Raising the Bars: Supporting the Collection and Triangulation of Quality HIV Data

By Lucy Slater October 7, 2014

NASTAD’s Global Program is funded through PEPFAR to build the organizational, programmatic and human resource capacity of its regional/state public sector AIDS program counterparts. NASTAD strengthens the HIV Care Continuum through strong partnerships with partner ministries of health and by providing targeted training, technical assistance and supportive supervision. 

The HIV Care Continuum provides a tool to identify needs and measure progress toward increased access to and retention in medical care and antiretroviral treatment (ART) as a primary means to prevent new HIV infections. By supporting all components of the HIV Care Continuum, we move closer toward achieving an AIDS-free generation.

In this series of blog posts, we provide a snapshot of how we are supporting locally designed strategies to support the HIV Care Continuum in the countries where we work.

Part II - Supporting the Collection and Triangulation of Quality HIV Data

At the 20th International AIDS Conference, the World Health Organization noted that “that while in many settings HIV incidence in the general population has stabilized or fallen, globally, key populations continue to experience significant HIV burden” and yet “health data, including HIV prevalence data, are less robust for key populations.” It is critical that ministries of health have the capacity to generate and use quality public health data to guide targeted and evidence-based HIV prevention, treatment, and care efforts. Using the HIV Care Continuum as a framework, high quality data allow ministries of health to answer key questions about the epidemic in their countries, such as:

  • How many people with HIV know their status?
  • Are those with diagnosed HIV linked to care?
  • Are people with HIV retained in care?
  • Are those eligible for antiretroviral treatment (ART) receiving it?
  • Are people taking ART remaining adherent?
  • Is viral suppression being achieved as a way to decrease the community viral load?

These questions and others can be answered by strong strategic information (SI) systems that include case-based surveillance systems that collect and link select patient-level data across the health system, sentinel surveillance studies, and effective and efficient patient monitoring. A strong, skilled cadre of public health officials is equally important in managing SI systems and interpreting data to inform efficient and effective allocation of resources.  

NASTAD Ethiopia is working in collaboration with the Ethiopian Public Health Institute (EPHI) to pilot case-based surveillance of HIV. Together with EPHI, NASTAD Ethiopia is implementing a Proof of Concept project to document the readiness for case-based surveillance in Ethiopia. To this end, NASTAD Ethiopia is assessing existing HIV-related service data, data collection and transmission processes, and data linkage unitization procedures. From this project, the Government of Ethiopia will be able to better define the epidemiological profile and HIV-related service gaps in the pilot region, as well as the criteria required for an effective expansion of the national HIV surveillance system to include case-based surveillance.

NASTAD Ethiopia staff meeting with local partners in Addis Ababa
to initiate HIV case surveillance implementation

NASTAD also continues to provide support to Ministries of Health in Haiti, Trinidad and Tobago, The Bahamas, and Guyana to optimize their HIV surveillance systems. In each of these countries, the information generated by case-based surveillance supports a stronger understanding of the HIV Care Continuum, which in turn is helping drive the public health response, including patient linkage and outcome tracking, program and system improvement, targeted resource allocation, and policy change.

If you are interested in learning more about how NASTAD Global works to strengthen the HIV Care Continuum in all of the countries where we work, please contact Lucy Slater.

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

Gen Meredith, Associate Director, Global Program, NASTAD; Anne Sites, Senior Manager, Global Program, NASTAD; and Anna Carroll, Senior Associate, Global Program, NASTAD, also contributed to the development of this post.