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Help for African Militaries: Epidemiologic Research and HIV-Related Services

In most sub-Saharan nations, soldiers are disproportionately affected by HIV. The mobile lifestyle of the military elevates risk for infection of the troops and their spouses and partners. It also complicates measurement of HIV prevalence and consistent access to HIV-related services.

In collaboration with the U.S. Naval Health Research Center, RTI is assisting troops in Africa through epidemiologic research and the implementation of HIV-related services funded by the U.S. Department of Defense HIV/AIDS Prevention Program (DHAPP), which supports multiple efforts to reduce the incidence of HIV/AIDS among uniformed personnel.

Members of the Mozambican military participate in a pilot test of self-administered group interviews to identify behaviors, attitudes, and beliefs associated with HIV prevalence. [Photo: Lauren Courtney]

DHAPP epidemiologic studies determine HIV prevalence and countries’ HIV-related research abilities. RTI has been conducting studies in Botswana, Ethiopia, Lesotho, Mozambique, Swaziland, and Uganda. Applying lessons learned through its initial DHAPP sero-behavioral research in Mozambique and Uganda, RTI now supports these militaries’ implementation of surveillance programs. The surveillance study design supports needs such as questionnaires, HIV rapid test procedures, and the logistics of blood collection and storage.

“Our key objective is to enable and encourage militaries to conduct HIV surveillance regularly among their troops,” said Lauren Courtney, RTI project director. “We are pleased that Mozambique requested a second round of surveillance with RTI assistance for 2009, after the initial implementation in 2006,” she said.

In Uganda, RTI is implementing HIV-related services that also respond to the country’s high rate of tuberculosis (TB), a co-infection responsible for many HIV-related deaths. Over three years, the project Expanding Access to Quality HIV Prevention, Care and Support Services in the Ugandan Military aims to increase access to HIV/AIDS-related services by military personnel and their families. RTI is partnering with the Uganda People’s Defence Force (UPDF)-HIV/AIDS Control Programme to support implementation.

This project will help soldiers and their dependents via HIV counseling and testing; prevention of mother-to-child transmission; better care and treatment of the infected; improved diagnosis and management of TB; and programs that mitigate the effects of HIV on orphans, other vulnerable children, and their families.

In February, RTI assessed health facilities managed by the Ugandan military for level and quality of services, facility conditions, supply needs, and staff capabilities. “The results of the assessment have been used to guide training of health workers, help build sufficient stocks of supplies, and improve infrastructure for HIV-related service delivery in the focus facilities,” said Dr. Robert Ssengonzi, RTI project director.

Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the Naval Health Research Center.