Session 9 – Developing Draft Plan for Direct Size Estimation

1. Training Course: Planning for Developing Population Size Estimates for Key Populations at Increased Risk of HIV 24-28 August, Tehran, Iran Session 9 – Developing Draft Plan for Direct Size Estimation

2. Things to include in plan for direct size estimation • Decision about the key populations for which you will do estimates • Preliminary thoughts about the locations where you will collect direct size estimation data for each key population in your size estimation plan • Clear definition of the populations for which you will do estimates • Description of which method you will use where

3. Key populations for which you will do estimates • Give justification for which groups you will include in your country size estimation plan • This should be based on an understanding of which populations are most affected by the epidemic, and contributing the most number of new infections

4. Preliminary thoughts about locations for direct data collection Things to include: • Number of locations where you will collect data for each population • Names of the locations where you will collect data for each group • If you do not know yet, what steps will you follow to help you finalize the decision?

5. How will key populations be defined? • Examples of more inclusive definitions • Men who had oral or anal sex at least once in the past one year • People who injected drugs at least once in the past once year • Women who exchanged sex for money or goods at least once in the past one year • Examples of less inclusive definitions • Men who had anal sex with other men in the past one month • People who injected drugs at least once in the past one month • Women who exchanged sex for money in the past month

6. How will key populations be defined? • When would you want to use more inclusive definitions? • When would you want to include less inclusive definitions?

7. More inclusive definitions • For what purposes are they helpful? • Convincing policy-makers to allocate resources • Helpful for attracting funding • Providing services to individuals across a broad spectrum of risk • For what purposes are they not helpful? • Can lead to gross overestimates of number of the number of people living with HIV (PLHA) • Overestimating the number of people who can be reached with services can lead to wasted resources or a failure to reach targets • Can also dilute ability to measure program impact

8. Less inclusive definitions • For what purposes are they helpful? • More realistic estimates of PLHA • More realistic projections of number of people who are likely to become infected • Helpful for prioritizing key population members who are most important to target

9. Matching the definition to the methodology • If you define the key population as those who engaged in the behavior in the past one year • Will be difficult to capture that group through mapping, capture recapture, or multiplier methods using venue based sampling • When using venue-based methods, you will be more likely to capture those who engage in the behavior more frequently. So this group will not match the definition

10. Instructions for Group Work Please prepare one slide to address each of the following questions • Key populations for which you will do estimates • Preliminary thoughts on locations for each group • How many locations? • Where? • Definition of the populations for which you will do estimates • Description of which method you will use where • Justification for choosing this method