Most-at-risk Populations: Prevention Programmes

Export Indicator

Percentage of most-at-risk population(s) reached with HIV-prevention programmes.
What it measures

To assess progress in implementing HIV prevention programmes for most-at-risk populations
This indicator should be calculated separately for each population that is considered most-at-risk in a given country: sex workers, injecting drug users, men who have sex with men.

Note: countries with generalized epidemics may also have a concentrated subepidemic among one or more most-at-risk populations. If so, they should calculate and report this indicator for those populations.
 

Rationale

Most-at-risk populations are often diffi cult to reach with HIV prevention programmes. However, in
order to prevent the spread of HIV among these populations as well as into the general population, it is
important that they access these services.

Numerator

Number of most-at-risk population respondents who replied “yes” to both (all three for injecting drug users) questions
 

Denominator

Total number of respondents surveyed

Calculation

Numerator / Denominator

Method of measurement

Respondents are asked the following questions:
1. Do you know where you can go if you wish to receive an HIV test?
2. In the last twelve months, have you been given condoms (e.g. through an outreach service, drop-in centre or sexual health clinic)?
Injecting drug users should be asked the following additional question:
3. In the last twelve months, have you been given sterile needles and syringes (e.g. by an outreach worker, a peer educator or from a needle exchange programme)?

Scores for each of the individual questions—based on the same denominator—are required in addition to the score for the composite indicator.

Whenever possible, data for most-at-risk populations should be collected through civil society organizations that have worked closely with this population in the field.

Access to survey respondents as well as the data collected from them must remain confidential.

Measurement frequency

Biennial

Disaggregation

Age group: (greater than) 25 years

Condom type: N/A

Education: N/A

Gender: Male, Female

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: N/A

Service Type: N/A

Target: Sex workers, Clients of sex workers, Injecting drug users, Men who have sex with men, Mobile Populations, Prisoners, Migrant workers, Military, Other

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

 Accessing and/or surveying most-at-risk populations can be challenging. Consequently, data obtained may not be based on a representative sample of the national, most-at-risk population being surveyed. If there are concerns that the data are not based on a representative sample, these concerns should be reflected in the interpretation of the survey data. Where different sources of data exist, the best available estimate should be used. Information on the sample size, the quality and reliability of the data, and any related issues should be included in the report submitted with this indicator.

The inclusion of these indicators for reporting purposes should not be interpreted to mean that these
services alone are suffi cient for HIV prevention programmes for these populations. The set of key interventions described above should be part of a comprehensive HIV prevention programme, which also includes elements such as provision of HIV prevention messages, (e.g. through outreach programmes and peer education), treatment of sexually transmitted diseases, opioid substitution therapy for injecting drug users, and others. For further information on the elements of comprehensive HIV prevention programmes most-at-risk populations please see the Practical Guidelines for Intensifying HIV Prevention: Towards Universal Access.

This indicator asks about services accessed in the past 12 months. If you have data available on another time period, such as the last 3 or 6 months or the last 30 days, please include this additional data in the comments section of the reporting tool.

It has been recommended that the issue of quality and intensity of reported services among most-at-risk
populations be addressed more explicitly in terms of criteria for the measurement of the components of
provided services. Taking into account the complexity of this element of measurement, particularly within
the context of most-at-risk populations, the development of such criteria requires an intensive process of
information gathering, synthesis and recommendations formulation. This process was initiated in 2008 and will inform the review of the UNGASS reporting system which is scheduled for 2010. In the meantime, it is recommended that the guidelines mentioned below be referred to as reference documents that can facilitate interpretation of the collected data from a quality and intensity perspective.

To maximize the utility of these data, it is recommended that the same sample used for the calculation of
this indicator be used for the calculation of the other indicators related to these populations.

Further information