1

WHO COLLABORATING CENTRE FOR HIV STRATEGIC INFORMATION

Andrija Stampar School of Public Health, School of Medicine University of Zagreb Rockefellerova 4, 10 000 Zagreb, Croatia

Phone: + 385 1 45 90 142/ 45 90 100; Fax: +385 1 46 84 212 www.hivevaluation.org

Simplified bio-behavioural surveys (BBS-Lite) and HIV data use

5-9 May 2025

Description Reliable and timely available HIV data are crucial for tracking of the epidemic, program management and program evaluation activities.

The aim of the course is to provide participants with practical guidance on how to design bio- behavioural survey “lite” (BBS-Lite), which is a programme-based survey method recently recommended by WHO and UNAIDS for collecting a limited amount of data in key populations.1 The course will also address HIV data use more broadly, and give examples of how different programmatic data sources can be used to improve service delivery.

A simplified bio-behavioural survey (BBS-Lite) does not replace BBS based on probabilistic sampling, that is surveys based on respondent-driven sampling (RDS) and time-location sampling (TLS) but rather supplements BBS. This method is less demanding in terms of implementation and data analysis, less costly than BBS and enables more timely data availability. It is recommended that this method is implemented more routinely, in-between rounds of BBS based on probabilistic methods. Participants in BBS-Lite are sampled through consecutive recruitment of eligible people accessing services (including facility- based, mobile and outreach services) and through snowball recruitment, which allows for sampling of both clients and non-clients of services. Presentations and exercises during the course will address a number of issues relevant for the appropriate design and implementation of BBS-Lite, data analysis and interpretation. The key advantage of this method is that it provides faster local-level results to assess the current situation, enabling community-based organisations to more effectively deliver their services.

The second part of the course will address data use through examples. These will include BBS data collected via RDS and TLS, and programmatic data sources that can be used to identify service delivery gaps. Programme-based systems that collect individual level data generated when a person receives health services can provide rich granular information to strengthen and monitor programme performance. Unique identifiers in programmatic sources enable to conduct longitudinal studies of patient and programme outcomes.

1 The BBS-l ite: A methodology for monitor ing programmes providing HIV, viral hepatit is and sexual health services to people from key populat ions . Geneva: WHO and UNAIDS, 2024.

2

Lectures will be followed by discussions about case studies to enable interactive exchange of knowledge and experiences. The wealth of information from routine programming should be used to generate context- specific knowledge on a continous basis to maximize population-level impact. The workshop will be held at the School of Public Health, Rockefeller str. no 4, Zagreb, Croatia. Key topics of the course are:

 Sampling frame in BBS-Lite and selection of recruitment sites

 Recruitment strategies in BBS-Lite

 Questionnaire development and biomarker data collection

 Data quality challenges and data interpretation in studies based on BBS-Lite

 Use of survey data to assess service delivery gaps and HIV prevention needs

 Using routinely collected HIV testing data to measure HIV incidence

 Use of routinely collected PrEP data to measure adherence to PrEP and HIV incidence

 Use of HIV phylogenetic analysis to support public health programmes Participants will be given opportunities to share their own country-specific experiences and challenges in implementing surveys in KPs and using data. Key aspects of the course is a group/individual work on development of protocols/ proposals. Participants can choose between these options:

A. To develop a protocol for a BBS-Lite or a BBS study B. To develop a protocol/proposal for a study to analyse routinely collected

programmatic data (alternatively, participants can bring their own data and do the analysis during the course)

Participants will present the results of this work on the final day of the course.

Teaching Methods The course consists of lectures, presentation of case studies, active discussions, exercises and group work. The course is designed to provide participants with practical skills and knowledge on how to design surveillance surveys and more effectively use data. Target Audience Epidemiologists, public health professionals, social scientists Course fee Course fee is 800 USD and includes lunch and coffee breaks during the course and course materials. Lecturers Professor George W. Rutherford, MD, Institute for Global Health Sciences, University of California, San Francisco, USA Professor Ivana Bozicevic, MD, DrPH, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia Zoran Dominkovic, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia

3

Programme

5 May 2025

9.00-9.30 Welcome and Introductions

9.30-10.00 Survey-based data collection methods in HIV surveillance in KPs (BBS, HIV sentinel surveillance and pooling both surveys, etc)

10.00-10.30 Principles of simplified programme-based survey methodology (BBS-Lite)

10.30-10.50 Break

10.50-11.45 Country presentations

11.45-12.30 Situational assessment before BBS-Lite and pre-survey planning Eligibility criteria

12.30-13.30 Lunch

13.30-14.15 Sampling frame and sampling stratification in BBS-Lite Selecting recruitment sites

