scholarly journals Programmatic Mapping to Estimate Size, Distribution, and Dynamics of Key Populations in Kosovo (Preprint)

2018 ◽  
Author(s):  
Dafina Gexha Bunjaku ◽  
Edona Deva ◽  
Luljeta Gashi ◽  
Pranvera Kaçaniku-Gunga ◽  
Carly A. Comins ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Population Size ◽  
Sex Work ◽  
Sex Workers ◽  
Large Scale ◽  
National Level ◽  
Key Populations ◽  
Hiv Prevention Strategies ◽  
Population Size Estimates ◽  
Size Estimates

BACKGROUND The burden of an HIV epidemic in Kosovo lies among the key populations (KPs) of female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs). The available interventions for KPs are fragmented and lack sufficient and appropriate granularity of information needed to develop large-scale outreach programs. OBJECTIVE The aim of this study was to estimate the size and distribution of these populations to create evidence for developing action plans for HIV prevention. METHODS The programmatic mapping approach was used to collect systematic information from key informants, including geographic and virtual locations in 26 municipalities of Kosovo between February to April 2016. In level 1, information was gathered about KPs’ numbers and locations through 1537 key informant interviews within each municipality. Level 2 involved validating these spots by conducting another 976 interviews with KPs congregating at those spots. Population size estimates were calculated for each spot, and finally a national-level estimate was developed, which was corrected for duplication and overlaps. RESULTS Of the estimated 6814 MSM (range: 6445 to 7117), nearly 4940 operate through the internet owing to the large stigma and discrimination against same-sex relationships. Geo-based MSM (who operate through physical spots) congregate at a few spots with large spot sizes (13.3 MSM/spot). Three-fourths of the MSM are distributed in 5 major municipalities. Fridays and Saturdays are the peak days of operation; however, the number only increases by 5%. A significant number are involved in sex work, that is, provide sex to other men for money. PWIDs are largely geo-based; 4973 (range: 3932 to 6015) PWIDs of the total number of 5819 (range: 4777 to 6860) visit geographical spots, with an average spot size of 7.1. In smaller municipalities, they mostly inject in residential locations. The numbers stay stable during the entire week, and there are no peak days. Of the 5037 (range: 4213 to 5860) FSWs, 20% use cell phones, whereas 10% use websites to connect with clients. The number increases by 25% on weekends, especially in larger municipalities where sex work is mostly concentrated. Other than a few street-based spots, most spots are establishments run by pimps, which is reflective of the highly institutionalized, structured, and organized FSW network. CONCLUSIONS This study provides valuable information about the population size estimates as well as dynamics of each KP, which is the key to developing effective HIV prevention strategies. The information should be utilized to develop microplans and effectively provide HIV prevention services to various KPs.

scholarly journals Estimating the Population Size of Female Sex Workers in Namibia Using a Respondent-Driven Sampling Adjustment to the Reverse Tracking Method: A Novel Approach (Preprint)

2018 ◽  
Author(s):  
Paul Douglas Wesson ◽  
Rajatashuvra Adhikary ◽  
Anna Jonas ◽  
Krysta Gerndt ◽  
Ali Mirzazadeh ◽  
...  
Keyword(s):  
Population Size ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Respondent Driven Sampling ◽  
Double Counting ◽  
Size Estimation ◽  
Tracking Method ◽  
Female Sex ◽  
Population Size Estimates ◽  
Size Estimates

BACKGROUND Key populations, including female sex workers (FSWs), are at a disproportionately high risk for HIV infection. Estimates of the size of these populations serve as denominator data to inform HIV prevention and treatment programming and are necessary for the equitable allocation of limited public health resources. OBJECTIVE This study aimed to present the respondent-driven sampling (RDS) adjusted reverse tracking method (RTM; RadR), a novel population size estimation approach that combines venue mapping data with RDS data to estimate the population size, adjusted for double counting and nonattendance biases. METHODS We used data from a 2014 RDS survey of FSWs in Windhoek and Katima Mulilo, Namibia, to demonstrate the RadR method. Information from venue mapping and enumeration from the survey formative assessment phase were combined with survey-based venue-inquiry questions to estimate population size, adjusting for double counting, and FSWs who do not attend venues. RadR estimates were compared with the official population size estimates, published by the Namibian Ministry of Health and Social Services (MoHSS), and with the unadjusted RTM. RESULTS Using the RadR method, we estimated 1552 (95% simulation interval, SI, 1101-2387) FSWs in Windhoek and 453 (95% SI: 336-656) FSWs in Katima Mulilo. These estimates were slightly more conservative than the MoHSS estimates—Windhoek: 3000 (1800-3400); Katima Mulilo: 800 (380-2000)—though not statistically different. We also found 75 additional venues in Windhoek and 59 additional venues in Katima Mulilo identified by RDS participants’ responses that were not detected during the initial mapping exercise. CONCLUSIONS The RadR estimates were comparable with official estimates from the MoHSS. The RadR method is easily integrated into RDS studies, producing plausible population size estimates, and can also validate and update key population maps for outreach and venue-based sampling.

