People living with HIV/AIDS (PLWHA) (indicators)
The core indicators, or specific indicators (such as injecting drug use or being on substitution treatment) shared with other populations can be used for PLWHA. In the case of questions on risk (sexual behaviour or injecting behaviour), supplementary questions on the HIV status of the partner(s) with whom risk behaviour has occured should be asked.
Other population-specific indicators are proposed, as indicated below.
Title and definition: New diagnosis of any STI reported by the respondent, in the last 12 months
Purpose and rationale The occurrence of any STI accounts for exposure to sexual risk and unsafe sex among the HIV+ population. Monitoring of the rate of reported STI among the population living with HIV complements information on unprotected sex and the epidemiological surveillance of STI, which is rarely optimal, and does not always take into account the HIV status of the patients. The frequency of STI has been increasing since 2000, especially among MSM and MSM living with HIV.
Measurement frequency Every year
Strengths and weaknesses STI diagnoses cover a range of very different STI with regard to route of transmission, effectiveness of condom use, acute or chronic clinical forms, symptoms, diagnosis and treatment; report of a diagnosis of HIV infection depends on recall bias, knowledge and understanding of an HIV diagnosis and on access to diagnosis and care
Additional sources of information This indicator of risk is seen as important, but as no commonly agreed satisfactory indicator is currently available; more research is needed and no specific definition is proposed
Title and definition: Medical treatment
a) being on antiretroviral treatment
b) undetectable viral load at last examination
Purpose and rationale
Effective antiretroviral treatment reduces the risk of transmission.
In the near future, treatment and viral load might be considered as a determinant of HIV transmission from a HIV positive subject and might be used as such in prevention messages targeting people living with HIV. This information is available from medical records, however the question should be asked of the subject him/herself in studies carried out outside medical settings, especially in surveys among MSM, IDU and migrants. Among PLWHA, this indicator is a priority indicator
Measurement frequency Every year
Strengths and weaknesses Being on ARV and undetectability of viral load are good proxy measures of the risk of HIV transmission within a population of PLWHA