14.15-15.30 Exercise

15.30-15.45 Break

15.45-16.30 Measurement and interpretation of HIV prevention cascade from survey data

6 May 2025

9.00-9.45 Recruitment strategy in BBS-Lite

9.45-10.30 Questionnaire development and specimen collection for testing for biomarkers in BBS-Lite

10.30-10.50 Break

10.50-11.30 Discussion: Methodological issues in surveys in key populations

11.30-12.30 BBS-Lite implementation and staffing Involvement of key populations

12.30-13.30 Lunch

13.30-14.30 Examples of data collection forms in BBS-lite

14.30-14.50 Break

14.50-15.30 Data analysis (examples of already implemented surveys) Indicators that can be obtained via BBS-Lite

15.30-16.00 Summary: advantages and disadvantages of BBS-Lite

16.00-16.45 Exercise

4

7 May 2025

9.00-9.45 Monitoring and evaluation of HIV prevention programs

9.45-10.30 Moving from aggregate to individual-level data: unique identifiers for person-centered monitoring

10.30-10.50 Break

10.50-11.30 Analysis of routinely collected HIV testing data (index client, self-testing, outreach, etc.) – 1. part

11.30-12.15 Exercise

12.15-13.00 Analysis of routinely collected HIV testing data (index client, self-testing, outreach, etc.) – 2. part

13.00–14.00 Lunch

14.00-15.00 Longitudinal assessment of HIV incidence through large-scale HIV prevention programs

14.30-14.50 Introduction to protocol/ proposal development exercise

14.50-16.30 Protocol/proposal development exercise - 1: Break

8 May 2025

9.00-10.00 Analysis and use of PrEP programme data: measuring PrEP coverage, adherence on PrEP and HIV seroconversion

10.00-10.45 Exercise

10.45-11.00 Break

11.00-11.45 Monitoring lost-to-follow up and HIV treatment interruptions

11.45-12.30 Use of HIV phylogenetic analysis to support public health programmes

12.30-13.30 Lunch

13.30-15.15 Protocol/ proposal development exercise 2:

15.15-15.30 Break

15.30-16.30 Protocol/ proposal development exercise 3:

5

9 May 2025

9.00-10.00 Presentations of protocols/ proposals

10.00-10.15 Break

10.15-12.30 Presentations of protocols/ proposals

12.30-13.00 Closure

13.00-14.00 Lunch

1

WHO COLLABORATING CENTRE FOR HIV STRATEGIC INFORMATION

Andrija Stampar School of Public Health, School of Medicine University of Zagreb Rockefellerova 4, 10 000 Zagreb, Croatia

Phone: + 385 1 45 90 142/ 45 90 100; Fax: +385 1 46 84 212 www.hivevaluation.org

Simplified bio-behavioural surveys (BBS-Lite) and HIV data use

5-9 May 2025

Description Reliable and timely available HIV data are crucial for tracking of the epidemic, program management and program evaluation activities.

The aim of the course is to provide participants with practical guidance on how to design bio- behavioural survey “lite” (BBS-Lite), which is a programme-based survey method recently recommended by WHO and UNAIDS for collecting a limited amount of data in key populations.1 The course will also address HIV data use more broadly, and give examples of how different programmatic data sources can be used to improve service delivery.

A simplified bio-behavioural survey (BBS-Lite) does not replace BBS based on probabilistic sampling, that is surveys based on respondent-driven sampling (RDS) and time-location sampling (TLS) but rather supplements BBS. This method is less demanding in terms of implementation and data analysis, less costly than BBS and enables more timely data availability. It is recommended that this method is implemented more routinely, in-between rounds of BBS based on probabilistic methods. Participants in BBS-Lite are sampled through consecutive recruitment of eligible people accessing services (including facility- based, mobile and outreach services) and through snowball recruitment, which allows for sampling of both clients and non-clients of services. Presentations and exercises during the course will address a number of issues relevant for the appropriate design and implementation of BBS-Lite, data analysis and interpretation. The key advantage of this method is that it provides faster local-level results to assess the current situation, enabling community-based organisations to more effectively deliver their services.

The second part of the course will address data use through examples. These will include BBS data collected via RDS and TLS, and programmatic data sources that can be used to identify service delivery gaps. Programme-based systems that collect individual level data generated when a person receives health services can provide rich granular information to strengthen and monitor programme performance. Unique identifiers in programmatic sources enable to conduct longitudinal studies of patient and programme outcomes.

1 The BBS-l ite: A methodology for monitor ing programmes providing HIV, viral hepatit is and sexual health services to people from key populat ions . Geneva: WHO and UNAIDS, 2024.

