Behavioural Surveillance Surveys - The Wisdom of Whores

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9. Indicators A key question in behavioral data collection is : what to measure ? There are many things to consider when choosing indicators. Obviously, they have to measure behaviors which are relevant to the spread of HIV, and which national program efforts are trying to change. They should be able to register change over time in a way that is easy to interpret. While they must meet local needs, they should to the extent possible conform to internationally agreed standards, so that progress can be compared not only over time, but between populations. Chapter 9 defines key indicators for each population sub-group, developed in conjunction with the United Nations Joint Program on HIV/AIDS (UNAIDS), the World Health Organization (WHO) and others. It describes how they can be constructed from the questionnaires included in these guidelines, and discusses the strengths and limitations of each. This section will help policy-makers pick indicators most appropriate to their needs, and guide data analysts in the formulation of those indicators. 10. Annexes The annexes include other useful items such as standardized questionnaires, fieldwork forms and examples of interviewer guidelines. The annexes also contain detailed descriptions of the sampling process used in many different settings to date. Keeping up to date The methods in these guidelines have been widely used, and with great success. While every effort is made to maintain consistency over time, these methods do not stand still. As they become even more widely used, new lessons will be learned and improvements will inevitably be made. The latest versions of the materials in these guidelines can always be downloaded from the internet at: http://www.fhi.org. Acknowledgments Contributions to these guidelines have been made by the following individuals (presented in alphabetical order) : Joseph Amon, Tim Brown, Jan Hogle, Joan MacNeil, Robert Magnani, Stephen Mills, Elizabeth Pisani, Thomas Rehle, Tobi Saidel, and Christine Kolars Sow. We wish to thank the following individuals who helped review the guidelines and field test the methodology : Jeanine Buzy Bardon, Somnath Basu, Tony Bennett, Ties Boerma, Sara Jane Bowsky, Txema Calleja, Michel Carael, Anindya Chatterjee, James Chin, Nick Crofts, Paul Deany, Philippe Girault, Pamina Gorbach, Don Des Jarlais, Delia Garcia, Carol Jenkins, Willi MacFarland, Stella Manoharan, Kishka O’Connor, Aaron Peak, Arunsiri Phothong, Ashok Row Kavi, Luke Samson, Ton Smits, William Stewart, Jerry Stimson, Danai Sundhagul, Jean Paul Tchupo, Sidhartha Man Tuladhar, Budi Utomo, Maxine Wedderburn, Gunter Weiller and Boonyaruk Winitthama. Special thanks are due to Elizabeth Pisani who edited major portions of the guidelines.
G UIDELINES FOR REPEATED BEHAVIORAL SURVEYS IN POPULATIONS AT RISK OF HIV Why behavioral surveillance? C H A P T E R 1 WHY BEHAVIORAL SURVEILLANCE? ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ • Uses of behavioral surveillance • Different approaches to collecting behavioral data • Issues and limitations in behavioral data collection
Page 1 and 2: BEHAVIORAL SURVEILLANCE SURVEYS GUI
Page 3 and 4: Family Health International (FHI) H
Page 5 and 6: Chapter 7 Analysis and interpretati
Page 7: 3. Choosing populations for behavio
Page 11 and 12: Recognizing that HIV surveillance d
Page 13 and 14: Different approaches to collecting
Page 15 and 16: The principal rationale for focusin
Page 17 and 18: It is not possible to validate data
Page 19 and 20: GUIDELINES FOR REPEATED BEHAVIORAL
Page 21 and 22: The process of building partnership
Page 23 and 24: Funders of HIV prevention activitie
Page 25 and 26: What is to be measured ? Indicators
Page 27 and 28: Step 7 : Constructing a sampling fr
Page 29 and 30: Step 12 : Data collection and super
Page 31 and 32: choosing population groups GUIDELIN
Page 33 and 34: the spread of HIV. For this reason,
Page 35 and 36: In some circumstances, public healt
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Page 39 and 40: The majority of sub-populations of
Page 41 and 42: In the end, the issue boils down to
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Page 45 and 46: Maps derived from program planning
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Table 6 : Sample size requirements
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equired. In this case, the pros and
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Should one- or two-tailed z-score v
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Other measurement issues for BSS Th
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A “low-tech” solution to the pr
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5 Weighting in multi-stage sampling
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Figure 6 : Procedures for calculati
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Calculating weights from sampling p
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Calculating standard errors with mu
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6 Adapting and using questionnaires
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Some attempts have in the past been
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Informed consent Confidentiality an
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GUIDELINES FOR REPEATED BEHAVIORAL
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Recommended Methods of Statistical
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where n is the sample size in the d
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Table 2 : Reported number of non-re
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False conclusions: the danger of co
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Analysis of trends in behavior over
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Changes in sampling methodology ove
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8 Using the data collected to impro
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Improving prevention programs As a
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Finally, information about HIV and
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Figure 9 : HIV and STD prevalence,
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9 Indicators This guide identifies
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The standard questionnaires are acc
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INDICATORS Page INDICATORS FOR YOUT
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INDICATORS Page INDICATORS FOR MEN
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KEY INDICATORS What follows is a fu
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The indicator uses promoted data. O
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To be counted the numerator for thi
