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National Behavioral Surveillance: Health Information Survey (H.I.S.); Web Survey

In collaboration with the Behavioral and Clinical Surveillance Branch, Division of HIV/AIDS Prevention, participating state and local health departments and other institutions will conduct national behavioral surveillance of men who have sex with men (NBS-MSM) on a biannual basis using a venue-based, time-space sampling method (1-3). Excluding the first surveillance period, for each alternate 12-month period that NBS-MSM is conducted, a period not to exceed 3 months will be used to hire and train staff, conduct formative research, and obtain requisite community support to conduct surveillance. The remaining 9 months will be used to sample and interview MSM in accordance with this national protocol. In the first surveillance period, sites will have 12 months to interview a minimum of 500 MSM > 18 years of age. Sampling will begin no later than September 1, 2003 and end no later than August 31, 2004. Participants will undergo a behavioral interview, receive monetary compensation for their participation, and obtain referrals for HIV prevention counseling and testing, case management, or medical care as needed. The behavioral interview will assess sexual, drug-use, and HIV/STD testing and other prevention-service-utilization behaviors with both standard and site-specific measures.

Background

Based on a review in June 1999 of national HIV prevention program gaps, CDC’s Advisory Committee for HIV and STD Prevention and other external experts called for the development of a national plan for HIV/AIDS prevention. In 2000, CDC in collaboration with representatives from state and local health departments, academic institutions, and clinical and prevention entities initiated a strategic planning process that culminated in the development of CDC’s HIV Prevention Strategic Plan Through 2005 (4). As part of this plan, four national goals were identified to reduce by half the annual number of new HIV infections in the United States. One of the four identified goals is to strengthen the national capacity to monitor the HIV epidemic to better direct and evaluate prevention efforts (4). As an initial step to meet this goal, in 2002 CDC awarded approximately $6 million in supplemental funds to state and local health departments to develop and implement a surveillance system to monitor behaviors that place people at risk for HIV infection. Eligible awardees included those health departments whose jurisdictions include the 15 metropolitan statistical areas that had the highest number of people living with AIDS in 1999. As stipulated in the award, populations targeted initially for behavioral surveillance include men who have sex with men (MSM) and injection drug users (IDUs). This document describes methods awardees will use to conduct national surveillance of HIV risk, testing, and prevention behaviors of MSM.

The History of H.I.S.man & the Health Information Survey (H.I.S.) A survey for men who like men.

The University of Texas Southwestern Medical Center at Dallas is conducting an HIV/AIDS behavioral survey at venues frequented by gay and bisexual men in Dallas County. In collaboration with the Centers for Disease Control and Prevention  and the Texas Department of Health , the Health Information Survey (H.I.S.) will examine HIV risk behaviors and measure the prevalence and incidence of HIV in the gay and bisexual community. H.I.S will collect relevant behavioral data to improve HIV prevention services in Dallas and other jurisdictions nationwide.

H.I.S. follows in the footsteps of a previous UT Southwestern Medical Center study conducted with gay and bisexual men between 1994 and 2000 called the Young Men’s Survey (YMS). YMS’s objectives were to assess HIV prevalence and risk behaviors among men who have sex with men ages 15 to 29. In addition, the survey explored potential factors that influence HIV risk taking.

Infection rates for HIV and hepatitis B (HBV) were found to be high in the target populations. Overall prevalence rates were 12% for HIV, 16% for HBV, and 2% for syphilis. Infection rates rose sharply with age, with rates being much higher among 27 to 29 year olds than among 15 to 17 year olds. African Americans had the highest rates of infection, up to 3 times the rates of Non-Hispanic Whites for HIV and twice the rate of HBV infection. While many of the young men were clearly at increased risk for HIV, personal perception of risk and knowledge of current infection were low.

