The Maryland Department of Health (MDH), Prevention and Health Promotion
Administration (PHPA) is requesting $1,368,262 in year one and a total of $6,602,996 over five years from the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC) to implement National HIV Behavioral Surveillance (NHBS) in the Baltimore-Columbia-Towson, Maryland metropolitan area. NHBS is an anonymous bio-behavioral surveillance activity which focuses on recruiting populations that are overburdened with HIV infection: Men who have sex with men (MSM), people who inject drugs (PWID), and heterosexually active persons at increased risk (HET). This project will consist of a series of five cross-sectional surveys using the same interview instrument, which will recruit
each of the above risk populations (MSM in years 2 and 5, PWID in years 1 and 3, HET in year 4). The proposed sample size is an annual minimum of 500 participants.
The proposed activity will include a detailed questionnaire to gather information on
demographics, sexual and drug use behaviors, HIV testing, and utilization of local HIV prevention program services. The questionnaire will be standardized nationally, with the addition of a limited number of questions specific to Baltimore. The study will also offer anonymous HIV testing, utilizing FDA approved HIV diagnostic tests, and collect specimens for additional future testing.
The sampling and recruitment methodologies will be selected as appropriate for each of the target populations and are developed in collaboration with the CDC. Recruitment methods include venue-based sampling (VBS), respondent-driven sampling (RDS), and other CDC-approved sampling methodologies. In VBS, day-time recruitment periods at public venues (e.g., bars, clubs, etc.) in Baltimore City will be randomly sampled and participants will be systematically approached for recruitment. In RDS, initial participants will be recruited through community key informants and then be trained to recruit additional members of their population
group. Successive waves of recruits will be trained to recruit additional participants.
Supplemental funding for optional populations and activities is requested to develop
methods for and then recruit transgender women during years 1 and 2 (300 participants), to develop methods for and then recruit women who engage in exchange sex (WES) during years 1 through 3 (300 participants), to perform anonymous gonorrhea and chlamydia testing for MSM recruits during years 2 and 5, HET recruits during year 4, transgender women recruits during year 2, and WES recruits during year 3, and to perform anonymous hepatitis B and C testing for
PWID recruits during years 1 and 3, transgender women recruits during year 2, and WES recruits during year 3.
Implementing NHBS will produce valuable information for measuring HIV risk
behaviors, for planning and targeting HIV prevention activities in Maryland, and for producing national estimates of HIV risk behaviors in populations overburdened by HIV in the most affected regions of the country.