Behavioural Surveillance Surveys - The Wisdom of Whores

Improving prevention programs
As a picture of risk behavior builds up and
changes over time, it will indicate which
behaviors have changed following interventions
and which remain entrenched. This information
can and should be used to improve prevention
programs. Packages of interventions which
appear to be associated with behavior change
in some groups may be continued and
expanded. Behaviors that remain unchanged
despite efforts to promote safer alternatives
will need a new approach, perhaps one that
pays more attention to the social or economic
context which determines why people behave
in that way.
Packaging data for different
users
There are many names for the Art of
Persuasion: advocacy, lobbying and marketing
to name just a few. While the words differ, the
art remains essentially the same: choose the
information that people most care about, and
present it to them in a way that provokes action.
The results of BSS should always be
presented in a full technical report, as discussed
below. But this is far from being enough.
The Minister of Education is not going to read
a 50 page report about HIV-related behavior
that includes information on sampling
methodology and statistical tests. In fact, the
Minister of Education may very well not think
that HIV-related behavior bears any relation to
his/her work at all. The task for HIV prevention
workers is to pick out of the BSS results
the two or three pieces of information most
likely to be relevant to the minister, and to
package them together with information from
other sources into a two-page brief that makes
a compelling case for greater HIV-prevention
activities in schools and among teachers.
The information chosen from BSS might
include the proportion of high school students
reporting more than one partner in the last
12 months, and the proportion of men and
women in the general population using
condoms at last risky sex, by level of education.
These might be packaged together with
information about school enrollment rates
from the ministry’s own records, showing at
what age children begin to drop out of
school, information about school attendance
according to orphanhood status obtained
from Demographic and Health studies, and
information about absenteeism and death
among teachers in service, obtained from the
teachers’ union. Together, these data can be
used to make a compelling case for policies
which promote HIV prevention activities
in schools at appropriate ages, which help to
keep children in vulnerable situations in schools,
and which promote effective forward planning
for the impact of HIV on the educational system.
National AIDS program officials or others
responsible for ensuring data use should not
be afraid to draw conclusions from the data
presented, or to suggest specific action to
improve HIV prevention and care policies.
B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 8
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