Use of data from HIV counselling and testing services for HIV surveillance in Africa

The rapid expansion of antiretroviral treatment for HIV-infected adults which has been helped by WHOs "3 by 5" strategy the Global Fund to fight AIDS Tuberculosis and Malaria the Presidents Emergency Plan for AIDS Relief and other international initiatives demands a scale-up of voluntary HIV counselling and testing services in participating countries. In Tanzania for example the expansion aimed to have more than 600 voluntary HIV counselling and testing sites by the end of 2006 representing an increase of almost 250% since 2005. Data-collection activities in voluntary HIV counselling and testing clinics are increasingly expected to fulfill donor-driven reporting requirements that include programme monitoring and assessment. Increases in clinic coverage and recorded indicators and the desire to measure the effect of HIV-related interventions on the evolution of the epidemic have led to suggestions to use data from these clinics for HIV and behavioural surveillance. We believe that such use of this data is not appropriate: the data are inherently biased and the function of the clinics could be compromised. (excerpt)