scholarly journals Population Size Estimation of Gay and Bisexual Men and Other Men Who Have Sex With Men Using Social Media-Based Platforms (Preprint)

2017 ◽  
Author(s):  
Stefan Baral ◽  
Rachael M Turner ◽  
Carrie E Lyons ◽  
Sean Howell ◽  
Brian Honermann ◽  
...  
Keyword(s):  
Social Media ◽  
Hiv Prevention ◽  
Population Size ◽  
The United States ◽  
Size Estimation ◽  
Same Sex ◽  
Care Needs ◽  
Population Size Estimates ◽  
Sex With Men ◽  
Size Estimates

BACKGROUND Gay, bisexual, and other cisgender men who have sex with men (GBMSM) are disproportionately affected by the HIV pandemic. Traditionally, GBMSM have been deemed less relevant in HIV epidemics in low- and middle-income settings where HIV epidemics are more generalized. This is due (in part) to how important population size estimates regarding the number of individuals who identify as GBMSM are to informing the development and monitoring of HIV prevention, treatment, and care programs and coverage. However, pervasive stigma and criminalization of same-sex practices and relationships provide a challenging environment for population enumeration, and these factors have been associated with implausibly low or absent size estimates of GBMSM, thereby limiting knowledge about the dynamics of HIV transmission and the implementation of programs addressing GBMSM. OBJECTIVE This study leverages estimates of the number of members of a social app geared towards gay men (Hornet) and members of Facebook using self-reported relationship interests in men, men and women, and those with at least one reported same-sex interest. Results were categorized by country of residence to validate official size estimates of GBMSM in 13 countries across five continents. METHODS Data were collected through the Hornet Gay Social Network and by using an a priori determined framework to estimate the numbers of Facebook members with interests associated with GBMSM in South Africa, Ghana, Nigeria, Senegal, Côte d'Ivoire, Mauritania, The Gambia, Lebanon, Thailand, Malaysia, Brazil, Ukraine, and the United States. These estimates were compared with the most recent Joint United Nations Programme on HIV/AIDS (UNAIDS) and national estimates across 143 countries. RESULTS The estimates that leveraged social media apps for the number of GBMSM across countries are consistently far higher than official UNAIDS estimates. Using Facebook, it is also feasible to assess the numbers of GBMSM aged 13-17 years, which demonstrate similar proportions to those of older men. There is greater consistency in Facebook estimates of GBMSM compared to UNAIDS-reported estimates across countries. CONCLUSIONS The ability to use social media for epidemiologic and HIV prevention, treatment, and care needs continues to improve. Here, a method leveraging different categories of same-sex interests on Facebook, combined with a specific gay-oriented app (Hornet), demonstrated significantly higher estimates than those officially reported. While there are biases in this approach, these data reinforce the need for multiple methods to be used to count the number of GBMSM (especially in more stigmatizing settings) to better inform mathematical models and the scale of HIV program coverage. Moreover, these estimates can inform programs for those aged 13-17 years; a group for which HIV incidence is the highest and HIV prevention program coverage, including the availability of pre-exposure prophylaxis (PrEP), is lowest. Taken together, these results highlight the potential for social media to provide comparable estimates of the number of GBMSM across a large range of countries, including some with no reported estimates.

scholarly journals Estimating the Size of Key Populations in Kampala, Uganda: 3-Source Capture-Recapture Study (Preprint)

