Rethinking HIV Prevalence Determination in Developing Countries

December 2014 - Epidemiology

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Makinde, O. A., & Oyediran, K. A. AIDS Care (August 2014), E-publication ahead of print.

The authors of this article described the advantages of routinely collecting HIV prevalence data generated during routine HIV testing and counseling (HTC) and routine prevention of mother-to-child transmission (PMTCT). This model would utilize information and communications technology, the Internet, and the mobile telephone system to connect HTC and PMTCT centers to a national database. Data from the national database archive could then be analyzed to determine HIV prevalence, but also to identify predominant risk factors in specific geographic locations. Geographic risks would be assessed by aggregating all sites providing HTC and PMTCT services enrolled into the system, using specific geographic identifier data as a unit of analysis. This would facilitate the design of intervention programs to target the behavioral or other risk factors for that area. The authors noted the challenges associated with collecting data through HTC and PMTCT surveillance systems, including the absence of a standardized process for collecting data and incorporating it into data management systems. Technical challenges, such as power outages and Internet connectivity, as well as non-technical challenges, such as lack of political will, poor technical support, and lack of funding, could also stymie implementation of this approach. Challenges notwithstanding, the expansion would allow access to data from a larger and more diverse cadre of respondents, compared to the sentinel surveillance data that is presently being derived from antenatal clinics.

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