(PP_PREV) Number of the priority populations (PP) reached with the standardized, evidence-based intervention(s) required that are designed to promote the adoption of HIV prevention behaviors and service uptake.
The indicator represents PEPFAR-supported programming only. This indicator helps to determine reach to priority populations (if no denominator) and may help inform coverage of PEPFAR-supported programming for priority populations when reliable population size estimates are included as the denominator.
Priority populations: Priority populations should be defined by each country in the indicator narrative and must have a documented HIV prevalence or incidence greater than the general population of the country. Groups that might be counted as priority populations include:
- Adolescent girls and young women
- Clients of sex workers
- Military and other uniformed services
- Mobile populations (e.g., migrant workers, truck drivers)
- Non-injecting drug users
Size estimation: The IP/country team will estimate the size of each of the priority populations in the geographic areas where the IP will implement the program. These areas are chosen based upon epidemiological data with attention to avoiding duplication of activities with those funded by donors (estimating the catchment area should be explained in the narratives).
Package of interventions: Together with the IP, the country team designs a set of interventions for each of the priority populations. In a defined catchment area for the specific priority population, all prevention interventions may not be offered by one IP. However, all required intervention must be available in the catchment area for the priority population. Interventions must adhere to written protocols, include goals and activities, and be designed to promote adoption of key behaviors that support HIV prevention and service uptake among the priority population(s). The interventions should comprise multiple encounters with the same individuals or groups.
HIV testing services (HTS) or referring an individual to HTS is required to be offered (at least once during the reporting period and/or in accordance with WHO/national guidance) unless the individual had previously been tested positive for HIV. If the individual is selfidentified as HIV positive, then HTS provision or referral to HTS will not be a required element of this indicator.
Number of the priority populations reached with standardized HIV prevention intervention(s) that are evidence-based.
Total estimated number of priority populations in the catchment area.
Sum across both reporting periods; de-duplicating unique individuals already reached and reported in Q1-Q2 of the same fiscal year in Q4 reporting.
Data collection requires reliable tracking systems that are designed to count the number of one-on-one encounters or participation in group interventions and that reduce doublecounting of individuals in a reporting period. Data should be collected at every encounter/point of service and aggregated in time for PEPFAR reporting cycles. This indicator only counts those interventions at the individual and/or group level.
A partner may count an individual (with unknown HIV serostatus or self-identified as HIV negative) as having received a prevention intervention if they have provided HTS and/or referral to HTS AND at least one of the other listed prevention interventions during the reporting period. If an individual is already known to be HIV positive at the time of service delivery, s/he should receive at least one of the interventions listed in the table (outside of HTS) to qualify as being counted under this indicator.
Tracking systems must be able to reduce double-counting of individuals in a reporting period. An individual will be reported when he/she first receives any of the required interventions in the reporting period; if the same individual receives any subsequent interventions during the same reporting period they will be reported as a returning beneficiary and not counted again in the reporting period.
Furthermore, double-counting of all returning beneficiaries within the Q3-Q4 reporting period (April 1 – September 30) will also need to take place in Q4 reporting if they had already been counted under PP_PREV in Q1-Q2 of the same fiscal year. . For example, if an individual had received prevention interventions under PP_PREV through PEPFAR-supported program in January 2017 and was counted as being reached in FY17 Q2 reporting cycle, and this same individual was later reached with prevention services again by PEPFAR-supported program in June 2017, that individual should NOT be reported again in the FY17 Q4 reporting period. This de-duplication is critical in order to accurately track the ANNUAL number of unique individuals reached by PEPFAR within a given fiscal year. Trend analysis of past performance PP_PREV data will be adversely affected with the change in frequency of PP_PREV reporting from annually to semi-annually if this de-duplication is ignored (i.e. annual number of PP_PREV reported within the same fiscal year would be inflated as the same individual would be counted twice if this de-duplication does not occur at Q4 reporting).
If possible, a unique identifier should be assigned to program participants or names can be collected to track individual participation in the prevention interventions/sites.
Site (facility and community) level system should maintain accurate registers for each individual priority population, and sum these individual populations when reporting this indicator.
