HIV testing in people who inject drugs

Export Indicator

Percentage of people who inject drugs who received an HIV test in the past 12 months and know their results
What it measures

It measures progress in implementing HIV testing and counselling among people who inject drugs

Rationale

In order to protect themselves and to prevent infecting others, it is important people who inject drugs to know their HIV status. Knowledge of one’s status is also a critical factor in the decision to seek treatment.
Note: Countries with generalized epidemics may also have a concentrated sub-epidemic among one or more key populations at higher-risk. If so, they should calculate and report this indicator for those populations.

Numerator

Number of people who inject drugs respondents who have been tested for HIV during the last 12 months and who know their results.

Denominator

Number of people who inject drugs included in the sample.

Calculation

Numerator / Denominator

Method of measurement

Behavioural surveillance or other special surveys.
Respondents are asked the following questions:
1. Have you been tested for HIV in the last 12 months?
If yes:
2. I don’t want to know the results, but did you receive the results of that test?
Whenever possible, data for people who inject drugs 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.
For further information, please consult the following references:
o WHO/UNAIDS Working Group on Global HIV/AIDS and STI Surveillance (2011). Guidelines on surveillance among populations most at risk for HIV. See http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2011/2011_Estimating_Populations_en.pdf
o Guidelines for using HIV testing technologies in surveillance: selection, evaluation and implementation (2010). See: http://www.who.int/hiv/pub/surveillance/hiv_testing_technologies_surveillance_.pdf
o WHO/UNODC/UNAIDS (2009). Technical Guide for Countries to set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users. Geneva: WHO.
o UNAIDS (2007). A Framework for Monitoring and Evaluating HIV Prevention Programmes for Most-At-Risk Populations. Geneva: UNAIDS.
o UNAIDS (2007). Practical Guidelines for Intensifying HIV Prevention: Towards Universal Access. Geneva: UNAIDS.

Measurement frequency

Biennial

Disaggregation

Age-group:

< (less than) 25 years

> (greater than) 25 years

Gender:

Female

Male

Strengths and weaknesses

Accessing and/or surveying people who inject drugs can be challenging. Consequently, data obtained may not be based on a representative sample of the national, people who inject drugs 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.
Tracking people who inject drugs over time to measure progress may be difficult due to mobility and the hard-to-reach nature of these populations with many groups being hidden populations. Thus, information about the nature of the sample should be reported in the narrative to facilitate interpretation and analysis over time.
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.
This indicator is most meaningful in settings where testing scale-up is relatively recent. People who tested more than 12 months ago and know they are positive will be considered “uncovered” by this indicator construction. Ideally, surveys should ask why respondents did not test in the past 12 months. If they report that they know their HIV status to be positive, they should not be included in the denominator. This indicator will be formally changed post-2015; we will ask countries that can to report against this indicator while omitting known HIV-positive persons from the denominator.
If the data are subnational, please provide the disaggregation by administrative area in the comment field. Please submit the digital version of any available survey reports using the upload tool.
Tracking people who inject drugs over time to measure progress may be difficult due to mobility and the hard-to-reach nature of these populations with many groups being hidden populations. Thus, information about the nature of the sample should be reported in the narrative to facilitate interpretation and analysis over time.
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.
This indicator is most meaningful in settings where testing scale-up is relatively recent. People who tested more than 12 months ago and know they are positive will be considered “uncovered” by this indicator construction. Ideally, surveys should ask why respondents did not test in the past 12 months. If they report that they know their HIV status to be positive, they should not
be included in the denominator. This indicator will be formally changed post-2015; we will ask countries that can to report against this indicator while omitting known HIV-positive persons from the denominator and state that they’ve done this in the comment field.

Further information

For further information, please consult the following references:
WHO/UNAIDS Working Group on Global HIV/AIDS and STI Surveillance.
Guidelines on surveillance among populations most at risk for HIV. Geneva,
UNAIDS, 2011 (http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2011/2011_Estimating_Populations_en.pdf).
Guidelines for using HIV testing technologies in surveillance: selection, evaluation and implementation. Geneva, World Health Organization, 2010
(http://www.who.int/hiv/pub/surveillance/hiv_testing_technologies_surveillance_.pdf).
WHO, UNODC and UNAIDS. Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva, World Health Organization, 2012 http://www.who.int/hiv/pub/idu/targets_universal_access/en/index.html.
A framework for monitoring and evaluating HIV prevention programmes for most-at-risk populations. Geneva, UNAIDS, 2007.
Practical guidelines for intensifying HIV prevention: towards universal access. Geneva, UNAIDS, 2007.