Programmatic mapping and size estimation of key populations to inform HIV programming in Tanzania.

Introduction: A programmatic mapping and size estimation study was conducted in 24 districts in 5 regions of Tanzania to estimate the size and locations of female sex workers (FSW) and men who have sex with men (MSM) to inform the HIV programming for Key Populations.

Methodology: Data were collected at two levels: first, interviews were conducted with informants to identify venues where FSWs and MSM frequent. Secondly, the size of MSM and FSWs were estimated through interviews with FSWs, MSM and other informants at the venue.

HIV surveillance systems in the Asia Pacific region.

In 2011, the United Nations Joint Programme on HIV/AIDS (UNAIDS) Regional Support Team for Asia-Pacific conducted a stock-taking process of available strategic information in the Asia Pacific region. This paper summarizes the progress of HIV surveillance for 20 countries in the region, covering population size estimates of key populations at higher risk, HIV case reporting, HIV sentinel surveillance and probability surveys of behavioural and biological markers. Information on surveillance activities was obtained from publically available surveillance reports and protocols, supplemented by personal communication with the UNAIDS monitoring and evaluation advisers and surveillance experts in country.

High rates of reinfection and incidence of bacterial sexually transmitted infections in a cohort of female sex workers from two Indian cities: need for different STI control strategies?

Background: Female sex workers (FSWs) in India are provided a standardised package of clinical interventions for management of sexually transmitted infections (STIs). A study was conducted among FSWs at known high STI prevalence sites to determine the effectiveness of the service package.

Methods: A cohort of FSW clinic attendees in two cities, Hyderabad and Mumbai, were enrolled and followed up from October 2008 to November 2009.

Assessment of non-marital sexual behaviours of men in Bangladesh: a methodological experiment using a modified confidential ballot-box method.

This study assessed the effectiveness of a modified ballot-box method (MBBM) in eliciting non-marital sexual behaviours compared with face-to-face interview (FTFI). A cross-sectional survey collected data from men aged 18-49 years in Bangladesh using a multistage cluster sampling method. In total, 3499 and 3623 respondents were interviewed by MBBM and FTFI, respectively.

Essential elements of strategic information systems to guide focused HIV responses in south and south-east Asia.

Strategic information is fundamental to the formulation and delivery of effective HIV programmes, but generating that information is a complex process, for which most countries in south and south-east Asia lack capacity and supporting structures. Although most countries in this region have made tremendous strides in collecting relevant data, advances in the ability to translate that data into strategic information and evidence for action, have not kept pace. To overcome these shortcomings, this paper presents a comprehensive approach to collecting strategic information and building the capacity to use it effectively, which is based on experience in the successful use of data in different countries in south and south-east Asia.

A situation update on HIV epidemics among people who inject drugs and national responses in South-East Asia Region.

We explore the magnitude of and current trends in HIV infection among people who inject drugs and estimate the reach of harm reduction interventions among them in seven high-burden countries of the South-East Asia Region. Our data are drawn from the published and unpublished literature, routine national HIV serological and behavioural surveillance surveys and information from key informants. Six countries (Thailand, Myanmar, Nepal, Indonesia, India, and Bangladesh) had significant epidemics of HIV among people who inject drugs.

The role of skin colour in face recognition.

People have better memory for faces from their own racial group than for faces from other races. It has been suggested that this own-race recognition advantage depends on an initial categorisation of faces into own and other race based on racial markers, resulting in poorer encoding of individual variations in other-race faces. Here, we used a study--test recognition task with stimuli in which the skin colour of African and Caucasian faces was manipulated to produce four categories representing the cross-section between skin colour and facial features.

Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges.

Objective: This paper presents key methodological approaches and challenges in implementing and analysing the first round of the integrated biobehavioural assessment of most-at-risk populations, conducted in conjunction with evaluation of Avahan, the India AIDS initiative.

Methods: The survey collected data on HIV risk behaviours, sexually transmitted infections and HIV prevalence in 29 districts in six high-prevalence states of India. Groups included female sex workers and clients, men who have sex with men, injecting drug users and truck drivers.

Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative.

Background: Closing the HIV prevention gap to prevent HIV infections requires rapid, worldwide rollout of large-scale national programmes. Evaluating such programmes is challenging and complex, requiring clarity of evaluation purpose and evidential approaches substantively different to those employed for pilots and small programmes.

Objectives: This paper describes the evaluation design for the implementation phase of Avahan, the India AIDS initiative, a large HIV prevention programme funded by the Bill and Melinda Gates Foundation.

Review of sampling hard-to-reach and hidden populations for HIV surveillance.

Adequate surveillance of hard-to-reach and 'hidden' subpopulations is crucial to containing the HIV epidemic in low prevalence settings and in slowing the rate of transmission in high prevalence settings. For a variety of reasons, however, conventional facility and survey-based surveillance data collection strategies are ineffective for a number of key subpopulations, particularly those whose behaviors are illegal or illicit. This paper critically reviews alternative sampling strategies for undertaking behavioral or biological surveillance surveys of such groups.

