Measuring service coverage and impact of HIV interventions in key and vulnerable populations
16 – 20 March 2020, Zagreb, Croatia
Adequate programmatic service coverage levels among key populations affected by the HIV epidemic, namely female sex workers [FSW], people who inject drugs [PWID], men who have sex with men [MSM]) and transgender persons, is a critical component for achieving HIV epidemic control. Real-time programmatic data are increasingly available by various delivery points such as prevention services, HIV testing, laboratory services and HIV patient monitoring programmes. However, measuring the coverage of essential services among key populations has been a challenge for national programmes and international organizations due to various deficiencies such as fragmented manner of services provision, concentration of services in larger urban areas and insufficient inclusion of services of community groups into the national reporting system.
“Coverage” describes the extent to which an intervention is delivered to the target population. The majority of the coverage indicators involve the use of programme data and population size estimates to estimate percentage levels of coverage. The reliability of coverage estimates derived by this method depends upon the completeness and quality of both the programme data and the population size estimate. To monitor coverage using programme data, it is important that programmes use a unique identifier code (UIC), which enables a service to record individual clients’ patterns of attendance. The use of UIC protects confidentiality and privacy of individuals captured in the programme records.
Coverage may also be assessed using bio-behavioural surveys (BBS). The reliability of the findings from surveys depends on how representative the sample is of the broader population. BBS can only be implemented with limited frequency i.e. rarely more than biennially in a selected number of sites in a country. In comparison to that, programme data should be available to measure coverage with interventions on an on-going basis.
The package of services for key populations should be designed and implemented in alignment with the most up-to-date technical guidelines and tailored to the local epidemiologic and environmental contexts.
Course objectives are to:
- Illustrate population size estimation methods (multiplier, capture-recapture, programmatic mapping and network scale-up) needed to estimate programmatic service coverage
- Describe BBS as a source of service coverage estimates and highlight best practices
- Describe methods of measuring impact of HIV programmes with the focus on HIV incidence and HIV mortality
- Provide overview of most effective interventions for reaching epidemic control in key and vulnerable populations:
- needle and syringe programmes and opioid substitution therapy
- HIV testing (index testing and partner notification, social network testing and HIV self-testing, community-based testing)
- Linkage to HIV care and treatment (linkage case management)
- Retention and re-engagement in HIV treatment (tracing patients lost-to-follow up, patient navigators, differentiated ART delivery, use of digital media)
- Describe methods of data quality assurance in HIV programmes
- Learn how to use cascade data to understand service coverage, target performance improvement and provide recommendations for the most effective and feasible interventions
The key part of the course is group/individual work. Participants may choose among the following options:
- Option A – Develop a proposal for measuring HIV coverage and impact indicators for specific interventions or a larger HIV programme (at sub-national or national-level)
- Option B – Analyze coverage with HIV services (for example, HIV testing, viral load testing, re-engagement in HIV treatment) from various data sources that participants will bring with themselves. Other tasks include identifying gaps in service coverage and recommending interventions to close the gaps.
- Option C – Develop a plan for strengthening routine data sources for programmatic coverage monitoring. These data sources can be various – HIV testing, harm reduction services, ART monitoring, viral load testing, tracing patients lost from HIV care, etc.
Participants are encouraged to work on plans/ proposals which they can later on use in their countries. Participants will present the results of this work on the final day of the course.
The course consists of lectures, exercises and case studies. Participants will have opportunities to share their own country-specific experiences and challenges.
Professor George W. Rutherford, MD, Institute for Global Health Sciences, University of California, San Francisco, USA George.Rutherford@ucsf.edu
Associate professor Ivana Bozicevic, MD, DrPH, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia email@example.com
Zoran Dominkovic, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia firstname.lastname@example.org
The course is held at:
WHO Collaborating Centre for HIV Strategic Information
Andrija Stampar School of Public Health
University of Zagreb School of Medicine
10 000 Zagreb, Croatia
Phone: + 385 1 45 90 142/ 45 90 100
The course fee is 1000 USD and includes lunches and coffee breaks during the course and course materials.
The deadline for applications is 14 February 2020.