Knowledge of HIV prevention among injecting drug users

Export Indicator

Percent of respondents in a survey of injecting drug users who, in response to prompting, identify switching to non-injecting drugs and avoiding sharing injecting equipment as methods of preventing HIV transmission
What it measures

In HIV epidemics where there is a concentration of HIV infection or risk behaviours among injecting drug users, some programmes actively promote HIV prevention in this population. Most efforts to reduce transmission between drug injectors try to encourage safer drug-taking, including using non-injecting drugs and not sharing injecting equipment. This indicator measures the extent to which drug injectors are aware of these methods of preventing HIV transmission.

Rationale
Numerator

Number of survey respondents who correctly identify both HIV prevention methods

Denominator

All respondents

Calculation
Method of measurement

In a behavioural survey in a community of drug injectors, respondents are asked about their knowledge of AIDS, and whether it can be prevented. They are then prompted for various correct and incorrect means of prevention, including switching to non-injection drugs and avoiding sharing injecting equipment. The indicator is derived from correct answers given for both prevention methods. Someone giving correct answers on only one way is not counted in the numerator of the indicator. All respondents are included in the denominator, regardless of whether they have ever heard of AIDS or not. Results for each component of the indicator should also be reported.

Measurement frequency
Disaggregation

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

The greatest difficulty in collecting information for this indicator is accessing a representative sample of injecting drug users. Sampling issues are discussed at greater length in the FHI module on sampling for behavioural surveillance surveys. This indicator will only be useful where efforts are being made to reach injecting drug users with prevention messages that help them reduce exposure to HIV infection, both for themselves and for other members of the drugtaking community. Where such programmes exist but concentrate only on a single message backed up by appropriate services, it may be possible to restrict the indicator to knowledge about that means of prevention. Obviously it will be difficult to use these data if programmes are not openly informing the drug using public about using clean needles and safer methods to use drugs. In the past some HIV prevention programmes among injecting drug users promoted carefully cleaning injecting equipment with bleach between users as an HIV prevention method. Recent research calls into question the effectiveness of this method, and few programmes for drug users now actively promote it. It is therefore not included as a prevention method in this indicator. Many programmes aimed at drug injectors also promote condom use in order to limit the spread of HIV from infected drug users to their sexual partners. This is covered in indicators of sexual risk, and is not included in the indicator of knowledge specific to prevention in druginjecting situations. Limitations of the use of prompted data were discussed in the introduction to this section; while the primary indicator should be constructed using prompted data, a comparison between prompted and non-prompted data where possible may yield interesting information about the methods most drug users consider to be effective in their personal circumstances.

Further information