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Behavioural Surveillance Survey

Behavioural Surveillance Survey. Pravin Pisudde. Behavioural Surveillance. One of the component & essential part of the HIV surveillance BSS is an important effort to

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Behavioural Surveillance Survey

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  1. Behavioural Surveillance Survey PravinPisudde

  2. Behavioural Surveillance • One of the component & essential part of the HIV surveillance • BSS is an important effort to • Monitor changes in behavioural aspects of general population as well as specific population groups vulnerable to HIV infection. • To derive necessary implications from the resultant differences between the ‘recommended behaviour’ and ‘reported behaviour’ for strategising appropriate programmatic solutions. • Track trends in HIV/AIDS knowledge, attitudes and risk behaviour in selected segments of a country.

  3. Need for BSS • To understand the multifaceted dynamics of the expanding HIV epidemic • Effective utilization of limited resources • To know about warning signals for newly emerging pockets of infection • Provide rich inputs to plan the preventive interventions and awareness campaigns.

  4. Methodology • Consultative Process in Planning the Survey • All key stakeholders agree on the goals of data collection. • A Technical Resource Group (TRG) was constituted by NACO (UNAIDS, UNICEF, WHO, NIMS, Clinton Foundation, RCSHA, and Population Council) • TRG meetings were held on weekly basis at every stage • Target Population for the Study • General Population • High Risk Group • Female Sex Workers (FSWs), • Clients of FSWs • Men who have Sex with Men (MSM), • Injecting Drug Users (IDUs) • Coverage of the survey • Rural and urban areas from all the states and union territories of India.

  5. Key indicators • Awareness of HIV/AIDS • Knowledge of HIV prevention methods • Incorrect beliefs about HIV transmission • Awareness of Sexually Transmitted Diseases (STDs) • Knowledge of STD symptoms • Awareness of condom • Access to condoms • Age at first sex • Sex with different types of sex partners • Last time condom use with different type of sex partners • Consistent condom use with different types of sex partners • HIV risk perceptions • Exposure to media • Exposure to interventions

  6. The structured and pretested of the questionaires was used for both BSS 1 and BSS 2 • Additional issues were covered in BSS 2: • Awareness about HIV and AIDS separately • Awareness about PPTCT and ICTC • Whether last partner was commercial or casual • Sexual history – Men who have Sex with Men • A detailed manual was prepared for field teams for their ready reference. • The bilingual questionnaires were used for the survey.

  7. Methodology contd…. • The indicators considered for calculating the sample size for each state/groups of states were: • Consistent condom use with non-regular partners in the last 12 months • Percent of the target group who had sex with non-regular partners in the last 12 months • The total urban and rural sample was equally divided among male and female respondents. • One respondent from a selected household. • Sample was calculated with the assumption that there would be 20 % points increase in the indicator value over BSS 2001. • Desired sample size was • males: 48,623; • females: 48,617; • total: 97,240

  8. Sampling procedures(In the Rural areas) • Selection of Districts • Four to six districts in each state/groups of states were selected randomly. • The required number of districts from each region was selected using PPS method. • Selection of Villages • The number of respondents to be covered from each village was fixed at 40, considering this the number of villages to be covered was calculated. • Required number of villages was selected using PPS systematic random sampling method. • Selection of Target Respondents • In each selected village, the total number of respondents was fixed at 40 per village. • An extra sample of six households were selected. (Care was taken to ensure to cover all the households/communities/hamlets in the village.)