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Strengths and limitations Some meas
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Adult Indicator 5 Consistent condom
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Adult Indicator 7 (men only) Number
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Adult Indicator 9 Consistent condom
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Adult Indicator 11 Population seeki
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Adult Indicator 12 Exposure to inte
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Youth Indicator 2 No incorrect beli
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Youth Indicator 4 Youth sexually ac
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Youth Indicator 6 Number of sexual
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Youth Indicator 8 Consistent condom
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Youth Indicator 10 Commercial sex a
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Youth Indicator 14 Exposure to inte
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Female Sex Worker Indicator 2 No in
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Female Sex Worker Indicator 5 Sex w
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Indicators for men who have sex wit
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Men Who Have Sex With Men Indicator
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Men who have sex with men Indicator
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Indicators for injecting drug users
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Injecting Drug User Indicator 3 Inj
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Injecting Drug User Indicator 8 Dru
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Injecting Drug User Indicator 10 Dr
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Suggested Reading Brown T, Sittitra
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QUESTIONNAIRE For Adult Target Grou
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The ADULT questionnaire includes th
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FHI 1999 HIV/AIDS/STD BEHAVIORAL SU
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POSSIBLE ADDITIONAL QUESTIONS Commu
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STD Treatment seeking behaviors No.
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STD Treatment seeking behaviors (co
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QUESTIONNAIRE For Unmarried Male An
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The YOUTH questionnaire includes th
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No. Questions and filters Coding ca
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Stigma and Discrimination No. Quest
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FAMILY HEALTH INTERNATIONAL (FHI) H
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STD Treatment seeking behaviors No.
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STD Treatment seeking behaviors (co
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QUESTIONNAIRE For Men Who Have Sex
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The MSM questionnaire includes the
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STD Treatment seeking behaviours No
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No. Questions and filters Coding ca
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QUESTIONNAIRE For Injecting Drug Us
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This questionnaire includes the fol
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EXAMPLE OF SUPERVISORS’ AND INTER
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A “take-all” approach is to be
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• To probe for additional informa
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Part B: How to use the Long Distanc
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An example of a question for which
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Part C: Section-by-section review o
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Q109. If the respondent says he/she
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it is asking if the respondent has
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Section 5 : Non-regular partners Q5
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Q706 : This question determines the
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Q910 - Q912 : Knowledge of maternal
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in riskier behavior (i.e., not usin
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Section 5 : Non-paying partners Que
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3 APPENDIX WORKING EXAMPLES OF SAMP
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For the purposes of the BSS, the ke
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The second stage sampling procedure
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Notes: 1. It may not always be poss
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The information from the mapping ex
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In Figure 3, clusters were chosen b
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Fieldwork assignments when the “t
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Figure 4 : Example of targeted snow
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In some settings it may not be acce
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Figure 6 : Steps in using the segme
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Figure 9 : Map of hypothetical samp
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In-class sampling of school youth T
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Alternative to “in-class” sampl
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found at the various locations at d
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What should be done if, even after
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FIELDWORK FORMS The following set o
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Form I Cluster Selection Sheet (Pro
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Form 2 Cluster Selection Sheet (Equ
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Form 3 Assignment Information Sheet
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Form 4 Cluster Information Sheet Su
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TABLE OF CHI-SQUARE STATISTICS AND
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Step 2 : Calculate the expected num
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Behavioural Surveillance Surveys - The Wisdom of Whores

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