2018 ◽  
Author(s):  
Reena H Doshi ◽  
Kevin Apodaca ◽  
Moses Ogwal ◽  
Rommel Bain ◽  
Ermias Amene ◽  
...  
Keyword(s):  
Population Size ◽  
Latent Class ◽  
Latent Class Model ◽  
Key Populations ◽  
Size Estimation ◽  
Public Health Response ◽  
Hiv Epidemic ◽  
Population Size Estimates ◽  
Capture Recapture ◽  
Size Estimates

BACKGROUND Key populations, including people who inject drugs (PWID), men who have sex with men (MSM), and female sex workers (FSW), are disproportionately affected by the HIV epidemic. Understanding the magnitude of, and informing the public health response to, the HIV epidemic among these populations requires accurate size estimates. However, low social visibility poses challenges to these efforts. OBJECTIVE The objective of this study was to derive population size estimates of PWID, MSM, and FSW in Kampala using capture-recapture. METHODS Between June and October 2017, unique objects were distributed to the PWID, MSM, and FSW populations in Kampala. PWID, MSM, and FSW were each sampled during 3 independent captures; unique objects were offered in captures 1 and 2. PWID, MSM, and FSW sampled during captures 2 and 3 were asked if they had received either or both of the distributed objects. All captures were completed 1 week apart. The numbers of PWID, MSM, and FSW receiving one or both objects were determined. Population size estimates were derived using the Lincoln-Petersen method for 2-source capture-recapture (PWID) and Bayesian nonparametric latent-class model for 3-source capture-recapture (MSM and FSW). RESULTS We sampled 467 PWID in capture 1 and 450 in capture 2; a total of 54 PWID were captured in both. We sampled 542, 574, and 598 MSM in captures 1, 2, and 3, respectively. There were 70 recaptures between captures 1 and 2, 103 recaptures between captures 2 and 3, and 155 recaptures between captures 1 and 3. There were 57 MSM captured in all 3 captures. We sampled 962, 965, and 1417 FSW in captures 1, 2, and 3, respectively. There were 316 recaptures between captures 1 and 2, 214 recaptures between captures 2 and 3, and 235 recaptures between captures 1 and 3. There were 109 FSW captured in all 3 rounds. The estimated number of PWID was 3892 (3090-5126), the estimated number of MSM was 14,019 (95% credible interval (CI) 4995-40,949), and the estimated number of FSW was 8848 (95% CI 6337-17,470). CONCLUSIONS Our population size estimates for PWID, MSM, and FSW in Kampala provide critical population denominator data to inform HIV prevention and treatment programs. The 3-source capture-recapture is a feasible method to advance key population size estimation.

scholarly journals Assessing Bias in Population Size Estimates Among Hidden Populations When Using the Service Multiplier Method Combined With Respondent-Driven Sampling Surveys: Survey Study

10.2196/15044 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e15044
Author(s):  
Sungai T Chabata ◽  
Elizabeth Fearon ◽  
Emily L Webb ◽  
Helen A Weiss ◽  
James R Hargreaves ◽  
...  
Keyword(s):  
Population Size ◽  
Sex Workers ◽  
Multiplier Method ◽  
Survey Study ◽  
Respondent Driven Sampling ◽  
Size Estimation ◽  
Hidden Populations ◽  
Increased Risk ◽  
Population Size Estimates ◽  
Size Estimates

Background Population size estimates (PSEs) for hidden populations at increased risk of HIV, including female sex workers (FSWs), are important to inform public health policy and resource allocation. The service multiplier method (SMM) is commonly used to estimate the sizes of hidden populations. We used this method to obtain PSEs for FSWs at 9 sites in Zimbabwe and explored methods for assessing potential biases that could arise in using this approach. Objective This study aimed to guide the assessment of biases that arise when estimating the population sizes of hidden populations using the SMM combined with respondent-driven sampling (RDS) surveys. Methods We conducted RDS surveys at 9 sites in late 2013, where the Sisters with a Voice program (the program), which collects program visit data of FSWs, was also present. Using the SMM, we obtained PSEs for FSWs at each site by dividing the number of FSWs who attended the program, based on program records, by the RDS-II weighted proportion of FSWs who reported attending this program in the previous 6 months in the RDS surveys. Both the RDS weighting and SMM make a number of assumptions, potentially leading to biases if the assumptions are not met. To test these assumptions, we used convergence and bottleneck plots to assess seed dependence of RDS-II proportion estimates, chi-square tests to assess if there was an association between the characteristics of FSWs and their knowledge of program existence, and logistic regression to compare the characteristics of FSWs attending the program with those recruited to RDS surveys. Results The PSEs ranged from 194 (95% CI 62-325) to 805 (95% CI 456-1142) across 9 sites from May to November 2013. The 95% CIs for the majority of sites were wide. In some sites, the RDS-II proportion of women who reported program use in the RDS surveys may have been influenced by the characteristics of selected seeds, and we also observed bottlenecks in some sites. There was no evidence of association between characteristics of FSWs and knowledge of program existence, and in the majority of sites, there was no evidence that the characteristics of the populations differed between RDS and program data. Conclusions We used a series of rigorous methods to explore potential biases in our PSEs. We were able to identify the biases and their potential direction, but we could not determine the ultimate direction of these biases in our PSEs. We have evidence that the PSEs in most sites may be biased and a suggestion that the bias is toward underestimation, and this should be considered if the PSEs are to be used. These tests for bias should be included when undertaking population size estimation using the SMM combined with RDS surveys.

