Supporting Biological and Behavioral HIV Surveillance in The Bahamas

By Rhonda Phill October 1, 2014

"If we focus where the infections are happening by geography and population we can get to control the epidemic." Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria at the 20th International AIDS Conference

The emphasis on location and population is increasingly recognized as a critical strategy in the movement to achieve an AIDS Free Generation. However, as the World Health Organization (WHO) noted in its recently released guidelines, “health data, including HIV prevalence data, are less robust for key populations,” rendering it difficult to effectively target HIV prevention, treatment, and care efforts among those most at risk. Recognizing the critical importance of generating and using quality data to design evidence-based HIV interventions for key populations, NASTAD has collaborated with Ministries of Health throughout the Caribbean region, one of the regions hit hardest by the HIV epidemic, to build targeted response capacity.

In The Bahamas, the government has made a strong commitment to targeting prevention and outreach activities to key populations. However, to date, few data have been collected to help guide effective interventions among those at elevated risk of HIV infection or transmission. To address this gap, NASTAD has partnered with The Bahamas Ministry of Health (MoH) to design and implement a national biological and behavioral surveillance survey (BBSS). Biological and behavioral surveillance surveys are an effective method for capturing HIV-related risk and exposure information, as well as disease prevalence rates, among key populations as they link demographic and behavioral data collected in surveys to biological testing results in order to provide greater explanatory power than either method alone. The goal of the survey in The Bahamas is to inform the MoH about characteristics of populations at increased risk for HIV, as well as those already infected, in order to facilitate targeted and effective prevention planning and related service delivery.

A steering committee was formed in The Bahamas to help plan for and guide the BBSS implementation process. The steering committee has 14 members representing the community as well as medical and support service providers who have positive working relationships with key populations and extensive experience working in the field of HIV. During the most recent meeting, the steering committee discussed the methodology that will be used for the BBSS in The Bahamas: Respondent-Driven Sampling (RDS), a popular methodology used to recruit hidden populations. The steering committee also designated member roles and responsibilities for community outreach activities in order to generate interest and support within the community and among stakeholders. In follow-up, the committee hosted promotional events such as community events and began to distribute promotional items at venues frequented by the target populations.

"It is worth my time because it's about my health." Steering Committee member expresses commitment to the project in the Bahamas.

The active involvement and contribution of the steering committee members in this initiative is an early indicator of success, as they have been and will continue to be instrumental in troubleshooting and supporting successful implementation of the BBSS as it is rolled out in the coming weeks.

If you are interested in learning more about how NASTAD is supporting HIV surveillance in The Bahamas, please contact Rhonda Phill.

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