Bozicevic Ivana, Handanagic Senad, Cakalo Jurja Ivana, Rinder Stengaard Annemarie, Rutherford George
WHO Collaborating Centre for HIV Strategic Information, University of Zagreb School of Medicine, Zagreb, Croatia.
Joint Tuberculosis, HIV/AIDS and Hepatitis Programme, Division of Communicable Diseases, Health Security and Environment, WHO Regional Office for Europe, Kopenhagen, Denmark.
JMIR Public Health Surveill. 2017 Jun 23;3(2):e41. doi: 10.2196/publichealth.7357.
Capacity building of the national HIV strategic information system is a core component of the response to the HIV epidemic as it enables understanding of the evolving nature of the epidemic, which is critical for program planning and identification of the gaps and deficiencies in HIV programs.
The study aims to describe the results of the assessment of the needs for further development of capacities in HIV strategic information systems in the non-European Union (EU) countries in the World Health Organization European Region (EUR).
Self-administered questionnaires were distributed to national AIDS programs. The first questionnaire was sent to all countries (N=18) to find out, among other issues, the priority level for strengthening a range of HIV surveillance areas and their key gaps and weaknesses. The second questionnaire was sent to 15 countries to more specifically determine capacities for the analysis of the HIV care cascade.
Responses to the first questionnaire were received from 10 countries, whereas 13 countries responded to the second questionnaire. Areas that were most frequently marked as being of high to moderate priority for strengthening were national electronic patient monitoring systems, evaluation of HIV interventions and impact analysis, implementation science, and data analysis. Key weaknesseses were lack of electronic reporting of HIV cases, problems with timeliness and completeness of reporting in HIV cases, under-estimates of the reported number of HIV-related deaths, and limited CD4 count testing at the time of HIV diagnosis. Migrant populations, internally displaced persons, and refugees were most commonly mentioned as groups not covered by surveillance, followed by clients of sex workers and men who have sex with men. The majority of countries reported that they were able to provide the number of people diagnosed with HIV who know their HIV status, which is important for the analysis of cross-sectional and longitudinal HIV care cascades. Ability to report on some of the key impact indicators of HIV programs-viral load suppression and mortality-should be considerably strengthened.
The assessment found a substantial need to invest in surveillance capacities, which is a cornerstone in the development of an evidence-informed response to HIV epidemics.
国家艾滋病战略信息系统的能力建设是应对艾滋病疫情的核心组成部分，因为它有助于了解疫情的演变性质，这对于项目规划以及识别艾滋病项目中的差距和不足至关重要。
本研究旨在描述对世界卫生组织欧洲区域（EUR）非欧盟（EU）国家艾滋病战略信息系统能力进一步发展需求的评估结果。
向国家艾滋病项目发放了自填式问卷。第一份问卷发送给了所有国家（N = 18），以了解除其他问题外加强一系列艾滋病监测领域的优先级别及其关键差距和弱点。第二份问卷发送给了15个国家，以更具体地确定艾滋病治疗级联分析的能力。
10个国家回复了第一份问卷，13个国家回复了第二份问卷。被标记为加强优先级高到中等的领域最常包括国家电子患者监测系统、艾滋病干预措施评估和影响分析、实施科学以及数据分析。关键弱点包括艾滋病病例缺乏电子报告、艾滋病病例报告的及时性和完整性存在问题、艾滋病相关死亡报告数量被低估以及艾滋病诊断时CD4细胞计数检测有限。移民人群、境内流离失所者和难民最常被提及为未被监测覆盖的群体，其次是性工作者的客户和男男性行为者。大多数国家报告称，他们能够提供已诊断出感染艾滋病且知晓自身感染状况的人数，这对于横断面和纵向艾滋病治疗级联分析很重要。在艾滋病项目的一些关键影响指标——病毒载量抑制和死亡率报告方面的能力应大幅加强。
评估发现迫切需要投资于监测能力，这是制定基于证据的艾滋病疫情应对措施的基石。