scholarly journals Perspectives of Brothel Leaders and HIV Prevention Experts on the Role of Gatekeepers on Improving Condom Use by Female Sex Workers in Abuja, Nigeria

2017 ◽  
Vol 9 (10) ◽  
pp. 183
Author(s):  
Uchenna O. Okafor ◽  
Rik Crutzen ◽  
Egbe A. Awo ◽  
Bart Van Den Borne
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Consistent Condom ◽  
Sociocultural Factors ◽  
Access To Health Services ◽  
Female Sex ◽  
Hiv Prevention Strategies

A qualitative study using in-depth interviews explored the perceptions and views of brothel leaders and HIV program experts on the acceptability and adoptability of using gatekeepers in interventions aimed at improving Female Sex Workers’ (FSWs) condom use in Nigeria. Brothel leaders are an influential group within the FSWs’ social and physical environment and their attitudes, beliefs and actions can influence the immediate brothel environment and the adoption of interventions within the brothel. HIV prevention experts make key decisions on the content and strategies adopted for HIV prevention efforts and also influence the design and implementation of HIV prevention strategies within programs. Four themes illustrating the benefits and barriers of the inclusion of gatekeepers within the immediate environment of the FSW were identified. Results show that brothel leadership inclusion in HIV prevention efforts could exert potential positive influence on the immediate brothel environment. Brothel leaders can support the institution of establishment policies supporting consistent condom use by the FSWs, promotion of HIV awareness, resolution of conflicts and harassments, support to new entrants into sex work and the reinforcement of protective behaviors among the FSWs. The decriminalization of sex work and the inclusion of gatekeepers support into country HIV program guidelines may contribute to mitigating prevalent sociocultural factors limiting FSWs’ rights as well as their access to health services. The present study provides insights into the potential positive roles of brothel leaders in improving condom use and other HIV/AIDs related interventions for brothel based FSWs in Abuja, Nigeria from the perspective of brothel leaders and HIV prevention experts.

scholarly journals Key Populations in Sub-Saharan Africa: Population Size Estimates and High Risk Behaviors

2014 ◽  
Vol 19 (S1) ◽  
pp. 1-2 ◽  
Author(s):  
Abu S. Abdul-Quader ◽  
Eleanor Gouws-Williams ◽  
Sheila Tlou ◽  
Linda Wright-De Agüero ◽  
Richard Needle
Keyword(s):  
High Risk ◽  
Population Size ◽  
Risk Behaviors ◽  
Sub Saharan Africa ◽  
Key Populations ◽  
High Risk Behaviors ◽  
Population Size Estimates ◽  
Sub Saharan ◽  
Size Estimates

scholarly journals Estimating the Size of Key Populations in Kampala, Uganda: 3-Source Capture-Recapture Study

10.2196/12118 ◽  
2019 ◽  
Vol 5 (3) ◽  
pp. e12118 ◽  
Author(s):  
Reena H Doshi ◽  
Kevin Apodaca ◽  
Moses Ogwal ◽  
Rommel Bain ◽  
Ermias Amene ◽  
...  
Keyword(s):  
Population Size ◽  
Latent Class ◽  
Latent Class Model ◽  
Key Populations ◽  
Size Estimation ◽  
Public Health Response ◽  
Hiv Epidemic ◽  
Population Size Estimates ◽  
Capture Recapture ◽  
Size Estimates

