HIV Surveillance Training Manuals

Our team focuses on developing surveillance tools that can be locally adapted and used to produce high-quality, reliable data that will inform policy and programs to improve the health of HIV-affected populations and reduce the spread of the virus.

To help scientists, officials, and health professionals advance their ability to gather such data, we have developed a series of HIV surveillance training materials in close partnership with collaborators and funders, including US Centers for Disease Control and Prevention (CDC), the President's Emergency Plan for AIDS Relief (PEPFAR), the San Francisco Department of Public Health, and Tulane University.

These courses, unless otherwise noted, are meant primarily for district-level surveillance officers, but can also be used for self-study. You can download the materials below, or you can engage our team to conduct surveillance workshops shaped to the needs of participants. For more information, contact Heidi Frank.

Overview of the HIV Epidemic with an Introduction to Public Health Surveillance

The overview presents an introduction to the HIV epidemic, including information on the epidemiology of the disease and public health surveillance measures used to combat it. After completing this course, participants should

  • Know the three HIV epidemic states and be able to characterize the HIV epidemic in their country
  • Be familiar with the predominant routes and key risk factors of HIV transmission
  • Be able to describe the components of an effective HIV surveillance system and the elements of second generation HIV surveillance
  • Understand the ethics involved in HIV surveillance and be aware of potential harm to individuals and to populations
  • Be able to develop a plan for evaluating their country's surveillance system

HIV Clinical Staging and Case Reporting

This course introduces HIV case surveillance with an emphasis on WHO guidelines and second generation HIV and STI surveillance, mortality monitoring, ethics and confidentiality, analysis and presentation of surveillance data, and regional reporting. Participants will learn how to:

  • Set up HIV and STI case reporting systems
  • Analyze HIV and STI surveillance data
  • Use surveillance data for prevention, care, and treatment planning
  • Evaluate a public health surveillance system
  • Prepare national guidelines on HIV/AIDS case reporting

This course incorporates the development of country operational and implementation plans.

HIV Sero-prevalence Surveillance

This course presents the key issues in HIV surveillance and complementary surveillance techniques for tracking the epidemic, focusing on the steps to conduct unlinked anonymous HIV sero-prevalence surveys at antenatal clinics. After completing this course, participants should be able to:

  • Understand the criteria for selecting sentinel populations and identify specific groups and sites in their district that are suitable for sentinel surveillance
  • Identify appropriate sampling schemes depending on the situation and the target population and create a sampling frame
  • Understand the considerations that determine which HIV testing approach is suited for HIV surveillance in their country and describe the advantages and disadvantages of different HIV testing options
  • Describe the staffing, training, and supervising requirements of HIV sentinel surveillance
  • Identify the key variables used in the analysis of HIV sentinel surveillance data

Sexually Transmitted Infection Surveillance

This course describes the interaction between HIV infection and STIs. The module describes how to develop and operate systems for STI surveillance in the context of integrated disease surveillance (IDS). After completing this course, participants should be able to

  • Understand the interrelationship between HIV and STIs and the principles of IDS
  • Explain the difference between etiologic and syndromic case reporting
  • Understand the advantages, disadvantages, and timing of STI universal case reporting and sentinel surveillance
  • Ensure confidentiality when collecting, archiving, and reporting STI data
  • Identify the STIs most suitable for inclusion in combined STI/HIV biological and behavioral surveillance

Surveillance of HIV Risk Behaviors

This course introduces behavioral surveillance with an emphasis on pre-surveillance activities, measures and indicators, survey methods, sampling approaches, data use, and ethics. The specific audience is senior-level planners, decision-makers, and Ministers of Health who will not conduct the surveillance. After completing this course, participants should be able to

  • Identify the uses of behavioral surveillance
  • Select indicators most suited to particular situations
  • Discuss at a high level the sampling issues and options for behavioral surveillance
  • Describe the types of data analysis commonly used in behavioral surveillance; explain appropriate data analysis and use
  • Discuss ethical considerations unique to behavioral surveillance

Surveillance of Key Populations at Higher Risk of HIV

This course introduces HIV surveillance among key populations at higher risk for HIV, including commercial sex workers, men who have sex with men, and injection drug users, which are described in depth. We recommend combining it with Surveillance of HIV Risk Behaviors. Specific surveillance techniques are recommended and detailed case studies are provided for each population to help participants plan implementation. The specific audience is surveillance officers who will conduct the surveillance.

After completing this course, participants should be able to

  • Discuss the importance of surveillance in key populations at higher risk
  • Understand the purpose of pre-surveillance assessments and the role of qualitative and quantitative research in these assessments
  • Discuss the advantages and disadvantages of various sampling approaches
  • Discuss how to choose the most effective biological and behavioral measures in surveys of key populations at higher risk
  • Understand the special ethical consideration of conducting behavioral and biological surveillance among these groups

Introduction to Time-Location Sampling

Prerequisite: Surveillance of HIV Risk Behaviors

Time-location sampling (TLS) is ideal for sampling visible populations that frequent public venues in a higher proportion than the background population. These venues may include injection drug sites, sex worker areas, and bars. The course will provide details on how to:

  • Set up a TLS surveillance project and will instruct participants in how to select venues for sampling
  • Construct a sampling calendar
  • Perform sampling at venues

Upon request, additional time can be provided on TLS protocol development.

Instrument Development

The specific audience is the Ministry of Health and National HIV/AIDS Program staff.

At the conclusion of the course, participants will be able to

  • Adapt survey instruments to a local context
  • Develop country-specific, measurable questions to include in national HIV-related surveys

Producing a National HIV Sentinel Surveillance and Estimates Report

This course is a natural follow-up to Electronic Data Processing, Analysis and Reporting for HIV Sentinel Surveys, although data from any source may be used. The workshop will focus on writing and presenting national or regional surveillance information. The specific audience is staff who will assist to develop an annual surveillance report then deliver the information to a variety of audiences. During the course, participants will:

  • Decide overall design
  • Create charts, tables, and other data displays using their own cleaned data
  • Practice developing a communication approach for different audiences

Surveillance Training of Trainers

A surveillance training-of-trainers event employs the teach-back methodology to improve participants' facilitation skills. These events can be added on to any of the surveillance courses in this curriculum. Please allow several months for preparation of these events.

Participants blend learning training skills with teaching the course content of any of the surveillance courses previously described. Participants will gain knowledge and skills in how to:

  • Train adults
  • Facilitate a lecture or small group discussion and role play
  • Give and receive verbal and written feedback
  • Create an action plan

Estimating the Size of Populations Most at Risk of HIV Infection

This course is a natural addition to Surveillance of Most-at-Risk Populations. This course presents an introduction to estimating the size of key populations at higher risk for HIV infection and is based upon updated guidelines entitled Guidelines on Estimating the Size of Populations Most at Risk to HIV, developed in 2010 by the UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance. Course participants will learn:

  • Recently developed methods and information on how to create local and national population size estimates
  • How to choose a method and collect data
  • How to analyze, disseminate, and use the results of the population size estimation