NASTAD's Global Program has been working with Haiti's Ministry of Health since 2003. Much of NASTAD's work in Haiti has focused on evaluating, planning, expanding, and supporting comprehensive HIV/AIDS surveillance, including the development of a national case-based HIV/AIDS case surveillance system. This web-based system, built via existing IT infrastructure, receives case reports in a low-barrier way from most known publicly funded HIV testing, treatment, and care sites in Haiti. NASTAD has helped to train more than 1,000 staff in Haiti on various aspects of the surveillance system, including patient interviewing, case notification and appropriate use of epidemiologic data.
At the close of 2012, over 150,000 case reports had been received from four electronic inputs, representing approximately 90% of annual HIV diagnoses. To date, data cleaning, matching, and de-duplication has allowed for the production of two types of case-based HIV/AIDS epidemiologic reports for the Ministry of Health: an Epidemic to Date summary, and a Six-Year Trend Data presentation. These reports are based on a unique count of HIV/AIDS cases, rather than the more frequently used aggregate program monitoring and evaluation.
To further support comprehensive HIV/AIDS surveillance, NASTAD and the Haitian Ministry of Health co-facilitate a National HIV/AIDS Surveillance Working Group to guide the planning and timing of surveillance activities, as well as the use of generated surveillance data. Using this group, NASTAD and the Ministry of Health have designed and are implementing a two-arm study study which will both examine HIV prevalence among pregnant women in Haiti using a traditional ANC sero-prevalence study method, and evaluate existing prevention-of-mother-to-child-transmission data for possible future use as an indicator of HIV prevalence in the population. In addition, NASTAD is piloting enhanced perinatal surveillance and patient following. Enhanced surveillance will ensure that pregnant women living with HIV have access to both treatment and prophylaxis to prevent mother-to-child HIV infection.