Transcript Document

Unit 8:
Uses and Dissemination of HIV
Sentinel Surveillance Data
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Warm Up Questions: Instructions

Take five minutes now to try the Unit 8 warm
up questions in your manual.

Please do not compare answers with other
participants.

Your answers will not be collected or graded.
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We will review your answers at the end of the
unit.
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What You Will Learn
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By the end of this unit you should be able to:
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discuss various uses for HIV sentinel
surveillance data
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discuss how to develop a clear and
understandable message about
surveillance data
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understand the tools for disseminating data
to target groups
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Uses of HIV Surveillance Data
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Data can be used for a variety of public
health actions:
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targeting prevention and care programmes
monitoring and evaluation
monitoring indicators
resource allocation and programme planning
informing and educating the public
guiding scientific research
triangulation
mobilising political commitment
advocacy
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Using Sentinel Surveillance Data
to Target Programmes
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Advantages
helpful in determining
where the burden of
disease is greatest in a
country
shows which
demographic groups
are most severely
affected
increased attention
directed to highprevalence areas
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Disadvantages
not very useful in
identifying specific highrisk behaviours since
only limited behavioural
data are collected
If sentinel surveillance
is only directed at ANCs,
trends in STI clinic
patients will be missed.
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Monitoring and Evaluation
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Evaluation refers to determining:
 how well a programme is functioning
(process evaluation)
 what its impact is (impact evaluation)
Monitoring refers to looking at a programme’s
performance over time.
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Monitoring Indicators
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HIV sentinel surveillance data are used as
indicators for evaluating the impact of
prevention programmes.
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Indicators are specific data, gathered to
measure how well a prevention or treatment
programme is doing.
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UNAIDS has developed the concept of
‘Impact Indicators’ to communicate these
outcomes most effectively.
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Monitoring Indicators:
Indicators 1 & 3
Impact Indicator
1
Impact Indicator
3
Population(s) it
reflects
Pregnant women
Sub-populations
with high-risk
behaviour
Epidemic state(s)
in which it is
used
Generalised
Low-level or
concentrated
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Monitoring and Evaluation
Limitations
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There are two limitations in using prevalence
for monitoring and evaluating prevention
programmes:
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Prevalence surveys measure prevalence,
not incidence.
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Populations targeted for prevention are
usually exposed to more than one
prevention message.
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Resource Allocation and
Programme Planning
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HIV sentinel surveillance can be used to
estimate the number of HIV-infected persons
in a country.
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Short-term projections on the annual
incidence of AIDS cases can be made using:
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HIV prevalence data
average time from HIV infection to AIDS diagnosis
survival after an AIDS diagnosis
population size
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Public Education
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Public education on local HIV prevalence can give
people a realistic perception of their risk of infection.
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Extremely important for those in high prevalence
areas who continue to engage in high-risk behaviours.
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Reinforces basic information and specific prevention
messages.
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May help in removing stigma of HIV infection.
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Guiding Scientific Research
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Higher prevalence in certain populations will
suggest where disease transmission is
highest.
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This will be where its epidemiology and
prevention are most easily studied.
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Triangulation
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The process of examining several different
sets of data, which are measuring different
things in order to come up with a better
understanding of how and where the
epidemic is spreading
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Second-generation surveillance stresses
comparing HIV sero-surveillance data to HIV
behavioural surveillance data
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Triangulation, Cont.
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Integrating these data with other sources of
data gives a better picture of the HIV epidemic.
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Some other sources of data may include:
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STI and TB surveillance data
blood donor data
AIDS case reporting
death registration information
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Mobilising Political Commitment
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It is challenging to maintain political commitment, and
HIV prevalence data can often help
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Selected kinds of people who need to be informed
about HIV prevalence include:
 politicians
 potential donors or funders
 public health planners
 health personnel at national and local levels
 health promotion and prevention staff
 the media
 individuals, groups and communities
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Advocacy
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Governments and NGOs are less able to
ignore the reality of HIV when its existence
and spread are documented thoroughly.
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The state of an epidemic helps to determine
what kind of advocacy is necessary
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Disseminating HIV
Surveillance Data
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establish the message you want to
communicate
select the audience to which you want to
deliver the message
select the channel through which the
message will be delivered
select the tool for delivering the message
evaluate the impact of the message
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Establish the Message
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What is the most important information that the
surveillance team and public health officials want to
convey?
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Is the epidemic increasing or decreasing?
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Is there evidence that what is being done is working?
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Note that messages will differ from audience to
audience as well
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Select the Audience(s)
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Once the message has been established, the
target audience should be defined.
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Important potential target audiences include:
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health professionals
general public
policy and decision makers
media
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Select the Audience(s), Cont.
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Other important potential target audiences:
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non-governmental organizations (NGOs)
other national and international organisations
surveillance staff members at national and local
levels who help conduct sero-surveys
The content of the message and the target
audience should be linked.
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Select the Communication
Channel(s)
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Communication channels for disseminating
HIV surveillance results include:
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television
radio
newspapers
scientific journals
conferences
newsletters
press releases
the internet
epidemiologic bulletins and technical reports
face-to-face briefings with decision-makers
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Table 8.3. Select the Tool(s)
Audiences
Channels
Tools
Technical professionals
involved in NACP and
monitoring and evaluation
Dissemination or
evaluation
workshops
Full technical report on
HIV, STI & behavioural
surveillance
Non-governmental
organisations, other
sectors and partners
Media, journalists, general
population
Conferences
Policy-makers, decisionmakers
Face-to-face
briefings and
planning meetings
A non-technical review
of data from different
sources
A press release
highlighting the main
findings
Brief summaries of
main findings with
some graphics
Press
conferences
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Evaluate Impact
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An important final step is an informal
evaluation of how well the surveillance
message was delivered, through, for example:
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informal conversations with the press
conversations with aides to senior policy-makers
asking people in behavioural surveys about the
most effective ways to communicate messages
about HIV
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Warm Up Review

Take a few minutes now to look back at your
answers to the warm up questions at the
beginning of the unit.
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Make any changes you want to.
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We will discuss the questions and answers in
a few minutes.
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Answers to Warm Up Questions
1. True or false? Reading or hearing about HIV
in the media strengthens basic information
and prevention messages. True
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Answers to Warm Up Questions,
Cont.
2. List two potential audiences for the
dissemination of surveillance data.
Technical professionals, NGOs, policy
makers, journalists, etc.
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Answers to Warm Up Questions,
Cont.
3. List three potential uses of HIV surveillance
data. Targeting intervention activities,
program monitoring and evaluation,
resource allocation, political mobilisation,
etc.
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Answers to Warm Up Questions,
Cont.
4. True or false? When disseminating HIV
surveillance results, a single message that
can be used for all target audiences in the
best way to transmit the information. False
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Small Group Discussion:
Instructions
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Get into small groups to discuss these
questions.
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Choose a speaker for your group who will
report back to the class.
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Take 15 minutes for this exercise.
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Small Group Reports
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Select one member from your group to
present your answers.
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Discuss with the rest of the class.
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Case Study: Instructions

Try this case study individually.
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We’ll discuss the answers in class.
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Case Study Review
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Follow along as we go over the case study in
class.
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Discuss your answers with the rest of the
class.
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Questions, Process Check
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Do you have any questions on the information
we just covered?
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Are you happy with how we worked on Unit 8?
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Do you want to try something different that will
help the group?
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