1. © 2013 Denver Health Evaluation of the National HIV Behavioral Surveillance System Among Men Who Have Sex With Men in Denver, Colorado Kathryn DeYoung, MS 1, Arthur Davidson, MD, MS 1, Alia Al-Tayyib PhD 1 1 Denver Public Health, Denver, USA Results Conclusions Contact Information: For more information or for additional copies of this abstract, please contact Kathryn DeYoung at kathryn.deyoung@dhha.orgkathryn.deyoung@dhha.org TIPS FOR POSTERS: [Do not adjust this area. It is outside the visible box and will not print] See “Making a Scientific Meeting Presentation” by D. Runyon Title : Big and Bold, but short Include scope, study design & goal, not conclusions Authorship : Rank list of contributors First author is presenter Full names & credentials Methods : This section most likely to be incomplete Include design, setting, randomization, sample, as applicable Size : Start by making the poster the correct dimensions [Design>Page Setup] based on the conference requirements. One side must be less than 44 inches to print correctly. Conclusions : Why your study is important and what does it mean? Comment only on the data Avoid passive voice Tables & figures : Include short narrative below each table or figure to highlight/elaborate on the key findings. Background Methods Objective Men who have sex with men (MSM) account for the majority of new HIV diagnoses in Denver. The National HIV Behavioral Surveillance System (NHBS) is a 20-site cyclical survey of those at increased HIV risk. Men who have sex with men (MSM) are surveyed every three years. MSM cycles utilize a time-space venue-based sampling approach, recruiting at bars, restaurants, and other venues with a high ratio of MSM attendees. NHBS has not been previously evaluated in Denver. To evaluate implementation of the MSM1, MSM2, and MSM3 cycles of NHBS in Denver, conducted in 2005, 2008, and 2011, respectively. CDC guidelines for evaluating public health surveillance systems include these attributes:  Acceptability, flexibility, simplicity (qualitative)  Data quality, representativeness, system sensitivity (quantitative) Acceptability, flexibility, simplicity, and data quality:  Assessed through local stakeholder input, reviews of protocols, local formative research, & process indicators Representativeness and system sensitivity to trends:  Comparison of responses to demographic and HIV testing history questions among Denver NHBS-MSM participants with comparable samples from local sources Denver data sources:  NHBS MSM cycles: 2005, 2008, 2011  Denver Public Health records from STD clinic patients and outreach HIV testing (census, not sample)  Included patients who would have been eligible to participate in NHBS-MSM cycles (2005, 2008, 2011) Demographic characteristics and HIV testing history among Denver MSM by data source NHBS n(%) STD Clinic n(%) Outreach 2 n(%) Total191935601794 Race / Ethnicity American Indian24 (1)16 (0)19 (1) Black126 (7)247 (7)105 (6) Hispanic454 (24)845 (24)346 (19) Other / Mixed race124 (7)180 (5)136 (8) White1172 (62)2272 (64)1188 (66) Age 18 – 24261 (14)861 (24)318 (18) 25 – 29292 (15)742 (21)295 (16) 30 – 39579 (30)958 (27)430 (24) 40– 49487 (25)634 (18)397 (22) >50300 (16)365 (10)354 (20) Mean Years Since Latest HIV Test 4 (95%CI) 2.27 (2.08-2.45) 1.77 (1.57-1.98) 1.52 (1.30-1.75) Last Known HIV Status 3 Negative1505 (83)960 (88)911 (94) Positive281 (16)102 (9)47 (5) Indeterminate/Unknown25 (1)32 (3)8 (1) New HIV Diagnosis 4,5 34 (3)37 (4)23 (2) Representativeness: Good  Site works to represent African Americans and Hispanics  Inclusion of younger MSM increasing but hindered by venue options  Concern: representation of internet-based MSM population Data quality: Good  Quality as high as self-report data collection method permits  Maintained by interviewer-guided data collection Acceptability: Good  Participants: In MSM2 and MSM3, 100% of eligible recruits interviewed; 84-92% accepted HIV testing  Venue owners: Participating owners enthusiastic; non- participating owners concerned about client impact  NHBS staff: Satisfied with venue selection, recruitment methods, and data security Simplicity: Low  The cyclical nature of NHBS does not allow adequate time or funding for local analysis, interpretation, dissemination of results  Data management issues  101 errors corrected in MSM2, 298 corrected in MSM3  Quality and timeliness of final datasets from CDC improved after transition to data management by DCC (MSM3) This study was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 5U38HM000414-5. 1 US Census, Denver-Broomfield MSA, 2010 2 Outreach:2008 and 2011 data only 3 American Community Survey, Denver County, 2007-2011 4 STD Clinic and Outreach : 2011 data only 5 NHBS: 2008 and 2011 cycles only Limitations There is no comparable population-based sample of MSM with which to compare NHBS. Recommendations Local implementation of NHBS has good representativeness, sensitivity, acceptability. These could be improved by continuing efforts to include underrepresented groups and by meeting with venue owners before events to improve buy-in. System complexity reduces local usefulness. Possible solutions include acquisition of cleaned data and code from CDC; funding of additional resources for data analysis and communication of results; and production of a local operations manual to document changes in NHBS methods over time and other factors to be considered in interpretation of data. Median age by NHBS venueTop locations where NHBS respondent met last male sex partner (by cycle)