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HIV/AIDS Regional Training Center, Bangkok Thailand

In 2003, COE submitted a plan to the Defense Department's HIV/AIDS Prevention Program that utilized a strategy of leveraging its established working relations with military partners and civilian experts to catalyze regional cooperation on HIV/AIDS issues. To accomplish this, a partnership with the Royal Thai Army was essential to enabling a "neighbors teaching neighbors" approach. PACOM/COE, together with Armed Forces Research Insititute of Medical Sciences (AFRIMS), stood up a military Regional Training Center (RTC) responsible for educating a core group of military medical officers. These officers form an important part of their respective country's military HIV/AIDS prevention efforts and serve as liaisons and advocates for future work. In the essence of capacity and partnership building, regional partners then contribute to issue selection, best practice approaches, and other empowering methods.

Key objectives of this strategies include the following:

• A partnership with Phramongukutklao Medical Foundation (PMK) with resources located at the Phramongukutklao Military Medical Center (PMMC) in Bangkok;
• Quarterly HIV/AIDS training conducted collaboratively with AFRIMS;
• Development of curriculum and issue selection with regional partners;
• Development of HIV/AIDS laboratory capacity and technical expertise;
• Facilitation of partnerships for multiple regional workshops to be held at the RTC;
• Engagement of maximal Asia Pacific military medical partners/nations within the region.

In 2004, COE and the RTA co-sponsored three trainings (Training of Trainers format) at the Regional Training Center in Bangkok. The first event was Technical Training held at PMK College of Medicine. The objectives of the workshop were to improve military medical laboratory capability related to HIV/AIDS prevention activities, provide technical instruction in HIV diagnostic testing, and expose participants to "best practice" in military HIV/AIDS prevention. Representatives from nine Asia Pacific countries attended. The second training, on Regional HIV/AIDS Counseling and Education, which included 22 delegates from 12 countries, was held at the RTC in March 2004. With its regional partners, the RTA and PMK Foundation executed a training that provided effective HIV/AIDS counseling training and educational awareness tools for its participants. It stressed the importance of these skills and their potential impact in an effective HIV/AIDS continuum of care. Curriculum was developed at COE to provide both didactic information and innovative hands-on counseling sessions, which included participant role-playing, to cover critical issues related to HIV/AIDS counseling. This demonstrated both assimilative and accommodative learning methods. The third and final event held in 2004 was an HIV/AIDS Policy development training in September, 2004. Its objectives were to provide a forum for continued dialogue on improving capacity to develop effective HIV/AIDS policy and to provide hands-on training for HIV/AIDS strategy development. Again, curriculum was developed by COE to include both didactic and hands-on elements. Twenty-seven (27) delegates from 16 nations (including 3 new nations) participated, demonstrating effective partnership building and regional networking over the course of the trainings. At the end of each of training event, take-away products, such as CD-ROMs, were distributed to participants. They contained the latest HIV/AIDS information, reference materials, and curriculum (including format for counseling sessions and case-studies) for use for future in-country training.

The final month of calendar 2004 produced a fourth overall RTC training. A second HIV/AIDS Counseling and Education workshop was executed in December with twenty-four delegates from 14 Asia Pacific nations, including Bangladesh, Philippines, Tonga, Fiji, India, Vietnam, Papua New Guinea, Malaysia, Mongolia, Indonesia, Thailand, Sri Lanka, Nepal, and the United States Objectives were to open dialogue on issues surrounding HIV/AIDS counseling and education.

The entire third day of the training was designed to allow participants to integrate the many principles of communication and counseling discussed between provider and patient via three role-playing sessions. Through active participation, delegates determine their own actions and words based on the concepts of counseling. This type of curriculum allows for accommodative learning in which participants gain a practical experience in counseling.

In March 2005, USPACOM/COE and its regional collaborators, RTA and AFRIMS, executed the fifth RTC training, and the first featuring in-depth treatment and care topics. The number of participants surpassed any previous event with 35 participants from 17 countries, including: Bangladesh, China, East Timor, Philippines, Tonga, Fiji, India, Vietnam, Papua New Guinea, Malaysia, Mongolia, Mauritius, Indonesia, Thailand, Sri Lanka, Nepal, and the United States. Objectives of the treatment and care event were similar to previous trainings, however the focus on clinical topics and capacity was much more apparent. Regional experts from the World Health Organization, Thailand's Ministry of Public Health, as well as USPACOM/COE, AFRIMS, and the University of Hawaii participated.

A sixth Regional Training Center initiative is being planned for 21-24 June 2005. This will be the third Counseling and Education event. As the series of trainings develop, a focus on training-of-trainers (ToT) methodology has evolved as an objective to provide all countries with the tools and in-country resources necessary to stand up training in their respective locations.

In addition to PACOM/COE and the RTA, PMK Military Medical Center, the United Nations Development Program (UNDP), AFRIMS, Tripler Army Medical Center, The Centers for Disease Control and Prevention (CDC), Family Health International (FHI), USAID, and the US Military HIV Research Program of the Walter Reed Army Institute of Research supported the workshops, demonstrating successful United States Government interagency collaboration. Since inception, the RTC is currently the only military regional HIV/AIDS training center in the world. Using effective community/partnership building models, it has grown and garnered interest outside the Asia Pacific region. Other US Combatant Commands, regional militaries, and international African military delegations have requested information on the RTC and have requested to participate. The RTC hopes this will be possible in the near future.

Achievements / Direct Impact

Over 130 military medical leaders (and now "Master Trainers") from 17 different Asia Pacific nations were directly trained via five regional trainings from August 2003 to March 2004. a period of 18 months.

Extended Program Impact:

Important outcomes from the workshop include open multilateral dialogue, the identification of barriers, and capacity building opportunities. Participants identified the need for more in-depth workshops on HIV/AIDS treatment, counseling, and best practices and requested inclusion of their military personnel in future regional workshops. Evaluations were distributed and returned indicating the participants rating of the program was excellent. As a result of the Asia Pacific Regional HIV/AIDS Education Counseling Workshop in March 2004:

• 4 workshops were held to train HIV/AIDS over 100 counselors in the Timor - Leste Defense Force (doctors, nurses, medics and section commanders).
• Using curriculum materials from the workshop, Papua New Guinea initiated HIV/AIDS awareness training within their Armed Forces. A bilateral HIV/AIDS initiative has been proposed as a subsequent key regional partnership. Following the third regional training HIV/AIDS Policy Development training - a member of the Papua New Guinea Defense Force (PNGDF) HIV/AIDS management committee - crafted a first draft of HIV/AIDS policy for the entire PNGDF. It was approved as of February 2005.
• The United Nations Development Programme and United States Agency for International Development are now working together to structure HIV/AIDS prevention activities with military partners from the RTC.
• RTC alumni from India are conducting in-country provider training in Pune based on portions of the RTC Counseling and Training Workshop held in December 2004.
• Plans for military medical trainings on HIV/AIDS counseling and education in the Phillipines, Sri Lanka, and India were reported via country presentations at the March 2005 training.
• Three to four more regional trainings have been proposed, approved, and are being planned for execution in FY06.

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Photos by HIV/AIDS staff