  9. Sampling procedures(In the Rural areas) • Selection of Cities/Towns • All the urban units in each state/group of states were stratified into the three strata & the number of CEBs (Selected from each stratum was proportional to the urban population it represents.) • Stratum I : Big size cities/towns (more than fi ve lakh population): 5 CEBs • Stratum II : Middle size cities/towns (one to five lakh population): 3 CEBs • Stratum III : Small cities/towns (less than one lakh population): 2 CEBs • Selection of CEBs • Considering the coverage of a sample of 40 interviews per CEB, the number of CEBs in each city/town were calculated. • In each selected city/town, the assigned quota of wards (equivalent to the required number of CEBs) was randomly selected using the PPS method. • From each ward one CEB was selected randomly. • Selection of Target Respondents • Similar as the rural

  10. Data Management and Analysis • Data Scrutiny • Respective state field offices • Five data entry locations. • Trained 80 coders and 5 coding supervisors for scrutiny and coding exercise. • Research professionals • Data Management • Entire data entry was handled at five centres namely Delhi, Kolkata, Lucknow, Baroda and Hyderabad where facilities to handle large volumes. • Data were entered in the Integrated System for Survey Analysis (ISSA) package. A senior system analyst with the support of a programmer monitored the data entry. • About 10 percent of the questionnaires were double entered to ensure that error levels are below 0.5 percent. • Data Analysis • The core team members and the system analyst under the guidance of the team leader/core team prepared the analysis/tabulation plan.

  11. Training of Research and Field Teams • Orientation Meeting of Professionals and Field Executives • 3 day training workshop for entire study team • Residential training workshop was organised for all the participants. • Recruitment of Field Staff • While selecting the field staff & fieldworkers it was ensured with prior experience of social research are recruited. • The field executives and supervisors, who were involved in BSS 2001, were preferably involved in BSS 2006. • Keeping in mind the dropout rate, 20 percent extra candidates were recruited and trained. A total of 116 teams, each team having one supervisor, three male interviewers and three female interviewers, were involved for the study. • Training of Field Staff • 4 days intensive workshop were organised, interactive sessions at class room and field exposure visit

  12. Methodology • Similar as above • Additional sample of 20 respondents aged 15-24 years was covered in each PSU for the BSS among young people. • 10 males and 10 females • The total sample covered for the BSS among young people was 78,916 • 30,791 was from the GP survey • 48,125 was the additional sample covered for the Youth survey.

  13. Methodology • Key indicators used • Clients of Female Sex Workers: Consistent condom use with commercial partners in last three months • Female Sex Workers: Consistent condom use with clients in last one month • Control Group for Female Sex Workers: Consistent condom use with clients in last one month • Sampling procedure • Selection of Sites (clusters) • The list of sites was prepared and revalidated from the existing mapping information. • The sampling interval (SI) was calculated by dividing the total number of sites (M) by the number of sets to be selected (a) i.e. SI = M/a. • Random number table used for selection of first unit • Subsequent units were selected by adding the sampling interval (SI) • This procedure was continued until the list finished. • Selection of Target Respondents • During peak hour & Required number of respondents were randomly selected. • Sample size • Client of sex workers: 6613 and FSWs: 7417 in each sampling unit .

  14. Methodology • Key indicators used • Men who have Sex with Men: Consistent condom use with commercial partners in last three months • Injecting Drug Users: Consistent use of needles that no one else used in the last one month • Similar as in FSW • Sample size • Men who have Sex with Men: 2638 • Injecting Drug Users: 2677

  15. Awareness & prevention of HIV/AIDS(MSM) Ever heard of HIV/AIDS both Aware of method of prevention

  16. Prevention of STD & treatment seeking(MSM) Atleast one symptom of STD in last 12 mn Saught t/t at govt hospital

  17. Sexual behaviour and condom usage(MSM) Sex with any female partner in last 6 mn used condom during the last 6 mn

  18. Awareness of HIV/AIDS(IDU) Ever heard of HIV/AIDS Needle sharing as a route of HIV transmission

  19. Prevention of HIV/AIDS(IDU) IDUs aware of switching to non injecting drugs as means of preventing HIV infection IDUs aware of two important methods of preventing HIV infection

  20. Prevalence & treatment of STD(IDU) IDUs reported to have suffered from at least one symptom of STD in last 12 mn IDUs who have not taken any T/t during last episode

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