Background Key populations, including people who inject drugs (PWID), men who have sex with men (MSM), and female sex workers (FSW), are disproportionately affected by the HIV epidemic. Understanding the magnitude of, and informing the public health response to, the HIV epidemic among these populations requires accurate size estimates. However, low social visibility poses challenges to these efforts. Objective The objective of this study was to derive population size estimates of PWID, MSM, and FSW in Kampala using capture-recapture. Methods Between June and October 2017, unique objects were distributed to the PWID, MSM, and FSW populations in Kampala. PWID, MSM, and FSW were each sampled during 3 independent captures; unique objects were offered in captures 1 and 2. PWID, MSM, and FSW sampled during captures 2 and 3 were asked if they had received either or both of the distributed objects. All captures were completed 1 week apart. The numbers of PWID, MSM, and FSW receiving one or both objects were determined. Population size estimates were derived using the Lincoln-Petersen method for 2-source capture-recapture (PWID) and Bayesian nonparametric latent-class model for 3-source capture-recapture (MSM and FSW). Results We sampled 467 PWID in capture 1 and 450 in capture 2; a total of 54 PWID were captured in both. We sampled 542, 574, and 598 MSM in captures 1, 2, and 3, respectively. There were 70 recaptures between captures 1 and 2, 103 recaptures between captures 2 and 3, and 155 recaptures between captures 1 and 3. There were 57 MSM captured in all 3 captures. We sampled 962, 965, and 1417 FSW in captures 1, 2, and 3, respectively. There were 316 recaptures between captures 1 and 2, 214 recaptures between captures 2 and 3, and 235 recaptures between captures 1 and 3. There were 109 FSW captured in all 3 rounds. The estimated number of PWID was 3892 (3090-5126), the estimated number of MSM was 14,019 (95% credible interval (CI) 4995-40,949), and the estimated number of FSW was 8848 (95% CI 6337-17,470). Conclusions Our population size estimates for PWID, MSM, and FSW in Kampala provide critical population denominator data to inform HIV prevention and treatment programs. The 3-source capture-recapture is a feasible method to advance key population size estimation.

scholarly journals Assessing Bias in Population Size Estimates Among Hidden Populations When Using the Service Multiplier Method Combined With Respondent-Driven Sampling Surveys: Survey Study (Preprint)

2019 ◽  
Author(s):  
Sungai T Chabata ◽  
Elizabeth Fearon ◽  
Emily L Webb ◽  
Helen A Weiss ◽  
James R Hargreaves ◽  
...  
Keyword(s):  
Population Size ◽  
Sex Workers ◽  
Multiplier Method ◽  
Survey Study ◽  
Respondent Driven Sampling ◽  
Size Estimation ◽  
Hidden Populations ◽  
Increased Risk ◽  
Population Size Estimates ◽  
Size Estimates

BACKGROUND Population size estimates (PSEs) for hidden populations at increased risk of HIV, including female sex workers (FSWs), are important to inform public health policy and resource allocation. The service multiplier method (SMM) is commonly used to estimate the sizes of hidden populations. We used this method to obtain PSEs for FSWs at 9 sites in Zimbabwe and explored methods for assessing potential biases that could arise in using this approach. OBJECTIVE This study aimed to guide the assessment of biases that arise when estimating the population sizes of hidden populations using the SMM combined with respondent-driven sampling (RDS) surveys. METHODS We conducted RDS surveys at 9 sites in late 2013, where the Sisters with a Voice program (the program), which collects program visit data of FSWs, was also present. Using the SMM, we obtained PSEs for FSWs at each site by dividing the number of FSWs who attended the program, based on program records, by the RDS-II weighted proportion of FSWs who reported attending this program in the previous 6 months in the RDS surveys. Both the RDS weighting and SMM make a number of assumptions, potentially leading to biases if the assumptions are not met. To test these assumptions, we used convergence and bottleneck plots to assess seed dependence of RDS-II proportion estimates, chi-square tests to assess if there was an association between the characteristics of FSWs and their knowledge of program existence, and logistic regression to compare the characteristics of FSWs attending the program with those recruited to RDS surveys. RESULTS The PSEs ranged from 194 (95% CI 62-325) to 805 (95% CI 456-1142) across 9 sites from May to November 2013. The 95% CIs for the majority of sites were wide. In some sites, the RDS-II proportion of women who reported program use in the RDS surveys may have been influenced by the characteristics of selected seeds, and we also observed bottlenecks in some sites. There was no evidence of association between characteristics of FSWs and knowledge of program existence, and in the majority of sites, there was no evidence that the characteristics of the populations differed between RDS and program data. CONCLUSIONS We used a series of rigorous methods to explore potential biases in our PSEs. We were able to identify the biases and their potential direction, but we could not determine the ultimate direction of these biases in our PSEs. We have evidence that the PSEs in most sites may be biased and a suggestion that the bias is toward underestimation, and this should be considered if the PSEs are to be used. These tests for bias should be included when undertaking population size estimation using the SMM combined with RDS surveys.

