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A Key Comprehensive System for Biobehavioral Surveillance of Populations Disproportionately Affected by HIV (National

Dafna Kanny¹, Dita Broz¹, Teresa Finlayson¹

¹Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.

JMIR Public Health and Surveillance

|November 15, 2022

Insights

The National HIV Behavioral Surveillance (NHBS) system monitors HIV risk factors and prevention service use in key populations. Data from 2003-2019 inform national HIV prevention efforts and resource allocation.

Area of Science:

Public Health Surveillance
Epidemiology
Behavioral Science

Background:

The National HIV Behavioral Surveillance (NHBS) system has collected biobehavioral data since 2003.
It focuses on populations disproportionately affected by HIV: men who have sex with men (MSM), people who inject drugs, and high-risk heterosexual individuals (HET).
The system is crucial for understanding HIV prevalence, risk factors, and prevention service utilization.

Purpose of the Study:

To provide an overview of the NHBS system's operations and data from 2003 to 2019.
To highlight the system's role in monitoring progress towards national HIV prevention goals.
To inform targeted HIV prevention strategies for key populations.

Main Methods:

NHBS employs annual, rotating cycles with standardized, anonymous questionnaires.
Venue-based, time-space sampling is used for MSM; respondent-driven sampling for people who inject drugs and HET populations.
Interviews and anonymous HIV testing are offered to approximately 500 individuals per cycle per area.

Main Results:

From 2003-2019, 168,600 persons were interviewed and 143,570 accepted HIV testing across 17-25 US cities.
In the 2017-2019 round, over 10,000 individuals were interviewed per cycle in 23 cities, with high HIV testing acceptance rates (92%-99%).
Some cities also conducted testing for sexually transmitted infections and hepatitis C.

Conclusions:

NHBS data are vital for monitoring the "Ending the HIV Epidemic" initiative.
The data enable description of trends in key populations and tailoring of prevention activities.
NHBS findings guide resource allocation, program development, and evaluation of national and local HIV prevention efforts.

Read full analysis

Abstract

Background:

The National HIV Behavioral Surveillance (NHBS) is a comprehensive system for biobehavioral surveillance conducted since 2003 in 3 populations disproportionately affected by HIV: gay, bisexual, and other men who have sex with men (MSM); people who inject drugs; and heterosexually active persons at increased risk for HIV infection (HET). This ongoing and systematic collection and analysis of data is needed to identify baseline prevalence of behavioral risk factors and prevention service use, as well as to measure progress toward meeting HIV prevention goals among key populations disproportionately affected by HIV.

Objective:

This manuscript provides an overview of NHBS from 2003 to 2019.

Methods:

NHBS is conducted in rotating, annual cycles; these 3 annual cycles are considered a round. Venue-based, time-space sampling is used for the MSM population. Respondent-driven sampling is used for people who inject drugs and HET populations. A standardized, anonymous questionnaire collects information on HIV-related behavioral risk factors, HIV testing, and use of prevention services. In each cycle, approximately 500 eligible persons from each participating area are interviewed and offered anonymous HIV testing.

Results:

From 2003 to 2019, 168,600 persons were interviewed and 143,570 agreed to HIV testing across 17 to 25 cities in the United States. In the fifth round (2017 to 2019), over 10,000 (10,760-12,284) persons were interviewed each of the 3 population cycles in 23 cities. Of those, most (92%-99%) agreed to HIV testing. Several cities also conducted sexually transmitted infection or hepatitis C testing.

Conclusions:

NHBS is critical for monitoring the impact of the Ending the HIV Epidemic in the United States initiative. Data collected from NHBS are key to describe trends in key populations and tailor new prevention activities to ensure high prevention impact. NHBS data provide valuable information for monitoring and evaluating national HIV prevention goals and guiding national and local HIV prevention efforts. Furthermore, NHBS data can be used by public health officials and researchers to identify HIV prevention needs, allocate prevention resources, and develop and improve prevention programs directed to the populations of interest and their communities.

Keywords:

HIV HIV epidemic HIV prevention HIV risk biobehavioral surveillance men who have sex with men persons who inject drugs, heterosexually active persons at increased risk for HIV infection public health surveillance

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