Abstract
High quality, representative data from HIV surveillance systems that have country ownership and commitment are critical for guiding national HIV responses, especially among key and priority populations given their disproportionate role in the transmission of the virus. Between 2011 to 2013, the Mozambique Ministry of Health has conducted five Biobehavioral Surveillance Surveys among key populations (female sex workers, men who has sex with men and people who inject drugs) and priority populations (long distance truck drives and miners) as part of the national HIV surveillance system. We describe the experience of strengthening the HIV surveillance system among those populations through the implementation of these surveys in Mozambique. We document the lessons learned through the impact on coordination and collaboration; workforce development and institutional capacity building; data use and dissemination; advocacy and policy impact; financial sustainability and community impact. Key lessons learned include the importance of multisectoral collaboration, vital role of data to support key populations visibility and advocacy efforts, and institutional capacity building of government agencies and key populations organizations. Given that traditional surveillance methodologies from routine data often do not capture these hidden populations, it will be important to ensure that Biobehavioral Surveillance Surveys are an integral part of ongoing HIV surveillance activities in Mozambique.
Highlights
Lessons learned Coordination & collaboration Implementation of the Biobehavioral Surveillance (BBS) surveys has provided increased opportunities for multisectoral collaboration among host government entities (MoH, Institute of Health (INS), Ministry of Labor and Provincial Health Departments), bilateral organizations (CDC, President’s Emergency Plan for AIDS Relief (PEPFAR)), multilateral agencies (UNAIDS), international academic research partners (UCSF), Nongovernmental organization (NGO) (ITECH, The International Centre for Reproductive Health (ICRH) and Pathfinder International Population Services International) and civil society organizations: Association for Sexual Minority Rights in Mozambique (LAMBDA), female sex workers (FSW) network (Tiyane Vavassate), and the National Network Against Drugs (UNIDOS)
The objective of this paper is to examine the BBS surveys in the context of their role in strengthening the Human immunodeficiency virus (HIV) surveillance system
Mozambique’s first experience with the design, implementation, and analysis of BBS surveys has contributed significantly to national understanding of the behavioral factors contributing to HIV transmission among key and priority populations in the country
Summary
Mozambique has a generalized HIV epidemic with a prevalence of 13.2% among adults aged 15–49 years old [1]. Semá Baltazar et al BMC Public Health (2021) 21:91 high-risk populations may not self-identify as such in household-based surveys Global agencies such as the Joint United Nations Programme on HIV/ AIDS (UNAIDS), World Health Organization (WHO), President’s Emergency Plan for AIDS Relief (PEPFAR), and the U.S Centers for Disease Control and Prevention (CDC), encourage the implementation of more effective data collection strategies such as Biobehavioral Surveillance (BBS) surveys, which capture essential behavioral data linked to HIV infection among these groups. These data are used to inform policy and programming [6]. We document the lessons learned with coordination and collaboration; workforce development and institutional capacity building; data use and dissemination; advocacy and policy impact; and financial sustainability and community impact (Table 2)
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