Behavioural Surveillance Surveys - The Wisdom of Whores

Funders of HIV prevention activities
Those who fund HIV prevention activities
have a special interest in knowing whether
their contribution is making any difference.
While this includes local tax-payers, in practice
the demand for evaluation very often comes
from international investors in prevention.
As part of a national surveillance system for
HIV, BSS is not designed to evaluate particular
interventions or the contribution of particular
donors. It is designed to monitor whether
the sum total of the national response to HIV
is having any effect on the behaviors that
threaten to spread the virus throughout
sub-populations or the general population.
However, public health officials managing
a surveillance system may be sensitive to the
needs of major donors by taking their concerns
into account in designing BSS. This may imply
including particular geographical areas or
population sub-groups in the surveillance
system. It should be stressed, however, that
BSS is designed to be a routine exercise which
meets the long-term information needs of a
national AIDS program. The concerns of
individual organizations funding particular
short-term prevention projects should remain
secondary to long-term national needs.
Mechanisms to sustain partnerships
It may be a good idea to formalize the
consultation process so that partners can
continue to contribute ideas and exchange
experience throughout the planning and
implementation of BSS, and can coordinate
their responses to its results. One mechanism
that appears to work well is a technical
working group on surveillance that includes
members of all the groups mentioned above.
This group should meet very regularly during
the design phase of BSS or wider second
generation surveillance systems, and continue
to meet at less frequent intervals during the
implementation and analysis phase to review
progress and plan for the effective use of the
emerging data.
Step 2 : Building agreement
on the BSS process
Together, the groups listed above need to
come to agreement on several issues. These
include :
• Which sub-populations will be included in
the surveys ?
• What information will be collected from
these groups ?
• Who will do the data collection and analysis ?
• What mechanisms will ensure that
information gathered will be used to
benefit the communities involved ?
These decisions are interdependent.
For example, the choice of respondent groups
may well determine which institution can
most effectively conduct the data collection.
How the information will ultimately be used
will influence what information is collected.
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C H A PTER 2 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S