What is the Population-based HIV Impact Assessment Project?

Jessica Justman, MD, senior technical director, ICAP, Mailman School of Public Health & associate professor of medicine in epidemiology, Columbia University explains the PHIA Project (population-based HIV impact assessments).

Interview Transcript (slightly modified for readability):

“The Population-based HIV Impact Assessment Project is a series of HIV-focused national surveys that aim to measure the key indicators that we need to have in order to understand how we are doing with the epidemic, and to guide future programs and the use of future resources.

We have had estimates of HIV prevalence through demographic and health surveys for approximately 10 years, but important indicators, such as HIV incidence, and, more recently, the 90-90-90 indicators have only been available, either through modeling for incidence, or through facility-based data for the 90-90-90 estimates. But, we really need to know what’s going on at the population level, so that we understand what’s happening, not just with the people who are accessing care and treatment at healthcare facilities, but, what is the story with people who are not accessing care and treatment at healthcare facilities. That’s what we mean by population-based [data].

And, so, we are doing surveys, and going to people’s homes. We ask them questions and do HIV testing in the home. We return with the results, [and] we provide counseling, [and] we do referrals to care. This way, we are getting as close as one can get to a true estimate of, not just HIV prevalence, but, the rate of new HIV infections, using more sophisticated incidence assays. We do viral load measurements on everyone who is HIV-positive, and then we ask them questions about care and treatment. We are also in the middle of doing ARV-detection assays, which will allow us to refine our estimates so that we know who is aware of their diagnosis and who is on treatment.

The surveys are going on in approx. 14 countries. All of them are in Africa, except for one in Haiti. We have completed data collection in 7 countries, and we are a little more than halfway through our 5-year project period. [Therefore,] to be done with 7 out of 14 countries is where we want to be for halfway through the project. We have data collection going on right now in 2 more countries. We are poised to begin in a couple more, and then we are lining things up for additional countries in 2018.”