HIV Combination prevention: Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia (2018 progress report)

Technical report
Publication series: Monitoring Implementation of the Dublin Declaration
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European Centre for Disease Prevention and Control. HIV: Combination prevention. Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia: 2018 progress report. Stockholm: ECDC; 2020.

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HIV combination prevention is an approach that brings together single prevention initiatives into a comprehensive programme. This approach considers that the offer of multiple evidence-based interventions in a comprehensive programme will have a greater impact on HIV transmission than investing in a single strategy. In this report we
present and test the feasibility of a novel approach to monitoring the implementation of combination HIV prevention at national level.

Executive summary

This report uses survey data collected from countries who took part in the 2018 round of reporting on implementation of the Dublin Declaration on Partnership to Fight HIV & AIDS in Europe and Central Asia (known as ‘Dublin Declaration’ data). Eleven indicators were considered, using information reported through the Dublin Declaration survey on condoms, PrEP, HIV testing, ART coverage, viral suppression and sexual and relationship education. Data availability was assessed together with an analysis of whether each target was met. Three indicators were excluded due to the lack of specific targets.

Overall, 42 of 52 countries could provide enough indicators, regardless of the outcome, to enable the metric of combination prevention to be used to evaluate their response to the HIV epidemic. A total of five were categorised as having evidence of combination prevention implementation, 15 as has having some evidence and 22 as having partial evidence. However, high levels of missing data mean that these baseline measurements should be interpreted cautiously. Furthermore, the indicators selected may not be equivalent in terms of impact, or evenly applied at sub-national level. The specific indicators and targets included in this approach must be further developed and can be adapted to particular settings, or as epidemics evolve.