Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
JWM Consulting, LLC, Washington, DC, United States of America.
PLoS One. 2020 Feb 26;15(2):e0228634. doi: 10.1371/journal.pone.0228634. eCollection 2020.
There has been a heightened emphasis on prioritizing data to inform evidence-based HIV responses, including data focused on both defining the content and scale of HIV programs in response to evidence-based need. Consequently, population size estimation (PSE) studies for key populations have become increasingly common to define the necessary scale of specific programs for key populations. This study aims to assess the research utilization of these size estimates in informing HIV policy and program documents across the African continent.
This study included two phases; Phase 1 was a review of all PSE for key populations, including men who have sex with men (MSM), female sex workers (FSW), people who use drugs (PWUD), and transgender persons in the 54 countries across Africa published from January 2009-December 2017. Phase 2 was a review of 23 different types of documents released between January 2009 -January 2019, with a focus on the US President's Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis and Malaria investments, for evidence of stakeholder engagement in PSE studies, as well as key population PSE research utilization to inform HIV programming and international HIV investments.
Of 118 size estimates identified in 39 studies, less than 15% were utilized in PEPFAR Country Operational Plans or national strategic health plan documents, and less than 2% in Global Fund Concept Notes. Of 39 PSE studies, over 50% engaged stakeholders in study implementation and identified target population stakeholders, a third of studies identified policy or program stakeholders, and 15% involved stakeholders in study design.
The past decade has seen an increase in PSE studies conducted for key populations in more generalized HIV epidemic settings which involve significant investments of finances and human resources. However, there remains limited evidence of sustained uptake of these data to guide the HIV responses. Increasing uptake necessitates effective stakeholder engagement and data-oriented capacity building to optimize research utilization and facilitate data-driven and human rights-affirming HIV responses.
人们越来越重视优先考虑数据，以提供循证艾滋病毒应对措施的信息，包括侧重于确定艾滋病毒方案内容和规模的、以循证需求为依据的数据。因此，为了确定特定重点人群方案的必要规模，针对重点人群的人口规模估计（PSE）研究变得越来越普遍。本研究旨在评估这些规模估计在告知整个非洲大陆艾滋病毒政策和方案文件方面的研究利用情况。
本研究包括两个阶段；第一阶段是审查 2009 年 1 月至 2017 年 12 月期间在非洲 54 个国家发表的针对男男性行为者（MSM）、女性性工作者（FSW）、吸毒者（PWUD）和跨性别者等重点人群的所有 PSE 研究；第二阶段是审查 2009 年 1 月至 2019 年 1 月之间发布的 23 种不同类型的文件，重点关注美国艾滋病紧急救援计划（PEPFAR）和全球抗击艾滋病、结核病和疟疾基金（The Global Fund）的投资，以了解利益攸关方在 PSE 研究中的参与情况，以及重点人群 PSE 研究利用情况，以告知艾滋病毒规划和国际艾滋病毒投资。
在 39 项研究中确定的 118 个规模估计中，不到 15%被纳入 PEPFAR 国家业务计划或国家战略卫生计划文件，不到 2%被纳入全球基金概念说明。在 39 项 PSE 研究中，超过 50%的研究在实施过程中让利益攸关方参与，并确定了目标人群的利益攸关方，三分之一的研究确定了政策或方案利益攸关方，15%的研究让利益攸关方参与了研究设计。
过去十年中，在更为普遍的艾滋病毒流行环境中，针对重点人群开展了更多的 PSE 研究，这些研究涉及大量的财力和人力资源投入。然而，这些数据在指导艾滋病毒应对措施方面的持续利用情况仍证据有限。为了增加利用，需要进行有效的利益攸关方参与和以数据为导向的能力建设，以优化研究利用，促进以数据为驱动和以人权为保障的艾滋病毒应对措施。
