmission (PMTCT) of HIV. Potential benefits to system-wide integration of these inherently linked services include improving access to care and addressing maternal HIV rates. This technical brief reviews clinical and programmatic considerations, as well as challenges, of reorienting health systems to include PMTCT interventions within the full continuum of existing public, private, and community-based women and newborn health services.
A growing body of research suggests that alcohol consumption is associated with the sexual behaviors that put people at risk for HIV. In developing countries battling severe HIV epidemics, addressing harmful drinking in conjunction with interventions to reduce sexual risk behavior may reduce HIV transmission more quickly than conventional HIV prevention interventions alone. Developed for program planners and implementers, this technical brief reviews the evidence on new and innovative programs in this emerging area. The brief catalogs what is known about the relationship between harmful alcohol use and HIV sexual risk behavior and offers a critical analysis of interventions to address the issue.
While gender, poverty, and gender-based violence alone do not define HIV risk, they increase women’s vulnerability. Gender-responsive economic empowerment/strengthening activities give women access to and control over vital economic resources, which ultimately enhance their ability to mitigate the impact of HIV/AIDS and reduce their vulnerability to HIV. With an increased focus on addressing the deeper structural and economic realities that limit the scope and impact of current HIV prevention activities, this technical brief offers HIV/AIDS field staff and program managers essential information on approaches to economic development—collectively known as economic empowerment or economic strengthening.
Gender inequity is a fundamental driver in the HIV epidemic, and integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs. Integrating gender strategies into programs targeting most-at-risk populations (MARPs) which include men who have sex with men, transgender people, injecting drug users, and male, female and transgender sex workers, whether in mixed or concentrated epidemic countries is much less prevalent. The purpose of this Technical Brief is to provide program managers and planners with an overview of the recent research literature on gender-related constraints effecting MARPs, future program approaches, and gender-related challenges that should be considered in programs to reduce HIV risk among MARPs.