The Health Information Survey (H.I.S.) retains many of the same data collection methods as YMS. The H.I.S. team is talking with businesses and organizations about H.I.S. in advance of the survey beginning.  Much of the visible work involves recruiting participants through street intercepts.   Over the years, you may have seen the YMS staff recruiting for the survey. You may also have noticed our recreational vehicle parked at local bars and street locations. The surveys, blood draws, and HIV counseling take place in the RV. The H.I.S. team will work in public areas as unobtrusively as possible.

To provide visibility and aid with recruitment efforts, the HISman character was created to appeal to the gay and bisexual community. HISman is our fictional superhero out to save men from the evils of Dr. No. HISman has made debut appearances at GayBingo and marketing materials can been found at serveral community events such as: Dallas Outakes, AIDS LifeWalk, Texas Gay Rodeo Association, etc. Throughout the year the HISman comic series can be found featured in the Dallas Voice.

H.I.S. will begin sampling in December of 2003 and attempt to recruit approximately 1,200 men through December 2004. All H.I.S. staff will have UT Southwestern Medical Center identification and will often be wearing a T-shirt or sweatshirt bearing our H.I.S. logo.The information we will gain is important in our fight against the continuing spread of HIV in the gay and bisexual community, both locally and across the nation.

How to sign up and participate in the Health Information Survey (H.I.S.)

H.I.S. is a 20-25 minute interviewer administered questionnaire. Participants are asked questions regarding sexual behavior, drug use behavior, access to HIV prevention services and health care. Participants are paid $25 for their time. The survey is completely anonymous and will not contain any identifiable information. Those surveyed will have the opportunity to test for HIV. Those who choose to test for HIV will be paid an additional $25 to have blood drawn. (Completion of both elements means $50 cash!) Those who are tested will be encouraged to get their results.

There are a couple of ways participants are recruited into the study. Once a venue is identified as a possible site where gay or bisexual men meet or socialize, the owner, manager, or leader of the establishment or social organizaiton  is contacted by a member of the HIS staff. HIS staff will discuss the purpose of the study and ask for permission to recruit patrons of their establishment or group. Once permission is granted, the establishment, or social organization will be known as a community partner and placed onto the approved venues list.

Each month, 20 community partners are randomly selected from the list and scheduled to be visited once throughout the month.  A patron visiting one of those venues during a site visit may be approached by the HIS staff.  If approached, a participant will be given a 10 second survey to determine eligibility. They must be 18 years or older, a Dallas area resident, and not a previous participant of the study. If the participant is recruited at a venue such as a club or park, they will have the opportunity to complete the survey that same day. HIS staff will have a 28ft RV nearby with interviewers ready to administer the survey.

If a participant is approached at a venue such as a social organization (church, school, and some sport) participants will be asked to set up an "other day appointment". Our team does not wish to interfere with a meeting or a game. Therefore, after eligibility is determined, HIS staff will ask participants to provide contact information and to commit to an appointment date for completion of their survey. The HIS staff will frequently have a 28ft RV parked at the fire station on Cedar Springs Rd. The participant will then be asked to meet the HIS staff at the RV on their appointed date and time. If a participant is unable to meet HIS staff at the RV, they will have the opportunity to complete their survey at: 1) A public location which is convenient to the participant, such as a cofee shop, a library, etc. 2) In our office Monday through Friday between 9am and 5pm.

20 major cities around the US are currently involved in the same study. If you are approached to participate in this study, we hope you will participate. Your information is very important and will help the gay community of Dallas. The HIS staff would like to thank you for your consideration and support. For futher information, to see the latest HISman comics featured in the Dallas Voice, or to meet the meet the members of the HIS team, please visit the official HISman website or call (214) 645-7322.

Web Survey

Under Construction. Please come again soon.

Community Prevention & Intervention Unit

HIV Epidemiology Research and Behavioral Studies (H.E.R.B.S.)

400 S. Zang Blvd. Suite 520 Dallas, Texas 75208

(214) 645-7300 Office  (210) 645-7303 Fax