Behavioural Surveillance Surveys - The Wisdom of Whores

Step 3 : Choosing
sub-populations for
behavioral surveillance
Experience has shown that the first of these
issues is often the most difficult to resolve.
Ideally, sub-populations should be chosen on
the basis of their contribution or potential
contribution to the spread of HIV in the local
situation, and because prevention efforts are
underway or planned to reduce risk behavior
in those particular groups. Some sub-populations
may be chosen to represent particular
types of risk behavior, with behavioral or
occupational groups all included as separate
respondent groups. In practice, the choice of
sub-populations is influenced by many factors
other than epidemiological concerns. Political
considerations, resources and feasibility of
access all have a part to play. Indeed the
process of choosing sub-populations for BSS
ideally should include a rapid assessment
stage that confirms that members of the group
exist in sufficient numbers and that they do
engage in high risk beheviors. It should also
investigate the feasibility of data collection
among potential respondents.
In this process of selecting sub-populations
and confirming their relevance and feasibility
as potential respondent groups for BSS, care
should be taken to use existing data which
can indicate what sub-populations are most at
risk in a society, and which behaviors put
them at risk. Press reports and interviews with
people likely to have information on sexual
and drug-taking behavior can also inform
preliminary decisions about relevant risk
groups and behaviors. This is discussed in
greater detail in the section on rapid assessment
on page 26.
Step 4 : Defining measurement
objectives
One of the driving factors behind the
choice of sub-populations for BSS will be the
country’s strategic prevention priorities. After
sub-populations have been discussed and
agreed upon, surveillance planners should
clearly articulate why they have chosen these
groups. In other words, what exactly they
want to know, how they plan to measure it,
and how that information will help improve
national prevention efforts.
Failure to articulate objectives clearly at this
stage may lead to wasted resources and lost
opportunities in the data collection phase.
Information may be collected in ways that are
not easy to interpret or not comparable with
other data sources, and questions which need
answering may go unanswered.
What will the information be used for ?
Information is collected to be used.
It follows that it must be presented in a form
that will be useful to those who have the
power to act on it. Defining the likely users
and uses of information is an important first
step in defining the overall measurement
objectives. Specifying the ultimate data uses
will lead to rational answers to the next
question period.
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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