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Evaluation of the National HIV Behavioral Surveillance System Among Men Who Have Sex with Men in Denver, Colorado

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Abstract

Denver Public Health implements the National HIV Behavioral Surveillance System (NHBS), a cyclical survey of populations at increased risk for HIV. We evaluated the implementation of NHBS among Denver men who have sex with men (MSM), considering the system’s simplicity, data quality, representativeness, and sensitivity to trends. We found that the time required for implementation and the complexity of data management and analysis are barriers to disseminating local findings. Data quality has improved in each cycle of the study but must be protected by continually checking for errors and training field staff to be attentive to detail. Compared with the US census and other convenience samples of Denver MSM, the overall demographic representativeness of NHBS has improved over time. However, there is concern that the underlying population included in the study may be changing. NHBS survey data show evidence of two suspected trends in the local MSM population at risk for HIV: increasing sexual risk-taking and the transition away from bars as a dominant partner-finding location. It is unclear whether the increasing reports of sexual risk-taking reflect a real trend or simply a change in the population sampled, since most NHBS participants are recruited at gay bars and other venues. To ensure that the sample continues to represent the underlying population at risk and accurately identify trends, it is necessary to closely monitor MSM sample characteristics during implementation and incorporate weighted data provided by the Centers for Disease Control and Prevention into analyses.

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Acknowledgments

This report was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 5U38HM000414-5. The authors gratefully acknowledge Jason Haukoos, Emily Caruso, and Christie Mettenbrink for their assistance in obtaining additional data sources for comparison. The authors thank Charles Chen, Toby LeRoux, Theresa Mickiewicz, and the Denver NHBS interviewers for their tireless efforts in collecting this important data. We also thank the community members and stakeholders who so generously gave of their time to provide their insights to inform this evaluation.

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Authors and Affiliations

  1. Denver Public Health, 605 Bannock St, Denver, CO, 80204, USA

    Kathryn H. DeYoung, Alia Al-Tayyib & Mark Thrun

  2. Department of Epidemiology, Colorado School of Public Health, Denver, CO, USA

    Alia Al-Tayyib

  3. Division of Infectious Diseases, Department of Medicine, University of Colorado Denver School of Medicine, Denver, CO, USA

    Mark Thrun

Authors
  1. Kathryn H. DeYoung
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  2. Alia Al-Tayyib
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Correspondence to Alia Al-Tayyib.

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DeYoung, K.H., Al-Tayyib, A. & Thrun, M. Evaluation of the National HIV Behavioral Surveillance System Among Men Who Have Sex with Men in Denver, Colorado. J Community Health 40, 291–300 (2015). https://doi.org/10.1007/s10900-014-9933-8

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  • DOI: https://doi.org/10.1007/s10900-014-9933-8

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