Abstract
BackgroundTimely monitoring HIV epidemic among key populations is a formidable challenge. This study aimed to evaluate the agreement between data collected from an enhanced HIV sentinel surveillance (HSS+) and an HIV service, and to discuss whether testing service data can be used for surveillance purposes.MethodsThe HSS+ data were collected from HIV sentinel surveillance conducted annually among men who have sex with men (MSM) between 2009 and 2013 in Guangzhou, China. The HIV service data were obtained from the China-Bill & Melinda Gates Foundation Cooperation Program on HIV Prevention and Care (China-Gates HIV Program) in Guangzhou during the same period. The China-Gates HIV Program aimed to increase HIV counseling and testing among MSM. We compared demographic characteristics, condom use, HIV testing history, and the HIV status among individuals in these two datasets. The Armitage-trend test was used to evaluate the HIV epidemic and behaviors of the participants in the two datasets over the study period.ResultsOverall, a total of 2224 and 5311 MSM were included in the surveillance and service datasets, respectively. The majority of participants in the two datasets were between 20 and 29 years old, at least attended college, and had never been married. However, socio-demographic characteristics varied slightly between the two datasets. Similar trends were observed for the HIV epidemic in these two datasets. The surveillance dataset indicated that HIV prevalence increased from 3.9% in 2009 to 11.4% in 2013 (P-value for trend < 0.001), while data from the HIV service dataset indicated that MSM HIV prevalence during this same period increased from 6.2 to 8.9% (P-value for trend = 0.025). The rates of condom use were similar between the two datasets and remained consistent throughout the study period.ConclusionHIV service data can complement existing HIV surveillance systems for MSM in China, though it may underestimate the HIV prevalence (HSS+ data contains people whose status is already know, while service data contains people who were initially negative or people of unknown status). HIV service data can be used for surveillance purposes, when prerequisite variables are collected from a large number people, if the quality assessment is conducted.
Highlights
Monitoring Human immunodeficiency virus (HIV) epidemic among key populations is a formidable challenge
Appendix used one formula we developed to reflect the differences between the HIV prevalence monitored by urveillance and HIV-positive rate identified from testing service data
The surveillance reported that HIV prevalence rose from 3.9% in 2009 to 11.4% in 2013 (Zfor trend = 4.09, P < 0.001), and data from the HIV service indicated that HIV-positive rate during this same time period increased from 6.2 to 8.9% (Zfor trend = 1.97, P = 0.025)
Summary
Monitoring HIV epidemic among key populations is a formidable challenge. Accurately monitoring infectious disease epidemics is challenge and expensive, it is a public health priority. [3] HIV surveillance and surveys are the major data sources for measuring HIV prevalence, risk factors, intervention coverage, and the potential public health impact. Representative samples usually need to be collected for HIV surveillance. Most of the probability sampling methods considered are limited in that they are adequate only under certain circumstances and for some groups. [4] On the contrary, probability sampling strategy is challenging among key population groups who are often hidden and difficult to reach. Most of the probability sampling methods considered are limited in that they are adequate only under certain circumstances and for some groups. [4] On the contrary, probability sampling strategy is challenging among key population groups who are often hidden and difficult to reach. [5] Instead of random sampling, quasi-probability methods such as time location sampling (TLS) [6] and respondent-driven-sampling (RDS) [7], and nonprobability sampling included snowball sampling and convenience sampling are often used. [5]
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