1. THE 6 TH NATIONAL SCIENTIFIC CONFERENCE ON HIV/AIDS Le Anh Tuan, Tran Dai Quang, Nguyen Anh Tuan SIZE ESTIMATION OF PEOPLE WHO INJECT DRUG, FEMALE SEX WORKERS, AND MEN WHO HAVE SEX WITH MEN IN VIETNAM, 2012-2013

2. The 6 th National Scientific Conference on HIV/AIDS Contents 1.Introduction 2.Objectives 3.Methodology 4.Results and discussion 5.Conclusions and recommendations

3. The 6 th National Scientific Conference on HIV/AIDS INTRODUCTION o PWID, FSW, MSM - 3 MARPs to HIV: hidden, hard-to-reach, illegal behaviors, stigmatized o Size estimation of MARPs helps: knowing epidemics, program planning and evaluating, and advocacy… o Current studies focus on prevalence HIV, behavioral indicators o Size estimation guidelines: 6-8 methods (2 main groups) o Size estimation of MARPs in Vietnam: Reported data from MOLISA, MOPS… Program/project outreach Modeling estimation and projection Small-scale applied methods

4. The 6 th National Scientific Conference on HIV/AIDS OBJECTIVES Police census Programmatic multiplier Unique object multiplier Feasibility DIEN BIEN CAN THO HCMC People who inject drug Female sex workers Men who have sex with men

5. The 6 th National Scientific Conference on HIV/AIDS METHODS PlacesTime Dien Bien, Can Tho, HCMC 2011 - 2013 Subjects PWID: Male and female, 16 years old and over, reported drug inject in the last 1 month, present at the province in study period FSW: Female, 16 years old and over, reported sell sex in the last 12 months, present at the province in study period MSM: Male, 16 years old and over, reported have sex with other men in the last 12 months, present at the province in study period Study design: Cross-sectional surveys and secondary data

6. The 6 th National Scientific Conference on HIV/AIDS PROGRAMMATIC MULTIPLIER Used 2 overlapping data sources on the same populations Consumptions: o Having the same chance into 2 data sources o Corresponding definitions o Same time frame 2 data sources applied: o Program: VCT o Survey: recapture sample The survey participant report using program services = The number served of program services Total survey participantsTotal size of MARP A B a b

7. The 6 th National Scientific Conference on HIV/AIDS Take all o Precinct police officers in the whole province Information collected: o PWUD, PWID, street-based FSW, venue-based FSW o Managed, estimated numbers Data collection procedures: o Collaborated with district police departments o Study team members were trained for data collection o Short, self-filled out questionnaires POLICE CENSUS

8. The 6 th National Scientific Conference on HIV/AIDS 2 independent sectional surveys Survey sample sizes were calculated for representative and for acceptable size estimation UNIQUE OBJECT MULTIPLIER

9. The 6 th National Scientific Conference on HIV/AIDS o RDS sampling o Unique objects o Study sites: coverage, overlap o Peer educator, invitation card o Training on real situations Object distribution Size Estimation Invitation coupon Address:______________________ Telephone:_____________________ Please stop by during the open hours below Days: ______ - ______ _:__ AM to _:__ PM This coupon can only be used between these dates: ____________________ to ___________________ Size Estimation Come with this coupon and, if eligible, you will receive compensation of ______ VND for participating. This coupon will not be accepted in the following conditions: -The project has reached the maximum number of participants (project has ended) -Coupon is not yet active (see first date on front) -Coupon has expired (see second date on front) -Coupon holder has already been in the study -Coupon holder does not meet eligibility criteria

10. The 6 th National Scientific Conference on HIV/AIDS o Step 1: Developed sampling frame by mapping o Step 2: Sampling methods Interview

11. The 6 th National Scientific Conference on HIV/AIDS Study forms o Short questionnaires: for both 2 surveys o Identifying information in 2 surveys o VCT information for programmatic multiplier o Refusal rate was collected for weighted analysis Estimated sizes were calculated by: o 95% CI for low and high estimates. n1 = m  N= n1 x n2 Nn2m Data collection and calculation

12. The 6 th National Scientific Conference on HIV/AIDS Independence of the two surveys (Wittes method) a b c d e f g A B C OR = cg/de OR = 1  independence OR > 1  positive dependence  underestimation of N OR < 1  negative dependence  overestimation of N

13. The 6 th National Scientific Conference on HIV/AIDS ESTIMATED NUMBER OF PWID IN DIEN BIEN

14. The 6 th National Scientific Conference on HIV/AIDS ESTIMATED NUMBER OF PWID, FSWs IN CAN THO

15. The 6 th National Scientific Conference on HIV/AIDS ESTIMATED NUMBER OF PWID, FSWs, MSM IN HO CHI MINH CITY

16. The 6 th National Scientific Conference on HIV/AIDS RESULTS CONSOLIDATION Adjusted police census results as low estimates Evaluation of methods consumptions achieved in the field Results from methods with inappropriate data quality were excluded Results from applied methods Triangulated with other sources and consensus with Local experts AVERAGE [LOW – HIGH]

17. The 6 th National Scientific Conference on HIV/AIDS CONCLUTIONS Dien Bien, 2012-2013: People who inject drug: 3.700 – 5.200 Can Tho: People who inject drug: 1.400 – 1.800 Female sex workers: 1.550 – 2.000 Ho Chi Minh city: People who inject drug: 10.000 – 14.000 Female sex workers: 16.500 – 22.500 Men who have sex with men: 8.500 – 10.500

18. The 6 th National Scientific Conference on HIV/AIDS STUDY LIMITATIONS No “gold standard” methods Information for adjustment was not enough collected (mapping, RDS network size) The 3 rd data source for C_RC independence test was not well-prepared (sample size, identifying) MARP networks in the field (personal relationship, peer educators)

19. THE 6 TH NATIONAL SCIENTIFIC CONFERENCE ON HIV/AIDS THANK YOU!