The Maryland Department of Health (MDH), Prevention and Health Promotion Administration (PHPA) is requesting $783,674 in year one and a total of $2,993,958 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 3). 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. Recruit 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 participant 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 risk 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 to perform anonymous gonorrhea and chlamydia testing for MSM recruits during years 2 and 5 and HET 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 high-risk populations in the most affected regions of the country.