Surveillance and modelling of HIV, STI, and risk behaviours in concentrated HIV epidemics.

Background: HIV epidemics in most countries are highly concentrated among population subgroups such as female sex workers, injecting drug users, men who have sex with men, mobile populations, and their sexual partners. The perception that they are important only when they cause epidemic expansion to general populations has obscured a critical lack of coverage of preventive interventions in these groups, as well as appropriate methods for monitoring epidemic and behavioural risk trends. The difficulties in accessing such groups have likewise often cast doubt on the representativeness of observed disease and behavioural risk estimates and their validity and reliability, particularly those related to sampling and the measurement of risk behaviours.

HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia.

A probability sample of 206 men who have sex with men from 16 sites in Phnom Penh were surveyed about sexual behaviors and tested for HIV and sexually transmitted infections (STIs). HIV and syphilis prevalence was 14.4% and 5.

Intravenous drug use among street-based sex workers: a high-risk behavior for HIV transmission.

Background: HIV prevalence among sex workers in Ho Chi Minh City has increased rapidly, from 6.5% in 1999 to 18.1% in 2000.

How well do antenatal clinic (ANC) attendees represent the general population? A comparison of HIV prevalence from ANC sentinel surveillance sites with a population-based survey of women aged 15-49 in Cambodia.

Background: The purpose of this study was to evaluate whether HIV-1 prevalence among antenatal clinic (ANC) attendees in Cambodia provided a reasonable estimate of HIV-1 prevalence among all women 15-49 years. METHODS Antenatal clinic attendees in five HIV sentinel surveillance sites (five provinces) were selected by consecutive sampling (n = 1695). The population survey of females by household was carried out in the same five areas.

Measuring the impact of needle exchange programs among injecting drug users through the National Behavioural Surveillance in Bangladesh.

Bangladesh is a low HIV prevalence country, with buprenorphine injectors having the highest prevalence of HIV at 2.5% as of 1999. Using National HIV Behavioral Surveillance data, the impact of a needle exchange program (NEP) on sharing behavior among injecting drug users in two cities was measured.

Preventing HIV infection through peer education and condom promotion among truck drivers and their sexual partners in Tanzania, 1990-1993.

HIV prevention through peer education and condom promotion among truck drivers and their sexual partners is described. Trends during an initial 18-month intensive phase, followed by a 24-month maintenance phase, were monitored with surveys. Trends for self-reported condom use were: increase among men (56 to 74%) during the first phase with a decrease (72%) during the maintenance phase.

Targeted intervention research studies on sexually transmitted diseases (STD): methodology, selected findings and implications for STD service delivery and communications.

Objective: To report the findings of qualitative studies designed for use in improving sexually transmitted disease (STD) programs. The studies explore illness conceptions and treatment behaviors for STD in five African countries. These targeted intervention research (TIR) studies were performed on clinic-based and community-based samples in representative communities and utilized a variety of qualitative research methods (e.

Indicators and the measurement of STD case management in developing countries. STD PI6&7 Working Group.

The paper reviews methodologies for measuring quality of sexually transmitted disease (STD) case management through facility based assessments. These include observations and interviews of providers, as promoted by the World Health Organization's Global Programme on AIDS, and some of the viable alternatives including patient exit interviews, mystery patients, record review and patient encounter forms with supervisory visits. The paper concludes that the alternative approaches are feasible in resource poor settings and that they provide crucial data for evaluation and continued program development.

HIV risk behavioral surveillance: a methodology for monitoring behavioral trends.

Objective: This article summarizes issues and recommendations for conducting HIV risk behavioral surveillance surveys (BSS) based on experiences from ten BSS projects in eight countries in Asia and Africa.

Background: BSS consists of systematic and repeated cross-sectional surveys of HIV and sexually transmitted disease-related behaviors, with other knowledge and attitudinal variables added where appropriate. Its major purpose and utility is in detecting trends among selected vulnerable and high-risk population groups whose behavioral change can have the most impact on the epidemic.

AVERT: a user-friendly model to estimate the impact of HIV/sexually transmitted disease prevention interventions on HIV transmission.

Objective: To introduce the newly developed AVERT model by describing the purpose, logic, advantages and limitations of the model, to validate the model's estimates against seroconversion data from a large randomized controlled trial, and to provide practical examples of its applications.

Design: Static, deterministic spreadsheet-type model based on per sex act HIV-1 transmission probabilities.

Methods: Data from a recently completed trial carried out in Cameroon were used to validate the estimated number of new HIV infections generated by the AVERT model.

[The prevalence of HIV and risk behavior of prostitutes living in 2 populous regions of Bujumbura (Burundi)].

This study was designed to determine the prevalence of HIV infection and associated high-risk behavior in female sex workers in two areas of Bujumbura (Bwiza and Musanga), Burundi. Between June 15th and July 15th 1993, 320 female sex workers responded to an anonymous questionnaire and gave a blood sample on filter paper for detection of HIV antibodies. The mean age of the prostitutes was 24.