MHRP

Prevention, Care & Treatment

MHRP research is conducted in the context of a robust HIV prevention, care and treatment program funded by the President’s Emergency Plan for AIDS Relief.

The integration with research sites has created vibrant synergy that enhances clinical research and improves the public health infrastructure in Africa.

Services

PEPFAR Services

Prevention of Mother-To-Child Transmission (PMTCT) – activities (including training) aimed at preventing mother-to-child HIV transmission, including antiretroviral (ARV) prophylaxis for HIV-infected pregnant women and newborns and counseling and support for maternal nutrition.

Abstinence/Be faithful (AB) – activities (including training) to promote abstinence, including delay of sexual activity or secondary abstinence, fidelity, reducing multiple and concurrent partners, and related social and community norms that impact these behaviors. Activities address programming for both adolescents and adults.

Other sexual Prevention (OP) – other activities (including training) aimed at preventing HIV transmission including purchase and promotion of condoms, sexually transmitted infection (STI) management, and messages/programs to reduce other risks of persons engaged in high-risk behaviors.  Prevention services are focused on target populations such as alcohol users; at risk youth; men who have sex with men (MSM); mobile populations, including migrant workers, truck drivers, and members of military and other uniformed services (e.g., police); and persons who exchange sex for money and/or other goods with multiple or concurrent sex partners, including persons engaged in prostitution and/or transactional sexual partnerships.

Blood Safety – activities supporting a nationally-coordinated blood program to ensure a safe and adequate blood supply including: infrastructure and policies; donor-recruitment activities; blood collection, testing for transfusion-transmissible infections, component preparation, storage and distribution; appropriate clinical use of blood, transfusion procedures and hemovigilance; training and human resource development; monitoring and evaluation; and development of sustainable systems.
 
Injection Safety – policies, training, waste-management systems, advocacy and other activities to promote medical injection safety, including distribution/supply chain, cost, and appropriate disposal of injection equipment and other related equipment and supplies.
 
Medical Male Circumcision (MMC) – policy, training, outreach, message development, service delivery, quality assurance, and equipment and commodities related to male circumcision. All MC services include the minimum package: HIV testing and counseling provided onsite; age-appropriate pre- and post-operative sexual risk reduction counseling; active exclusion of symptomatic STIs and syndromic treatment when indicated; provision and promotion of correct and consistent use of condoms; circumcision surgery in accordance with national standards and international guidance; counseling on the need for abstinence from sexual activity during wound healing; wound care instructions; and post-operative clinical assessments and care.

Counseling and Testing – includes activities in which both HIV counseling and testing are provided for those who seek to know their HIV status (as in traditional VCT) or provider-initiated counseling and testing. 

Adult Care and Support – all facility-based and home/community-based activities for HIV-infected adults and their families aimed at extending and optimizing quality of life for HIV-infected clients and their families throughout the continuum of illness, through provision of clinical, psychological, spiritual, social, and prevention services. 

  • Clinical care includes prevention and treatment of opportunistic infections (OI) (excluding TB) and other HIV/AIDS-related complications including malaria and diarrhea (providing access to commodities such as pharmaceuticals, insecticide-treated nets, safe water interventions, and related laboratory services), pain and symptom relief, and nutritional assessment and support including food.
  • Psychological and spiritual support includes group and individual counseling and culturally appropriate end-of-life care and bereavement services.
  • Social support includes vocational training, income-generating activities, social and legal protection, and training and support of caregivers.
  • Prevention services include prevention for HIV-positives, behavioral counseling, and counseling and testing of family members.
  • Treatment services provide ARV drugs.

Pediatric Care and Support – all health facility-based care for HIV-exposed children aimed at extending and optimizing quality of life for HIV-infected clients and their families throughout the continuum of illness, through provision of clinical, psychological, spiritual, social, and prevention services.

  • Clinical care includes early infant diagnosis, prevention and treatment of OIs (excluding TB) and other HIV/AIDS-related complications including malaria and diarrhea (providing access to commodities such as pharmaceuticals, insecticide-treated nets, safe water interventions, and related laboratory services), pain and symptom relief, and nutritional assessment and support including food.
  • Other services – psychological, social, spiritual, and preventive – are provided as appropriate.

Orphans and Vulnerable Children (OVC) – activities aimed at improving the lives of orphans and other vulnerable children affected by HIV/AIDS and doing so in a measurable way.

  • Services to children (0-17 years) are based on the actual needs of the child and include ensuring access to basic education (from early childhood development through secondary level), broader health care services, targeted food and nutrition support (including support for safe infant feeding and weaning practices), protection and legal aid, economic strengthening, and training of caregivers in HIV prevention and home-based care.
  • Household-centered approaches that link OVC services with HIV-affected families (e.g., linkages with PMTCT, palliative care, and treatment) and strengthen the capacity of the family unit (caregiver) are included along with strengthening community structures that protect and promote healthy child development (e.g., schools, churches, clinics, child protection committees) and investments in local and national government capacity to identify, monitor, and track children's well-being.
  • Programs that strengthen the transition from residential OVC care to more family-centered models may be included as well.

TB/HIV – includes exams, clinical monitoring, related laboratory services, treatment and prevention of tuberculosis (including medications), as well as screening and referral of TB clinic clients for HIV testing and clinical care. TB/HIV activities may be performed in general medical settings, HIV/AIDS clinics, individual homes, and traditional TB clinics and hospitals.

Adult Treatment – includes infrastructure, training clinicians and other providers, exams, clinical monitoring, related laboratory services, and community-adherence activities.

Pediatric Treatment – includes infrastructure, training clinicians and other providers, exams, clinical monitoring, related laboratory services, and community-adherence activities.

Laboratory Infrastructure – development and strengthening of laboratory systems and facilities to support HIV/AIDS-related activities, including purchase of equipment and commodities and provision of quality assurance, staff training, and other technical assistance.

Strategic Information – HIV/AIDS behavioral and biological surveillance, facility surveys, monitoring partner results, reporting results, supporting health information systems, assisting countries to establish and/or strengthen such systems, and related analyses and data dissemination activities.

Health Systems Strengthening – includes activities that contribute to national, regional or district-level systems by supporting finance, leadership and governance (including broad policy reform efforts related to stigma and gender), institutional capacity building, supply chain or procurement systems, Global Fund programs, and donor coordination.