Behavioral surveillance, defined as an ongoing, systematic collection, analysis, and interpretation of behavioral data for preventing or controlling disease or injury, is important for AIDS and many chronic diseases whose onset is separated from their putative exposures by several years or decades. A national surveillance system that provides relevant, timely, and high-quality data on risk and prevention behaviors of MSM, IDUs and HET is needed to help direct and evaluate local and national HIV prevention efforts. In the absence of an effective vaccine against HIV, reducing known risk factors for HIV infection is essential for reducing HIV transmission. HIV behavioral surveillance data can be used to target prevention efforts on identified risk behaviors that need to be changed in populations at greatest risk for HIV infection. Behavioral surveillance data is important for evaluating whether prevention efforts within a community are reaching important population segments and in meeting local and national goals for HIV prevention. An ongoing, systematic collection, interpretation, and analysis of behavioral data are needed to identify baseline risk and prevention-service-utilization outcomes, and to quantify progress towards meeting the plan's objectives. For those populations that are identified with unmet prevention needs, behavioral surveillance data can be used at local, state, and federal levels to help improve or redirect prevention efforts, or to obtain additional prevention resources. CDC's HIV/AIDS strategic plan has identified that monitoring behaviors that place people at risk for HIV infection is a key element of an integrated surveillance system, particularly in MSM, IDU's, and HRH. This programs goal is to develop an ongoing surveillance system to ascertain the prevalence of HIV risk behaviors among groups at high risk for HIV infection to be used in the development and directing national prevention services and programs; and to evaluate the impact of a variety of prevention efforts. This data will be important to implement strategies and provide local relevant epidemiological information for the Puerto Rico Health Department, CBO's and other groups. For this reason and in collaboration with the Behavioral and Clinical Surveillance Branch, Division of HIV/AIDS Prevention, and other participating state and local health departments we will conduct the National HIV Behavioral Surveillance in MSM, IDU's, and HET populations. The HIV Behavioral Surveillance System will be conducted in three research cycles. Each cycle will approach three different populations: MSM, IDU's, and HET and each cycle will be of one year duration. The first cycle will be MSM and it will be conducted through from January to December 31, 2008. The second cycle will be the IDU's and it will be conducted from January to December 31st, 2009. The third and last cycle will be the HRH, starting from January to December 31, 2010. High-risk individuals from non-healthcare community settings will be recruited using a scientifically sound methodology to develop an ongoing system for surveillance of behaviors related to HIV acquisition. We will assess risk behaviors and trends in behaviors over time among adults 18 years old and older at high risk for HIV infection through sexual behavior between men, injection drug use and heterosexual contact. HIV testing will be assessed in addition to access and utilization of HIV prevention programs. We will interview at least 500 persons per cycle. Through the community planning process and the collaboration of CDC directly funded community-based organizations (CBO's) or CBO's funded by states/cities, HIV prevention programs, schools of public health, universities, ethnographers and behavioral scientist we will conduct a formative research, and questionnaire development. ? ? ?
