Hard to reach populations such as injecting drug users (IDUs), men who have sex with men (MSM), and commercial sex workers (CSWs) are at the highest risk of HIV infection due to their specific social and behavioural characteristics. In the countries with low-level and concentrated HIV epidemic, these populations account for most HIV infections and are also called “core groups” for HIV transmission. The most demanding task in surveillance of these groups is in reaching them. Because of stigma, discrimination and often illicit nature of their behaviours, they are difficult to reach and standard probabilistic sampling methods such as cluster-based sampling cannot be used. That is why another, recently used sampling methods such as respondent-driven sampling and time-location sampling are recommended to be used. Achieving a high quality sample allows us to monitor trends of the epidemic over time, and compare results across different geographical areas of the country. Surveillance of HIV in high-risk groups is challenging but immensely important, and it is the main component of HIV/AIDS surveillance in low-level and concentrated epidemics. High-quality surveillance in these groups and its links with the system of monitoring and evaluation enables programmatic responses to be cost-effective and well-targeted.
The aim of this course is to provide skills in designing and implementing surveillance surveys in hard to reach populations, with an emphasis on men who have sex with men, injecting drug users, and commercial sex workers. Focus of the course is on gaining practical skills which is achieved through interactive sessions on protocol development. Participants will be presented with the main methodological tasks and challenges related to surveying hard to reach populations, ranging from issues on how to choose an adequate sampling method to interpreting and disseminating data collected.
The course will cover selected topics that are the cornerstone of any project of HIV/AIDS surveillance in hard to reach populations, including both biological and behavioural aspects:
- Pre-surveillance assessment and mapping of high risk groups
- Qualitative data collection used in presurveillance assessment
- Size estimates of target populations
- Selecting the sampling method:
- cluster-based stratified sampling
- time-location sampling
- respondent-driven sampling
- Calculations of sample size and data weighting
- Field work organisation and quality control
- Indicators and questionnaire development
- Ethical issues in surveillance in hard to reach populations,
- Data management, analysis and dissemination,
- Establishing a surveillance system for high-risk groups
The course also presents participants with experiences from a number of studies conducted among high risk groups in different parts of the world, various sampling strategies used, and advantages and disadvantages of these different approaches and lessons learned.
Epidemiologists, social scientists, public health professionals.
The course takes place in five days.
- Health Protection Agency, UK
- United Nations Development Programme
- Faculty of Arts and Humanities, Zagreb