PS08-001, NATIONAL HIV BEHAVIORAL SURVEILLANCE

描述（由申请人提供）：艾滋病办公室与疾病预防控制中心合作，将在圣地亚哥县的大都会统计区（MSA）开展NHBS项目。NHBS将通过艾滋病毒行为监测监测来监测艾滋病毒的流行， 关于男男性行为者（MSM）、注射吸毒者（IDUs）和艾滋病毒感染高风险异性恋者（HET）的风险和预防行为的高质量数据。MSM、IDUs和HET的NHBS的主要目标是通过确定性和药物使用行为、HIV检测行为以及暴露和利用HIV检测和其他由州和地方卫生部门资助的预防服务的流行率和趋势，帮助指导和评估地方和国家的预防工作。数据收集将每年轮流在男男性行为者、注射吸毒者和艾滋病毒/艾滋病患者之间进行。每个数据收集 不同群体之间的一年称为一个周期，因此，本合作协议适用于3个数据收集周期。受资助的研究中心预计将与社区组织（CBO）和人种学家以及其他在定性和定量方法方面具有专业知识的学术或公共卫生合作伙伴合作，以开展这些行为监测活动。所有合格的参与者均获得书面知情同意书。在给予知情同意后，每名参与者都由经过培训的工作人员使用标准化问卷进行访谈。这一调查工具涉及人口统计信息、性行为和吸毒行为、性行为和吸毒史、艾滋病毒检测经历、健康状况、获得医疗服务的机会以及对预防活动的评估。此外，每个合格的参与者都可以自愿接受艾滋病毒检测和咨询。OA获得了PA 04017的资助，目前正在圣地亚哥县MSA进行的HET中完成第三个NHBS周期。本周期的供资将于2007年12月31日到期。行为监测应该是一个持续的，系统的收集，分析和解释行为数据，以预防或控制疾病或伤害。从本质上讲，艾滋病毒行为监测系统应收集来自不同人群的数据：一般人群、艾滋病毒感染风险人群和艾滋病毒感染者。疾病预防控制中心的艾滋病毒预防战略计划和美国艾滋病联合规划署（艾滋病规划署）/世界卫生组织（世卫组织）的第二代监测框架都阐明了为艾滋病毒感染风险人群建立国家行为监测系统的必要性。国家艾滋病毒行为监测系统旨在实现疾病预防控制中心的战略目标，即加强全国监测艾滋病毒流行病的能力。艾滋病规划署关于艾滋病毒感染第二代监测的指导意见强烈建议在规划和评价行为干预措施时使用行为监测，特别是在流行程度低和集中的国家。NHBS的主要目标是在美国HIV感染高危人群中进行行为监测，以评估以下方面的流行率和趋势：1）HIV感染的风险行为; 2）HIV检测行为; 3）接触、使用和影响HIV预防服务。随着时间的推移，这些行为可以在不同的地理区域进行评估。在美国，艾滋病毒主要是一种影响城市地区的流行病。2002年报告的艾滋病病例中有82%居住在人口超过50万的大都市统计区。此外，报告的艾滋病病例中有10%居住在人口为50，000至499，999人的大都市地区;其余8%在诊断时居住在农村地区。因此，国家保健局的工作重点是艾滋病毒疾病负担最重的管理服务区。随着时间的推移，NHBS必须能够解决美国不断变化的艾滋病毒流行情况，尽管可以而且应该做出改变，以确定改进系统的方法或信息需求的变化，但这些都需要考虑如何影响对趋势的解释。监测系统的广泛地理覆盖范围包括艾滋病毒发病率最高的地区，这意味着收集的数据可能准确反映全国艾滋病毒感染风险增加的人的行为。因此，NHBS收集的信息将对美国未来艾滋病预防计划的目标至关重要。

DESCRIPTION (provided by applicant): The Office of AIDS, in collaboration with the CDC, will be conducting the NHBS project in the Metropolitan Statistical Area (MSA) of San Diego County. NHBS will monitor the HIV epidemic through HIV behavioral surveillance by providing relevant, timely, and high-quality data on risk and prevention behaviors among men who have sex with men (MSM), injection drug users (IDUs), and heterosexuals at high risk for HIV infection (HET). The main objective of NHBS of MSM, IDUs, and HET is to help direct and evaluate local and national prevention efforts by identifying the prevalence and trends in sexual and drug-use behaviors, HIV testing behaviors, and exposure to and utilization of HIV testing and other prevention services funded by state and local health departments. Data collection will rotate each year among MSM, IDU, and HET. Each data collection year among a different group is called a cycle, thus, this cooperative agreement is for 3 cycles of data collection. Funded sites are expected to collaborate with community-based organizations (CBOs) and with ethnographers, and other academic or public health partners with expertise in qualitative and quantitative methods to conduct these behavioral surveillance activities. All eligible participants are given written informed consent. After giving informed consent, each participant is interviewed by trained staff using a standardized questionnaire. This survey instrument pertains to demographic information, sexual and drug using behaviors, sexual and drug using histories, HIV testing experiences, health conditions, access to medical care, and assessment of prevention activities. Additionally, each eligible participant is offered voluntary HIV testing and counseling. OA was awarded funding for PA 04017 and is currently completing the third cycle of NHBS among HET being conducted in the MSA of San Diego County. Funding for the current cycle will expire on December 31, 2007. Behavioral surveillance should be an ongoing, systematic collection, analyses, and interpretation of behavioral data for preventing or controlling disease or injury. In essence, HIV behavioral surveillance systems should collect data from various populations: the general population, people at risk for HIV infection, and people living with HIV infection. The need for development of a national behavioral surveillance system for people at risk for HIV infection was articulated in both CDC's HIV Prevention Strategic Plan, and the in the United States Joint Program on AIDS (UNAIDS)/World Health Organization's (WHO) second generation surveillance framework. The National HIV Behavioral Surveillance (NHBS) system aims to meet CDC's strategic goal of strengthening the capacity nationwide to monitor the HIV epidemic. The guidance from UNAIDS on second-generation surveillance for HIV infection strongly recommended the use of behavioral surveillance in the planning and evaluation of behavioral interventions, particularly in countries with low-level and concentrated epidemics. The primary objective of NHBS is to conduct behavioral surveillance among a representative group of people at high risk for HIV infection in the United States in order to assess prevalence of and trends in: 1) risk behaviors for HIV infection; 2) HIV testing behaviors; and 3) exposure to, use of, and impact of HIV prevention services. These behaviors can be assessed across geographic areas over time. In the U.S., HIV is primarily an epidemic that affects urban areas. Eighty-two percent of AIDS cases reported in 2002 resided in metropolitan statistical areas (MSAs) with populations of 500,000 or more. Additionally, 10% of reported AIDS cases resided in metropolitan areas with a population of 50,000 to 499,999; the remaining 8% lived in rural areas at the time of their diagnosis. For this reason, NHBS efforts are being focused in the MSAs with the largest burden of HIV disease. Over time, NHBS must be able to address the changing HIV epidemic in the U.S. Although changes can and should be made as ways to improve the system are identified or information needs change, these will need to be made with consideration for how they could impact interpretation of trends over time. The widespread geographic coverage of the surveillance system to include areas with the highest HIV morbidity means that data collected are likely to accurately reflect the behaviors of people at increased risk for HIV infection nationally. As a result, the information gathered by NHBS will be critical in the targeting of future HIV prevention programs in the U.S.