Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 22, 2020
Date Accepted: Oct 20, 2020
Availability and Quality of Surveillance and Survey Data on HIV Prevalence among Sex Workers, Men Who Have Sex with Men, People Who Inject Drugs and Transgender Women in Low- and Middle-Income Countries: Review of Available Data 2001-2017
ABSTRACT
Background:
In 2018, 54% of new human immunodeficiency virus (HIV) infections occurred among key populations (KPs), namely sex workers (SW), gay men and other men who have sex with men (MSM), people who inject drugs (PWID), and transgender women (Transwomen) and their sexual partners. World Health Organization (WHO) recommends implementation of bio-behavioral surveys every 2-3 years to obtain serologic and behavioral data for all KPs. However, these data are often collected less frequently and geographically limited.
Objective:
To assess the availability and quality of HIV prevalence data among SW, MSM, PWID and Transwomen in low- and middle-income countries.
Methods:
Data were obtained from survey reports, national reports, journal articles, and other grey literature available to the Global Fund, UNAIDS, WHO or in other open sources. Elements reviewed included name of subnational units, HIV prevalence, sampling method and size. Based on geographical coverage, availability of trends over time, and recency of estimates, data were categorized by country and group as either: nationally adequate; nationally inadequate but locally adequate; no recent data; no trends available; and no data.
Results:
Among 123 countries assessed, 13 countries were categorized as having nationally adequate data for any KP between 2001 and 2017. Thirty-three countries were nationally inadequate but locally adequate within selected subnational units. Among 113 countries with at least one HIV prevalence data point for any KP, 96 (85%) had data for at least two groups, 63 (56%) for at least three groups, and only 18 countries (16%) had data for all four groups. Overall, the trend in availability and quality of HIV prevalence data was increasing.
Conclusions:
Despite improvements in data availability and quality, availability of serologic and behavioral data to inform KP programming in low-and middle-income countries remains insufficient. Data collection should be expanded through context-specific differentiated survey approaches while emphasizing data use for program improvements. Ending HIV as an epidemic by 2030 is only achievable if the HIV epidemic among KPs is controlled.
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