Engaging Key Populations in Trinidad and Tobago for Bio-behavioral HIV Surveillance

By Tracie Rogers December 18, 2014

HIV surveillance among key populations has been identified as a national priority by the government of Trinidad and Tobago since 2004. Despite this, human resource challenges and a lack of surveillance expertise have contributed to the absence of surveillance data to inform the government’s HIV/AIDS response for these populations. NASTAD, in partnership with the Ministry of Health HIV/AIDS Coordinating Unit, has worked to address this need through the implementation of a surveillance survey with one prioritized population, and a formative assessment to inform the conduct of another surveillance survey with a second population. These initiatives have elucidated the realities of key populations and equipped the government with empirical evidence to inform programmatic areas. Surveillance and program partnerships with key populations are not common in the Caribbean context. Since NASTAD began its work in Trinidad and Tobago in 2011 we have found that key populations feel “over-researched” and not included in applicable conversations. NASTAD recognizes that partnerships with community members are integral to devising a national survey that will be relevant and impactful to both public health planners and the population itself. As a result, NASTAD prioritized the inclusion of peers and community members to inform and produce a thorough and rich formative assessment.

To this end, in October 2013, NASTAD invited key population community members to a surveillance methods training workshop to build a working knowledge of formative assessment practices among participants and enable them to collect data from their peers. Peer input was prioritized because the data collected via the formative assessment will inform the design of a subsequent national biological and behavioral surveillance survey (BBSS), forthcoming in early 2015. After six days of skills-building on the conduct of in-depth interviews, enumeration and social mapping activities, six participants were hired as part of the formative assessment implementation team. The implementation team is diverse both geographically and professionally, in order to better represent and reach the community as a whole.

The formative assessment was implemented over a six month period and a total of 30 people representing the population of interest were interviewed. Observations were conducted at 44 locations throughout the country, resulting in the most comprehensive account of activity of the key population in Trinidad and Tobago to date. The demographic and geographic diversity evident in the formative assessment report is unparalleled.

The results of the formative assessment have positioned the Ministry of Health to conduct a national BBSS that can be efficient and impactful. The meaningful inclusion of the targeted populations in the formative assessment has broadened the scope of the Ministry of Health’s collaboration with stakeholders. Furthermore, one of the recommendations resulting from the formative assessment was the creation of a Community Advisory Board, consisting of representatives from vulnerable and key populations. The Ministry of Health has adopted this recommendation, and this Advisory Board will work in tandem with the national steering committee of technical experts to guide the BBSS.

NASTAD’s technical assistance in Trinidad and Tobago has extended the scope of government and community partnership in surveillance research. The Community Advisory Board will strengthen the national surveillance research initiatives, ultimately enabling the Ministry of Health to gather information critical to delivering quality HIV programming that is inclusive and effective.

If you are interested in learning more about how NASTAD is supporting HIV surveillance research in Trinidad and Tobago and throughout the Caribbean region, please contact Robin Flanagan.

Visit NASTAD.org/global to learn more about the NASTAD Global Program.

Robin Flanagan, Senior Manager, Global Program, NASTAD, and Anna Carroll, Senior Associate, Global Program, NASTAD, also contributed to the development of this post.