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Sources of HIV Epidemiological Data for Monitoring and Estimating the burden of HIV. Txema Calleja, World Health Organization. Outline. WHO/UNAIDS technical recommendations HIV sentinel surveillance: ANC and Key Populations National Population HIV based surveys Conclusions. HIV and
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Sources of HIV Epidemiological Data for Monitoring and Estimating the burden of HIV Txema Calleja, World Health Organization
Outline • WHO/UNAIDS technical recommendations • HIV sentinel surveillance: ANC and Key Populations • National Population HIV based surveys • Conclusions
HIV and AIDS case & mortality reporting STI Surveillance Size Estimation of Risk Groups Second Generation Surveillance (SGS) Behavioural or Bio-Behavioural Surveys Sentinel Surveillance UNAIDS/WHO HIV Surveillance Working Group:Second Generation Surveillance framework
UNAIDS/WHO Global Surveillance Working Group on HIV/AIDS and STI surveillance 1997……
Second Generation Surveillance: Norms, standards, guidelines, recommendations
HIV Surveillance recommendations What to do where?
For Low and Concentratedepidemics • HIV infection case reporting, new diagnosis • Integrated Biological Behavioural Surveillance for HIV/STI among Key Populations • Population size estimates • Mortality surveillance
For Generalisedepidemics • HIV sentinel surveillance among ANC • HIV infection case reporting, new diagnosis • National Population based HIV surveillance • IntegratedBiological and Behaviour surveillance • among KP • Mortality surveillance
HIV Sentinel Surveillance Some examples of country data
HIV sentinel surveillance in generalised epidemics among ANC
National Population based surveys: HIV prevalence men and women (15-49 y)selected countries
HIV among men who have sex with men in sub-Saharan Africa HIV prevalence (%) among male adults 15–49 years old who have sex with men in seven countries in sub-Saharan Africa, 2009 or latest available year. Source: Baral et al. (28); Nigeria Federal Ministry of Health (29); Lane et al. (30); Parry et al. (31); Sander et al. (32); Sander et al. (33); and Wade et al. (34). Marps or Key populations highlighted in SSA
Trends in HIV prevalence among female sex workers, selected sentinel sites, 2004-2008 Source: Directorate General of Disease Control and Environmental Health, Ministry of Health, Indonesia (2009). Progress Report HIV & AIDS Situation in Indonesia up to December 2009, the Ministry of Health
Myanmar: Trends of HIV prevalence among key affected populations and male STI patients, 1992-2009 Sources: Prepared by www.aidsdatahub.org based on 1. National AIDS Programme Myanmar, & WHO. (2007). HIV Sentinel Sero-Surveillance Survey 2007, 2. National AIDS Programme Myanmar, & WHO. (2009). HIV Sentinel Sero-Surveillance Survey 2008 and 3. National AIDS Programme Myanmar, & WHO. (2010). HIV Sentinel Sero-Surveillance Survey 2009
Quality of HIV sero surveillance in low and middle income countries
Conclusions • Need to reinforce and maintain HIV surveillance • Increase ART coverage it makes more difficult to interpret HIV trends, need to look for new infections • Consistency of population, sites and tools are key to improve HIV surveillance