16th International AIDS Conference


Toronto, Canada - August 13 - 18, 2006

A GEOGRAPHIC APPROACH TO MAPPING HIGH RISK LOCATIONS FOR SCALING UP OF HIV PREVENTION PROGRAM IN KARNATAKA, A SOUTHERN INDIAN STATE: METHODOLOGY AND FINDINGS

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. TuAc0403

B.M. Ramesh1, N. Shiv Kumar2, J.F. Blanchard3
1 Karnataka Health Promotion Trust & University of Manitoba, Winnipeg, Canada, Monitoring and Evaluation & Department of Community Health Sciences, Bangalore, India, 2 Swasti, Bangalore, India, 3 Karnataka Health Promotion Trust & University of Manitoba, Winnipeg, Canada, Project Director & Department of Community Health Sciences, Bangalore, India

BACKGROUND: Karnataka has a population of more than 60 million and an estimated adult HIV prevalence of 1.6%. Scaling up focused prevention programs for at risk groups is a priority for the state HIV control strategy. To plan these programs a rapid mapping methodology was developed and implemented in all 197 cities and towns across the states 26 districts under the India AIDS Initiative (Avahan) funded by the Bill and Melinda Gates Foundation. The purpose was to identify the location, size and typology of key at risk population groups including female sex workers (FSWs), high-risk men who have sex with men (MSMs) and injecting drug users (IDUs).

METHODS: We developed a geographical approach wherein the locations of specific high-risk activities – female and male sex work and injecting drug use – are identified through a series of structured interviews with key informants in a particular city/town. These locations are later profiled through site visits and interviews with primary stakeholders providing population estimates and operational typology. Over 76,700 key informants were interviewed in 5,260 spots within 6 months statewide.

RESULTS: In the urban areas of Karnataka, the mapping estimated about 75,800 persons engaging in high-risk activities, and 47% of this estimate was from Bangalore city. FSWs constitute 71%, followed by street-affiliated MSMs (11%), IDUs (9%), Hijra sex workers (5%) and other traditional risk groups (7%). Results provided site-specific estimates, which were used to prioritize program locations. Site-by-site validation during program implementation showed that the mapping methodology provided accurate information on the location and size of at risk groups (within 5% overall). In this setting, the methodology appears more valid for FSWs than for MSMs and IDUs.

CONCLUSIONS: This mapping methodology is simple, rapid, scalable and accurate and should be assessed in other settings. Additional approaches are needed for mapping MSMs and IDUs.

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2006-08-13
TuAc0403

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