DATA NEEDS TO FIGHT AGAINST HIVAIDS

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DATA NEEDS TO FIGHTAGAINST HIV/AIDS

• By
• Rafiqul Huda Chaudhury
• August 2003

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Roles of Data to Fight Against HIV/AIDS

• Providing information necessary for continuous
  and accurate understanding of the status, spread,
  future trends, and demographic/socio-economic
  impact of the epidemic.
• Guiding Government officials in taking
  appropriate actions against the AIDS epidemic.

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• Providing information for determining the extent
  of new infections on various population groups
  (sex, age, urban, rural, employment status,
  etc.).
• Formulating, monitoring and evaluating of
  HIV/AIDS programmes and projects.
• Assessing the achievement of national, regional
  and international targets including MDG targets
  on HIV/AIDS.

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• Developing effective HIV/AIDS advocacy
  programmes, aimed at all stakeholders including
  religious leaders and community leaders, youth,
  women, men, government decision makers,
  international agencies, etc.
• Facilitating the integration of HIV/AIDS
  variables into development planning.
•  
• Providing facts and figures necessary for
  fighting against myths, beliefs, etc.

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• Forecasting potential evolution of the epidemic
  (future will depend on the size of the groups
  with higher risk behaviours, current prevalence
  levels in these group, frequency of risk
  behaviour within these groups and behavioural
  links between sub-epidemics).

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Step Towards Better Utilization of Data

• Collecting of accurate data on new infections.
•  
• Providing detailed information on total number of
  cases by sex, age and socio-economic status of
  the population.
•  
• Disseminating information, which clearly shows
  how the numbers are changing for each population
  group.

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• Ensuring that data is effectively analyzed, by
  showing different scenarios of taking action or
  not taking action.
• Disseminating information using simple language,
  which can easily be understood by all in the
  community. There should less literature and
  figures and more graphics. The information should
  also be for different audiences rural urban,
  literate, illiterate, etc.

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Types of Data Needed for Monitoring and
Evaluation of HIV/AIDS

• Epidemiological and behavioural surveillance to
  monitor the spread of the epidemic as well as
  trends and also provide a more balanced view of
  the epidemic's potential evolution.
•  
• Population data, by sex, age, urban, rural,
  administrative areas, income level, etc.
•  

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• Sero-positive data from all persons, including
  number of new cases.
• Number of deaths due to HIV/AIDS related causes.
•  
• Household survey data by sex, age, income level,
  health, etc.
•  

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• Health data.
• Awareness, knowledge and behaviour data, as
  related to HIV/AIDS.
• Behavioural data The behavioural data is
  essential in analysis of relationships and trends.

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• Impact data Impact data is important for
  assessing demographic, household, health care and
  socio-economic indicators, specifically (a)
  mortality due to HIV/AIDS, (b) orphanhood, (c)
  household impact, (d) commercial farms, and (e)
  macro-economic analysis.
• HIV sentinel surveillance should be focused on
  female sex workers and STI patients to provide
  adequate warning should extensive heterosexual
  HIV transmission begins.

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• Regular collection and analysis of the data, from
  various socio-economic groups, will facilitate
  development of behavioural, impact and prevalence
  indicators.

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Sources of Data
Main sources of data for HIV/AIDS indicators
include

• Population and housing census reports, which
  provide demographic and socio-economic data.
•  
• Sentinel surveillance sites reports, (results
  from blood tests, AIDS cases reported, HIV
  sero-positive data and HIV incidence, new cases).

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• Health records, routine collection of information
  by the health units.
•  
• Demographic and health survey reports.
•  
• Cross-sectional survey reports.
•  
• Socio-cultural surveys.

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• Multi-indicator survey reports, which are
  regularly undertaken by UNICEF.
•  
• Population projection reports, from IPC, US
  Bureau of Census.
•  
• Population projections (taking HIV into account)
  from UN Population Division.

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Shortcomings of Data

• Availability of data in terms of quantity,
  quality and coverage is far from satisfactory.
•  
• In most countries, there are no major plans and
  programmes for collection and analysis of
  HIV/AIDS. Thus, several agencies conduct own data
  collection and analysis. No doubt that such a
  situation has its weaknesses, mainly disjointed
  and contradictory information.

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• The HIV/AIDS data has not been harmonized into
  national statistical systems. Thus, it has been
  observed that some indicators have different
  values, a problem, which complicates planning,
  and decision-making.
• Population censuses are undertaken every ten
  years and most of the time projections are used.

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• HIV prevalence data Most data come from routine
  sentinel surveillance, usually from pregnant
  women at antenatal care clinics. In most cases,
  rural areas are under-represented, and which is a
  serious concern since about 80 of populations
  live in rural areas.

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• Household based surveys These have better
  geographical coverage but are of high cost.
•  
• Health data most data is not analyzed, coverage
  is poor and recording is poor.
• Behavioural surveillance data are hardly
  available.

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• Data to measure impact presents a number of
  problems (a) difficulties in measurement, (b)
  weakness of vital statistics, and (c) enumeration
  often requires fieldwork, which is expensive.
•  
• New incidence of HIV is rarely measured, they are
  highly selective to change and requires large
  samples and can be difficult to interpret.

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• HIV/AIDS is seen as a health matter. This has
  extended to collection and analysis of HIV/AIDS
  related data.
• Basic data for measuring the spread of the
  disease comes from health units, mostly from
  sentinel surveillance sites. It has however been
  observed that these sites are few, biased and
  non-representative of the target population. It
  should not, therefore, be used in generalizing to
  the total population.

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• It is expected that estimates cannot be error
  free. However, reports on the spread and status
  of HIV/AIDS in countries do not include statement
  of estimates on statistical accuracy, a
  phenomenon that does not facilitate
  decision-making process.
•  
• Projection models, which take into account the
  impact of HIV/AIDS are not yet fully developed.

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UNFPA Response to Strengthening Data Collection
and AnalysisSuggested Actions for Improving Data
Quality
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UNFPA response is what UNFPA can provide
(financially or technical), in partnership with
other stakeholders in addressing the identified
constraining factors.
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• Thank You!

G\RAFIQUL\HIV_AIDS\DATA_NEEDS_RHC, 26 August
2003