Washington D.C., USA, July 2012www.aids2012.org Sources of HIV Epidemiological Data for Monitoring and Estimating the burden of HIV Txema Calleja, World Health Organization

Washington D.C., USA, July 2012www.aids2012.org Outline WHO/UNAIDS technical recommendations HIV sentinel surveillance: ANC and Key Populations National Population HIV based surveys Conclusions

Washington D.C., USA, July 2012www.aids2012.org UNAIDS/WHO HIV Surveillance Working Group: Second Generation Surveillance framework STI Surveillance Second Generation Surveillance (SGS) HIV and AIDS case & mortality reporting Behavioural or Bio- Behavioural Surveys Sentinel Surveillance Size Estimation of Risk Groups

Washington D.C., USA, July 2012www.aids2012.org UNAIDS/WHO Global Surveillance Working Group on HIV/AIDS and STI surveillance 1997……

Washington D.C., USA, July 2012www.aids2012.org Second Generation Surveillance: Norms, standards, guidelines, recommendations

Washington D.C., USA, July 2012www.aids2012.org HIV Surveillance recommendations What to do where?

Washington D.C., USA, July 2012www.aids2012.org For Low and Concentrated epidemics HIV infection case reporting, new diagnosis Integrated Biological Behavioural Surveillance for HIV/STI among Key Populations Population size estimates Mortality surveillance

Washington D.C., USA, July 2012www.aids2012.org For Generalised epidemics HIV sentinel surveillance among ANC HIV infection case reporting, new diagnosis National Population based HIV surveillance Integrated Biological and Behaviour surveillance among KP Mortality surveillance

Washington D.C., USA, July 2012www.aids2012.org HIV Sentinel Surveillance Some examples of country data

Washington D.C., USA, July 2012www.aids2012.org HIV sentinel surveillance in generalised epidemics among ANC

Washington D.C., USA, July 2012www.aids2012.org HIV median prevalence among ANC 15 to 49 years old people

Washington D.C., USA, July 2012www.aids2012.org HIV median prevalence among young people

Washington D.C., USA, July 2012www.aids2012.org Monitoring trends in young people

Washington D.C., USA, July 2012www.aids2012.org National Population based surveys: 48 countries

Washington D.C., USA, July 2012www.aids2012.org National Population based surveys: Level of HIV prevalence

Washington D.C., USA, July 2012www.aids2012.org National Population based surveys: HIV prevalence men and women (15-49 y)selected countries

Washington D.C., USA, July 2012www.aids2012.org HIV among men who have sex with men in sub-Saharan Africa HIV prevalence (%) among male adults 15–49 years old who have sex with men in seven countries in sub-Saharan Africa, 2009 or latest available year. Source: Baral et al. (28); Nigeria Federal Ministry of Health (29); Lane et al. (30); Parry et al. (31); Sander et al. (32); Sander et al. (33); and Wade et al. (34). Marps or Key populations highlighted in SSA

Washington D.C., USA, July 2012www.aids2012.org 18 Trends in HIV prevalence among female sex workers, selected sentinel sites, Source: Directorate General of Disease Control and Environmental Health, Ministry of Health, Indonesia (2009). Progress Report HIV & AIDS Situation in Indonesia up to December 2009, the Ministry of Health

Washington D.C., USA, July 2012www.aids2012.org 19 Myanmar: Trends of HIV prevalence among key affected populations and male STI patients, Sources: Prepared by based on 1. National AIDS Programme Myanmar, & WHO. (2007). HIV Sentinel Sero-Surveillance Survey 2007, 2. National AIDS Programme Myanmar, & WHO. (2009). HIV Sentinel Sero-Surveillance Survey 2008 and 3. National AIDS Programme Myanmar, & WHO. (2010). HIV Sentinel Sero-Surveillance Survey 2009

Washington D.C., USA, July 2012www.aids2012.org Quality of HIV sero surveillance in low and middle income countries

Washington D.C., USA, July 2012www.aids2012.org Conclusions Need to reinforce and maintain HIV surveillance Increase ART coverage it makes more difficult to interpret HIV trends, need to look for new infections Consistency of population, sites and tools are key to improve HIV surveillance