Behavioural Surveillance Surveys - The Wisdom of Whores

First, they are likely to want to use the
data generated to support their own project
evaluation efforts and to improve their
prevention services. They are therefore likely
to have useful ideas about appropriate survey
questions and indicators. Secondly, they are
likely to have good access to communities that
are otherwise difficult to reach. The trust that
they have established with these communities
provides a platform from which successful
behavioral surveys can be launched. NGOs
providing services to communities at risk for
HIV may therefore become a primary partner
(or the lead actor) in carrying out the surveys
themselves.
Communities at risk for HIV, and those that
interact with them
The full and active participation of all
quarters of government and of non-governmental
service providers will be of no value
unless the communities at risk for HIV are
themselves willing to participate in behavioral
surveillance. And people are only likely to
be willing to participate if they believe that
the exercise will benefit them and their
communities. The translation of data into
better service provision is the weakest link
in what should be a circular chain of
programming, surveillance, evaluation and
improved programming. Often, people are
right to be wary of vague promises that a
survey will be followed by improved
programming. This is one of the reasons that
it is so critically important to plan realistically
how data will be used before the survey
process begins.
The provision of information and service
is an important part of HIV prevention
programming, but it is up to members of the
communities themselves to use those services
to reduce their exposure to HIV, and that of
their partners. They know better than anyone
what the current profile of risk behavior is.
The more BSS answers questions raised within
the community itself, the more community
members are likely to act on the information it
generates. It is therefore important to consult
with members of the communities who will be
answering questionnaires about what should
be included in the survey.
Like the NGOs that serve them, community
members know the ins and outs of the world
they inhabit. Key individuals can provide
essential information, helping to delineate the
community and to facilitate access to its
members. Community members can also shed
light on the power structures that operate
within a community. For BSS to succeed,
those planning the data collection have to deal
not only with individuals at high risk for HIV,
but also with the men, women and organizations
that hold the keys to their community.
These people - be they brothel owners and
pimps, drug dealers and shooting gallery
owners, taxi company bosses, union leaders or
head teachers - may stand to gain or to lose
from a better understanding of risk behavior
in the communities they influence, and from
more effective prevention efforts in these
communities. Certainly, they can stand in the
way of a successful data collection exercise.
One of the jobs of those planning BSS is
to consult key power brokers about their
concerns, and to clarify the benefits that better
HIV prevention efforts can bring to them and
to the communities they influence.
B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 2
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