2

Lectures will be followed by discussions about case studies to enable interactive exchange of knowledge and experiences. The wealth of information from routine programming should be used to generate context- specific knowledge on a continous basis to maximize population-level impact. The workshop will be held at the School of Public Health, Rockefeller str. no 4, Zagreb, Croatia. Key topics of the course are:

 Sampling frame in BBS-Lite and selection of recruitment sites

 Recruitment strategies in BBS-Lite

 Questionnaire development and biomarker data collection

 Data quality challenges and data interpretation in studies based on BBS-Lite

 Use of survey data to assess service delivery gaps and HIV prevention needs

 Using routinely collected HIV testing data to measure HIV incidence

 Use of routinely collected PrEP data to measure adherence to PrEP and HIV incidence

 Use of HIV phylogenetic analysis to support public health programmes Participants will be given opportunities to share their own country-specific experiences and challenges in implementing surveys in KPs and using data. Key aspects of the course is a group/individual work on development of protocols/ proposals. Participants can choose between these options:

A. To develop a protocol for a BBS-Lite or a BBS study B. To develop a protocol/proposal for a study to analyse routinely collected

programmatic data (alternatively, participants can bring their own data and do the analysis during the course)

Participants will present the results of this work on the final day of the course.

Teaching Methods The course consists of lectures, presentation of case studies, active discussions, exercises and group work. The course is designed to provide participants with practical skills and knowledge on how to design surveillance surveys and more effectively use data. Target Audience Epidemiologists, public health professionals, social scientists Course fee Course fee is 800 USD and includes lunch and coffee breaks during the course and course materials. Lecturers Professor George W. Rutherford, MD, Institute for Global Health Sciences, University of California, San Francisco, USA Professor Ivana Bozicevic, MD, DrPH, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia Zoran Dominkovic, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia

3

Programme

5 May 2025

9.00-9.30 Welcome and Introductions

9.30-10.00 Survey-based data collection methods in HIV surveillance in KPs (BBS, HIV sentinel surveillance and pooling both surveys, etc)

10.00-10.30 Principles of simplified programme-based survey methodology (BBS-Lite)

10.30-10.50 Break

10.50-11.45 Country presentations

11.45-12.30 Situational assessment before BBS-Lite and pre-survey planning Eligibility criteria

12.30-13.30 Lunch

13.30-14.15 Sampling frame and sampling stratification in BBS-Lite Selecting recruitment sites

14.15-15.30 Exercise

15.30-15.45 Break

15.45-16.30 Measurement and interpretation of HIV prevention cascade from survey data

6 May 2025

9.00-9.45 Recruitment strategy in BBS-Lite

9.45-10.30 Questionnaire development and specimen collection for testing for biomarkers in BBS-Lite

10.30-10.50 Break

10.50-11.30 Discussion: Methodological issues in surveys in key populations

11.30-12.30 BBS-Lite implementation and staffing Involvement of key populations

12.30-13.30 Lunch

13.30-14.30 Examples of data collection forms in BBS-lite

14.30-14.50 Break

14.50-15.30 Data analysis (examples of already implemented surveys) Indicators that can be obtained via BBS-Lite

15.30-16.00 Summary: advantages and disadvantages of BBS-Lite

16.00-16.45 Exercise

4

7 May 2025

9.00-9.45 Monitoring and evaluation of HIV prevention programs

9.45-10.30 Moving from aggregate to individual-level data: unique identifiers for person-centered monitoring

10.30-10.50 Break

10.50-11.30 Analysis of routinely collected HIV testing data (index client, self-testing, outreach, etc.) – 1. part

11.30-12.15 Exercise

12.15-13.00 Analysis of routinely collected HIV testing data (index client, self-testing, outreach, etc.) – 2. part

13.00–14.00 Lunch

14.00-15.00 Longitudinal assessment of HIV incidence through large-scale HIV prevention programs

14.30-14.50 Introduction to protocol/ proposal development exercise

14.50-16.30 Protocol/proposal development exercise - 1: Break

8 May 2025

9.00-10.00 Analysis and use of PrEP programme data: measuring PrEP coverage, adherence on PrEP and HIV seroconversion

10.00-10.45 Exercise

10.45-11.00 Break

11.00-11.45 Monitoring lost-to-follow up and HIV treatment interruptions

11.45-12.30 Use of HIV phylogenetic analysis to support public health programmes

12.30-13.30 Lunch

13.30-15.15 Protocol/ proposal development exercise 2:

15.15-15.30 Break

15.30-16.30 Protocol/ proposal development exercise 3:

5

9 May 2025

9.00-10.00 Presentations of protocols/ proposals

10.00-10.15 Break

10.15-12.30 Presentations of protocols/ proposals

12.30-13.00 Closure

13.00-14.00 Lunch