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HIV INFECTION
Calleja JM, Marum LH, Carcamo CP, Kaetano L, Muttunga J, Way A.
Lessons learned in the conduct, validation, and interpretation of national
population based HIV surveys. AIDS 19 Supplement 2, S9-S17, May 2005.
In the past
few years several countries have conducted national population-based HIV
surveys. Survey methods, levels of participation bias from absence or refusal
and lessons learned conducting such surveys are compared in four national
population surveys: Mali, Kenya, Peru and Zambia. In Mali, Zambia, and Kenya,
HIV testing of adult women and men was included in the national-level
demographic and health surveys carried out regularly in these countries, whereas
in Peru the national HIV survey targeted young people in 24 cities with
populations over 50 000.
The
household response rate was above 90% in all countries, but some individuals
were absent for interviews. HIV testing rates were between 70 and 79% of those
eligible, with higher test rates for women. Three critical questions in this
type of survey need to be answered: who did the surveys miss; how much it
matters that they were missed; and what can be done to increase the
participation of respondents so the coverage rates are adequate. The level of
representativeness of the populations tested was adequate in each survey to
provide a reliable national estimate of HIV prevalence that complements other
methods of HIV surveillance. Different lessons were learned from each survey.
These
population-based HIV seroprevalence surveys demonstrate that reliable and useful
results can be obtained, although they require careful planning and increased
financial and human resource investment to maximize responses at the household
and individual level, which are key elements to validate survey results.
This review
was initiated through an international meeting on 'New strategies for HIV/AIDS
Surveillance in Resource-constrained Countries' held in Addis Ababa on 26-30
January 2004 to share and develop recommendations to guide future surveys.
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