Population-Based HIV Impact Assessments Survey Methods, Response, and Quality in Zimbabwe, Malawi, and Zambia.
Adolescent
Adult
Anti-HIV Agents
/ therapeutic use
Biomarkers
/ blood
Child
Child, Preschool
Epidemiological Monitoring
Female
HIV Infections
/ blood
HIV-1
Health Surveys
Humans
Incidence
Infant
Malawi
/ epidemiology
Male
Middle Aged
Surveys and Questionnaires
Young Adult
Zambia
/ epidemiology
Zimbabwe
/ epidemiology
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
received:
28
01
2021
accepted:
04
02
2021
entrez:
24
6
2021
pubmed:
25
6
2021
medline:
6
11
2021
Statut:
ppublish
Résumé
The population-based HIV impact assessment (population-based HIV impact assessments) surveys are among the first to estimate national adult HIV incidence, subnational prevalence of viral load suppression, and pediatric HIV prevalence. We summarize the survey methods implemented in Zimbabwe, Malawi, and Zambia, as well as response rates and quality metrics. Each cross-sectional, household-based survey used a 2-stage cluster design. Survey preparations included sample design, questionnaire development, tablet programming for informed consent and data collection, community mobilization, establishing a network of satellite laboratories, and fieldworker training. Interviewers collected demographic, behavioral, and clinical information using tablets. Blood was collected for home-based HIV testing and counseling (HBTC) and point-of-care CD4+ T-cell enumeration with results immediately returned. HIV-positive blood samples underwent laboratory-based confirmatory testing, HIV incidence testing, RNA polymerase chain reaction (viral load), DNA polymerase chain reaction (early infant diagnosis), and serum antiretroviral drug detection. Data were weighted for survey design, and chi square automatic interaction detection-based methods were used to adjust for nonresponse. Each survey recruited a nationally representative, household-based sample of children and adults over a 6-10-month period in 2015 and 2016. Most (84%-90%) of the 12,000-14,000 eligible households in each country participated in the survey, with 77%-81% of eligible adults completing an interview and providing blood for HIV testing. Among eligible children, 59%-73% completed HIV testing. Across the 3 surveys, 97.8% of interview data were complete and had no errors. Conducting a national population-based HIV impact assessment with immediate return of HIV and other point-of-care test results was feasible, and data quality was high.
Sections du résumé
BACKGROUND
The population-based HIV impact assessment (population-based HIV impact assessments) surveys are among the first to estimate national adult HIV incidence, subnational prevalence of viral load suppression, and pediatric HIV prevalence. We summarize the survey methods implemented in Zimbabwe, Malawi, and Zambia, as well as response rates and quality metrics.
METHODS
Each cross-sectional, household-based survey used a 2-stage cluster design. Survey preparations included sample design, questionnaire development, tablet programming for informed consent and data collection, community mobilization, establishing a network of satellite laboratories, and fieldworker training. Interviewers collected demographic, behavioral, and clinical information using tablets. Blood was collected for home-based HIV testing and counseling (HBTC) and point-of-care CD4+ T-cell enumeration with results immediately returned. HIV-positive blood samples underwent laboratory-based confirmatory testing, HIV incidence testing, RNA polymerase chain reaction (viral load), DNA polymerase chain reaction (early infant diagnosis), and serum antiretroviral drug detection. Data were weighted for survey design, and chi square automatic interaction detection-based methods were used to adjust for nonresponse.
RESULTS
Each survey recruited a nationally representative, household-based sample of children and adults over a 6-10-month period in 2015 and 2016. Most (84%-90%) of the 12,000-14,000 eligible households in each country participated in the survey, with 77%-81% of eligible adults completing an interview and providing blood for HIV testing. Among eligible children, 59%-73% completed HIV testing. Across the 3 surveys, 97.8% of interview data were complete and had no errors.
CONCLUSION
Conducting a national population-based HIV impact assessment with immediate return of HIV and other point-of-care test results was feasible, and data quality was high.
