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UNAIDS/WHO Working Group on Global HIV/AIDS/STI Surveillance
Case Study on Estimating HIV Infection in a Concentrated Epidemic: Lessons from Indonesia
Description of Work
UNAIDS - Joint United Nations Programme on HIV/AIDS and WHO - World Health Organization, Geneva, March 2004, 24 pp
92 9173 359 8

" Previous efforts to estimate the impact of HIV in Indonesia produced numbers that ranged wildly from a few thousand to several million, with little information about the distribution of infection either across the country or among people with different forms of risky behaviour. The principal weaknesses of these earlier estimates is that they were developed by one or two individuals from outside Indonesia, and were based on very limited data. Recognizing the importance of improving the scope and quality of information to inform decision-making
about HIV prevention and care, the Indonesian Government in May 2001 strongly endorsed the principles of second-generation surveillance for HIV, as recommended by the World Health Organization and UNAIDS1. Second-generation surveillance concentrates surveillance resources among those whose behaviours are most likely to be contributing to the spread of HIV. Information from behavioural and biological surveillance activities is used to improve understanding of the HIV epidemic: where is infection currently concentrated, and who is likely to be at risk in the future, if there is no change in existing behaviour? Newly-available information from the second generation surveillance system provided an opportunity for Indonesia to make more reliable estimates of the number of people infected with HIV. In 2002, the Ministry of Health began a process that led to vastly more informative estimates of the number of people at risk of contracting HIV in Indonesia, and the number currently infected with the virus. This document focuses on the process that the country undertook in developing its estimates, discussing some of the challenges faced, the decisions made and the lessons learned."

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