Estimating the population size of people who inject drugs in Ho Chi Minh City, Vietnam: A two-survey capture-recapture exercise (Preprint)

2019 ◽  
Author(s):  
Abu Abdul-Quader
Keyword(s):  
Population Size ◽  
Illicit Drugs ◽  
People Who Inject Drugs ◽  
Care Service ◽  
Ho Chi Minh City ◽  
Size Estimation ◽  
Population Size Estimates ◽  
Capture Recapture ◽  
The City ◽  
Size Estimates

BACKGROUND Population size estimation of people who inject drugs (PWID) in Ho Chi Minh City (HCMC), Vietnam relied on the UNAIDS Estimation and Projection Package and reports from the city police department. The two estimates vary widely. OBJECTIVE To estimate the population size of people who inject drugs in Ho Chi Minh City, Vietnam METHODS Using Respondent-driven sampling (RDS), we implemented two-source capture-recapture method to estimate the population size of PWID in HCMC in 2017 in 7 out of 24 districts. The study included men or women aged at least 18 years who reported injecting illicit drugs in the last 90 days and who had lived in the city the past six months. We calculated two sets of size estimates, the first assumed that all participants in each survey round resided in the district where the survey was conducted, the second, used the district of residence as reported by the participant. District estimates were summed to obtain an aggregate estimate for the seven districts. To calculate the city total, we weighted the population size estimates for each district by the inverse of the stratum specific sampling probabilities. RESULTS The first estimate resulted in a population size of 19,155 (95% CI: 17,006–25,039). The second one generated a smaller population size estimate of 12,867 (95% CI: 11,312–17,393). CONCLUSIONS The two-survey capture-recapture exercise provided two disparate estimates of PWID in HCMC. For planning HIV prevention and care service needs among PWID in HCMC, both estimates may need to be taken into consideration together with size estimates from other sources.

scholarly journals Integrating syphilis screening in a large-scale HIV prevention program for key populations: the Avahan experience from India

2013 ◽  
Vol 7 (06) ◽  
pp. 484-488 ◽  
Author(s):  
Mugundu Ramien Parthasarathy ◽  
Prakash Narayanan ◽  
Anjana Das ◽  
Anup Gurung ◽  
Parimi Prabhakar ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Prevention Program ◽  
Large Scale ◽  
Point Of Care ◽  
Key Populations ◽  
Immunochromatographic Strip ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Syphilis Screening ◽  
Strip Test

Introduction: Documented experiences from India on the implementation of syphilis screening in large-scale HIV prevention programs for “key populations at higher risk’ (KPs) are limited. Avahan is a large-scale HIV prevention program providing services to more than 300,000 KPs in six high HIV prevalence states of India since 2004. Avahan clinics provide a sexually transmitted infection service package which includes bi-annual syphilis screening. The trends in the coverage of syphilis screening among Avahan clinic attendees were studied retrospectively. Methodology: Screening was performed using either the Rapid Plasma Reagin (RPR) test or point-of-care immunochromatographic strip test (ICST). Clinic records from 2005 to 2009 were collated in an individual tracking database and analyzed with STATA-10. Results: Initially the coverage of syphilis screening (2.6% in 2005) was constrained by the availability and operational complexity of the RPR test. After its introduction in 2007, the use of ICST for screening increased from 7.4% to 77.0% and the proportion of clinic attendees screened increased from 9.0% to 21.6% during 2007-2009. The RPR reactivity rates declined from 6.6% (2006) to 4.4% (2009). Conclusion: The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

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