Identifiants
pubmed: 34166308
doi: 10.1097/QAI.0000000000002710
pii: 00126334-202108011-00003
pmc: PMC8650710
mid: NIHMS1751003
doi:
Substances chimiques
Anti-HIV Agents
0
Biomarkers
0
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
S6-S16Subventions
Organisme : CGH CDC HHS
ID : U2G GH000994
Pays : United States
Organisme : CGH CDC HHS
ID : U2G GH001226
Pays : United States
Organisme : PEPFAR
Pays : United States
Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
UNAIDS. Global AIDS Update 2016. Geneva, Switzerland: Geneva UNAIDS; 2018. Available at: https://www.unaids.org/en/resources/documents/2016/Global-AIDS-update-2016 .
UNAIDS. Miles to Go: Closing Gaps Breaking Barriers Righting Injustices. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS (UNAIDS); 2018. Available at: https://www.unaids.org/en/20180718_GR2018 .
UNAIDS. AIDSinfo. Available at: http://aidsinfo.unaids.org/ . Accessed June 11, 2019.
UNAIDS. 90-90-90: An Ambitious Treatment Target to Help End the AIDS Epidemic. Geneva, Switzerland: UNAIDS; 2014. Available at: https://www.unaids.org/en/resources/documents/2017/90-90-90 .
Zimbabwe National Statistics Agency and ICF International. Zimbabwe Demographic and Health Survey 2015 Final Report. Rockville, MD: Zimbabwe National Statistics Agency (ZIMSTAT) and ICF International; 2016.
Central Statistical Office (CSO) [Zambia], Ministry of Health (MOH) [Zambia], and ICF International. Zambia Demographic and Health Survey 2013-14. Rockville, MD. Central Statistical Office, Ministry of Health, and ICF International; 2014.
National Statistical Office (NSO) [Malawi] and ICF. Malawi Demographic and Health Survey 2015-16. Zomba, Malawi, and Rockville, MD: NSO and ICF; 2017.
Bicego GT, Nkambule R, Peterson I, et al. Recent patterns in population-based HIV prevalence in Swaziland . PLoS One, 2013. 8:e77101.
Justman J, Reed JB, Bicego G, et al. Swaziland HIV Incidence Measurement Survey (SHIMS): a prospective national cohort study . Lancet HIV, 2017. 4:e83–e92.
Waruiru W, Kim AA, Kimanga DO, et al. The Kenya AIDS Indicator Survey 2012: rationale, methods, description of participants, and response rates . J Acquir Immune Defic Syndr. 2014;66(Suppl 1):S3–S12.
Patel H, Birhanu S, Dobbs T, et al. PHIA laboratory methods . JAIDS, 2021.
Nyathi A, Gundidza P, Mpofu D, et al. ZIMPHIA Song: Knock, Knock, Knock. Harare, Zimbabwe; 2015.
National AIDS and STI Control Programme (NASCOP) Kenya. Kenya AIDS Indicator Survey 2012: Final Report. Nairobi, Kenya: NASCOP; 2014.
U.S. Centers for Disease Control and Prevention. Violence Against Children Surveys: Our Methods. 2019. Available at: https://www.cdc.gov/violenceprevention/childabuseandneglect/vacs/methods.html . Accessed January 2019.
The U.S. Department of State Office of the Global AIDS Coordinator. PEPFAR 3.0: Controlling the Epidemic, Delivering on the Promise of an AIDS-free Generation. Washington, DC: A/GIS/GPS; 2014. Available at: https://www.avac.org/resource/pepfar-30-%E2%80%93-controlling-epidemic-delivering-promise-aids-free-generation .
The PHIA Project: Summary Sheets. 2019. Available at: https://phia.icap.columbia.edu/resources/ . Accessed July 2019.
UNAIDS, Improving UNAIDS' Paediatric and Adolescent Estimates. Geneva, Switerland: UNAIDS; 2018. Available at: https://www.unaids.org/en/resources/documents/2018/20180720_paed_ado_estimates .
Reid G, Voetsch A, Kalton G, et al. Improving the efficiency of sampling for pediatric HIV prevalence: evidence from 9 sub-saharan African countries . JAIDS. 2021.
Lin TH, Weil N, Cervantes IF, et al., Developing nonresponse weighting adjustments for population-based HIV impact assessments surveys in three African countries. JSM Survey Research Methods Section. 2017.
Saito S, Duong YT, Metz M, et al. Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016 . J Int AIDS Soc. 2017;20(Suppl 7):19–25.
Justman JE, Mugurungi O, El-Sadr WM, HIV population surveys—bringing precision to the global response . N Engl J Med. 2018. 378:1859–1861.