October 20, 2015 UNAIDS Monitoring and Evaluation of HIV Programs for MSM Linking data to Program Planning, Implementation, and Advocacy UNAIDS/S.NOORANI Mauricio Cysne International Conference on HIV Infection in Hidden Groups Lisbon, March

October 20, 2015 UNAIDS Roles of M&E Global  Assess progress toward universal access to HIV prevention, care and treatment  Assess global response across countries National  Assess national program response to HIV epidemic  Coordinate activities of stakeholders around common goals, objectives and harmonized measurements Local (Project-Level)  Assess program interventions  Is our project working? Is the project having the intended affect on the knowledge, behavior, clinical outcomes, or quality of life of our clients?  If not, why? And how do we fix it?

October 20, 2015 UNAIDS Global M&E - UNGASS 2010 Among 180 countries reporting globally this year to UNAIDS  MSM (along with IDU and SW indicator data) rank among the lowest in number countries reporting when compared with other general population indicators  Improving the number of countries reporting quality MSM (as well as IDU and SW data) is urgently needed to inform HIV prevention programmes

October 20, 2015 UNAIDS Global M&E - UNGASS 2010

October 20, 2015 UNAIDS Monitoring & Evaluation What is it and why should we do it? M&E is a framework for organizing, presenting and using information in order to help decision makers to better plan, develop, implement, and evaluate the program response to a given epidemic need. A cyclical learning process  Through each cycle (Semi-annual, Annual, Biennial, or Multi-year) we seek to understand more so we can plan better, implement more effectively & efficiently, achieve greater outcomes and impact.  Programs are rarely ALL GOOD or ALL BAD  M&E helps us to understand what is working and what is not so that we can keep what works and make the mid-course corrections needed to fix or improve.

October 20, 2015 UNAIDS M&E Framework – Linking Data to Program Planning and Implementation ProgramM&E (Metrics)Time Frames GoalsImpact Indicators3-5 years ObjectivesOutcome Indicators1-2 Years ActivitiesOutput Indicators Quarterly, Semi- Annually, Annually

October 20, 2015 UNAIDS M&E Framework Using Data for Planning and Decision Making

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Program Planning ProgramM&E (Metrics)Time Frames 5-year Goal: Reduce the Annual Transmission Rate of HIV among MSM HIV Incidence rate among MSM3-5 years Objective 1.1: Increase knowledge of HIV Percentage of MSM who correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions 1-2 Years Objective 1.2: Increase percent of MSM who are aware of their HIV status Percentage of MSM who receive and HIV test and are aware of their status 1-2 Years Objective 1.3: Reduce risk of HIV infection through sexual transmission Percentage of men reporting the use of a condom the last time they had sex with a male partner 1-2 Years Technical Area: Prevention of HIV among MSM

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Program Planning and Implementation Technical Area: Prevention of HIV among MSM 5-Year Goal 1 Reduce the Annual Transmission Rate of HIV among MSM Program Objectives (for Goal 1): Objective 1.1: Increase knowledge of HIV Objective 1.2: Increase percent of MSM who are aware of their HIV status Objective 1.3: Reduce risk of HIV infection through sexual transmission

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Program Planning and Implementation Technical Area: Prevention of HIV among MSM 5-Year Goal - 1 Reduce annual transmission of HIV Intermediate Program Objectives (for Goal 1): Objective 1.1: Increase knowledge of HIV among MSM Outcome Indicator: Percentage of MSM who correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions Objective 1.2: Increase percent of MSM who are aware of their HIV status Outcome Indicator: Percentage of MSM who receive and HIV test and are aware of their status Objective 1.3: Reduce risk of HIV infection through sexual transmission Outcome Indicator: Percentage of men reporting the use of a condom the last time they had sex with a male partner Impact Indicator: HIV Incidence rate among MSM

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Program Planning and Implementation

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Program Planning and Implementation

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Hidden

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Program Planning and Implementation Define Numerator, denominator, disaggregation (age, gender)  Describe the variables that will be used to create your indicator as well as any equations or other definitional information required to calculate the indicator Measurement tool  Surveillance, survey, program records? Data collection frequency  Monthly, Quarterly, Annually, Biennially? Responsibility  Who is responsible for what data and at what level? Purpose and use Set targets Collect data Use operational guideline – now in pilot countries

October 20, 2015 UNAIDS M&E - Putting the Framework into Practice Linking Data to Advocacy Example from Mozambique KYE KYR NASA/MEGAS I-RARE Data Triangulation Modes of Transmission

October 20, 2015 UNAIDS Incidence model results Sex-work related 19% Related to multiple partner behaviours 24% Note: The incidence model requires detailed data. Many of the data required were not available, and many proxy data or estimations were necessary. Such the model results should be interpreted with caution.

October 20, 2015 UNAIDS Figura 63. Gastos em prevenção, por população beneficiária em Moçambique (US$), Fonte: Análise MEGAS suplementar, J. Durão Nov. 2010

October 20, 2015 UNAIDS Thank You!