Unit 8: Uses and Dissemination of HIV Sentinel Surveillance Data #3-8-1.

Unit 8: Uses and Dissemination of HIV

Sentinel Surveillance Data

#3-8-1

Warm Up Questions: Instructions

Take five minutes now to try the Unit 8 warm up questions in your manual.

Please do not compare answers with other participants.

Your answers will not be collected or graded.

We will review your answers at the end of the unit.

#3-8-2

What You Will Learn By the end of this unit you should be able to:

discuss various uses for HIV sentinel surveillance data

discuss how to develop a clear and understandable message about surveillance data

understand the tools for disseminating data to target groups

#3-8-3

Uses of HIV Surveillance Data Data can be used for a variety of public

health actions: targeting prevention and care programmes monitoring and evaluation monitoring indicators resource allocation and programme planning informing and educating the public guiding scientific research triangulation mobilising political commitment advocacy

#3-8-4

Using Sentinel Surveillance Data to Target Programmes

Advantages helpful in determining

where the burden of disease is greatest in a country

shows which demographic groups are most severely affected

increased attention directed to high-prevalence areas

Disadvantages not very useful in

identifying specific high-risk behaviours since only limited behavioural data are collected

If sentinel surveillance is only directed at ANCs, trends in STI clinic patients will be missed.

#3-8-5

Monitoring and Evaluation

Evaluation refers to determining: how well a programme is functioning

(process evaluation) what its impact is (impact evaluation)

Monitoring refers to looking at a programme’s performance over time.

#3-8-6

Monitoring Indicators

HIV sentinel surveillance data are used as indicators for evaluating the impact of prevention programmes.

Indicators are specific data, gathered to measure how well a prevention or treatment programme is doing.

UNAIDS has developed the concept of ‘Impact Indicators’ to communicate these outcomes most effectively.

#3-8-7

Monitoring Indicators:Indicators 1 & 3

#3-8-8

  Impact Indicator 1

Impact Indicator 3

Population(s) it reflects

Pregnant women Sub-populations with high-risk behaviour

Epidemic state(s) in which it is used

Generalised Low-level or concentrated

Monitoring and Evaluation Limitations

There are two limitations in using prevalence for monitoring and evaluating prevention programmes:

Prevalence surveys measure prevalence, not incidence.

Populations targeted for prevention are usually exposed to more than one prevention message.

#3-8-9

Resource Allocation and Programme Planning

HIV sentinel surveillance can be used to estimate the number of HIV-infected persons in a country.

Short-term projections on the annual incidence of AIDS cases can be made using: HIV prevalence data average time from HIV infection to AIDS diagnosis survival after an AIDS diagnosis population size

#3-8-10

Public Education

Public education on local HIV prevalence can give people a realistic perception of their risk of infection.

Extremely important for those in high prevalence areas who continue to engage in high-risk behaviours.

Reinforces basic information and specific prevention messages.

May help in removing stigma of HIV infection.

#3-8-11

Guiding Scientific Research

Higher prevalence in certain populations will suggest where disease transmission is highest.

This will be where its epidemiology and prevention are most easily studied.

#3-8-12

Triangulation

The process of examining several different sets of data, which are measuring different things in order to come up with a better understanding of how and where the epidemic is spreading

Second-generation surveillance stresses comparing HIV sero-surveillance data to HIV behavioural surveillance data

#3-8-13

Triangulation, Cont.

Integrating these data with other sources of data gives a better picture of the HIV epidemic.

Some other sources of data may include: STI and TB surveillance data blood donor data AIDS case reporting death registration information

#3-8-14

Mobilising Political Commitment It is challenging to maintain political commitment, and

HIV prevalence data can often help

Selected kinds of people who need to be informed about HIV prevalence include: politicians potential donors or funders public health planners health personnel at national and local levels health promotion and prevention staff the media individuals, groups and communities

#3-8-15

Advocacy

Governments and NGOs are less able to ignore the reality of HIV when its existence and spread are documented thoroughly.

The state of an epidemic helps to determine what kind of advocacy is necessary

#3-8-16

Disseminating HIV Surveillance Data

establish the message you want to communicate

select the audience to which you want to deliver the message

select the channel through which the message will be delivered

select the tool for delivering the message evaluate the impact of the message

#3-8-17

Establish the Message

What is the most important information that the surveillance team and public health officials want to convey?

Is the epidemic increasing or decreasing?

Is there evidence that what is being done is working? Note that messages will differ from audience to

audience as well

#3-8-18

Select the Audience(s)

Once the message has been established, the target audience should be defined.

Important potential target audiences include: health professionals general public policy and decision makers media

#3-8-19

Select the Audience(s), Cont.

Other important potential target audiences: non-governmental organizations (NGOs) other national and international organisations surveillance staff members at national and local

levels who help conduct sero-surveys

The content of the message and the target audience should be linked.

#3-8-20

Select the Communication Channel(s)

Communication channels for disseminating HIV surveillance results include: television radio newspapers scientific journals conferences newsletters press releases the internet epidemiologic bulletins and technical reports face-to-face briefings with decision-makers

#3-8-21

Table 8.3. Select the Tool(s)

Audiences 

Channels Tools

Technical professionals involved in NACP and monitoring and evaluation

Dissemination or evaluation workshops

Full technical report on HIV, STI & behavioural surveillance

Non-governmental organisations, other sectors and partners

Conferences A non-technical review of data from different sources

Media, journalists, general population

Press conferences

A press release highlighting the main findings

Policy-makers, decision-makers

Face-to-face briefings and planning meetings

Brief summaries of main findings with some graphics

#3-8-22

Evaluate Impact

An important final step is an informal evaluation of how well the surveillance message was delivered, through, for example:

informal conversations with the press conversations with aides to senior policy-makers asking people in behavioural surveys about the

most effective ways to communicate messages about HIV

#3-8-23

Warm Up Review

Take a few minutes now to look back at your answers to the warm up questions at the beginning of the unit.

Make any changes you want to.

We will discuss the questions and answers in a few minutes.

#3-8-24

Answers to Warm Up Questions

1. True or false? Reading or hearing about HIV in the media strengthens basic information and prevention messages. True

#3-8-25

Answers to Warm Up Questions, Cont.

2. List two potential audiences for the dissemination of surveillance data. Technical professionals, NGOs, policy makers, journalists, etc.

#3-8-26

Answers to Warm Up Questions, Cont.

3. List three potential uses of HIV surveillance data. Targeting intervention activities, program monitoring and evaluation, resource allocation, political mobilisation, etc.

#3-8-27

Answers to Warm Up Questions, Cont.

4. True or false? When disseminating HIV surveillance results, a single message that can be used for all target audiences in the best way to transmit the information. False

#3-8-28

Small Group Discussion: Instructions

Get into small groups to discuss these questions.

Choose a speaker for your group who will report back to the class.

Take 15 minutes for this exercise.

#3-8-29

Small Group Reports

Select one member from your group to present your answers.

Discuss with the rest of the class.

#3-8-30

Case Study: Instructions

Try this case study individually.

We’ll discuss the answers in class.

#3-8-31

Case Study Review

Follow along as we go over the case study in class.

Discuss your answers with the rest of the class.

#3-8-32

Questions, Process Check

Do you have any questions on the information we just covered?

Are you happy with how we worked on Unit 8?

Do you want to try something different that will help the group?

#3-8-33