How to review for data quality
Data should be reviewed regularly for the purposes of program management, to monitor progress towards achieving targets, and to identify and correct any data quality issues. Potential data quality issues for PP_PREV:
Denominator is greater than or equal to the Numerator: The total number of people from priority populations must be greater than or equal to the total number of individuals from priority populations who completed a standardized HIV prevention program.
Numerator is greater than or equal to the subtotal of the age/sex disaggregation: The number of individuals from priority populations who completed a standardized HIV prevention program should be greater or equal to the sum of the disaggregation by age/sex.
Site level: facility and community.
Semi-Annual - In the Q2 and Q4 narratives should include information pertaining to the results by priority population, and, if possible, describe progress made toward coverage for each one.
Numerator: Number of the target population who completed a standardized HIV prevention intervention including the minimum components during the reporting period.
10-14 M, 10-14 F, 15-19 M, 15-19 F, 20-24 M, 20- 24 F, 25-49 M, 25-49 F, 50+ M, 50+ F
Testing Service (Optional)
Known Positive – Persons within each key population type for whom HIV testing is not indicated because they are known to be HIVpositive. HIV-positive test results should be verified, if possible, for all persons accessing HIV prevention services during the reporting period. Implementing partners should maintain records on whether the HIV-positive client is linked to treatment.
Newly Tested and/or Referred for Testing – Persons within each key population type for whom HIV testing is indicated because they do not know their HIV status or their last HIVnegative test was more than 3-6 months ago (or more/less frequently as indicated by National Guidelines) should either be offered an HIV test on site or given information about where and when they can access an HIV test at another nearby clinic. Every attempt should be made to ensure the client is linked with HIV testing services that are KP-friendly, and where possible the completed referral should be documented (i.e. the client accessed HIV testing).
Note: Persons who access testing and whose results are newly tested HIV-positive in the reporting period should also be counted under “newly tested” even if they return for additional prevention services during that reporting period. Patients tested positive in previous reporting periods should be counted as Known Positives.
Declined Testing and/or Referral – Persons who, after explaining the benefits of HIV testing and the reason for testing every 3-6 months (or more/less frequently as indicated by National Guidelines), decline to be tested on-site or referred to a site where HIV testing is offered. Although every attempt should be made to support key/priority populations with HIV testing as part of the package of HIV prevention services and to provide HIV testing on site or KP-friendly sites, programs should also respect the autonomy of clients to decline this service. Clients who decline testing and/or referral can still receive other prevention services, as long as the benefits of HIV testing were explained and testing or a referral for testing was offered.
Denominator: Total number of people in each priority population (recommended, if available). Dissagraates: N/A Country teams should encourage methodological harmonization across their priority population partners when estimating priority population size within a catchment area
The numerator is the number of individuals from each priority population reached with HIV prevention interventions during the reporting period. For the purposes of reporting, the team will sum the numbers reached in each of the priority populations and report that total (details of the priority populations reached should be explained in the narratives).
Catchment area: The denominator is the estimated number of individuals in the priority populations. Programs need to define their geographic catchment area from which priority population clients receive HIV prevention services. Country teams should encourage methodological harmonization across their priority partners when estimating population size within a catchment area.
MER 1.0 to 2.0 Change
Age/sex disaggregations changed, updated the minimum required standardized HIV prevention interventions and included the requirement that HIV testing or referral to HIV testing service must be offered to those who are not known as diagnosed HIV positive.
The denominator is now optional, but recommended for those with good estimation metrics (estimating the catchment area should be explained in the narratives).
PEPFAR Support definition
Standard definition of DSD and TA-SDI used.
Provision of key staff or commodities for priority populations receiving HIV prevention services includes: ongoing procurement of critical commodities such as condoms, teaching materials, or community promotion materials; funding for salaries of personnel who deliver components of the intervention; or paying for transportation of those staff to the point of Service delivery. Staff responsible for the completeness and quality of routine patient records (paper or electronic) can be counted here; however, staff who exclusively fulfill MOH and donor reporting requirements cannot be counted.
For priority populations receiving HIV prevention, ongoing support services service delivery improvement includes: site supervision; training or assistance with monitoring and evaluation; QI/QC; and development of materials and protocols.