ICAP Swaziland HIV Incidence Measurement Survey

ICAP, a global health leader situated at Columbia University, has worked since 2003 with one central goal: to improve the health of families and communities.

ICAP was responsible for the Swaziland HIV incidence measurement survey (SHIMS), a multi-phased study that measures HIV prevalence and incidence in a household-based, nationally representative sample of men and women ages 18-49,  before and after the scale-up of Soka Uncobe in the context of other HIV combination prevention programs.

From December 2010 through June 2011, participants were enrolled in a pre-cohort survey (T1) throughout the four regions of Swaziland. Approximately six months after recruitment, a follow-up survey (T2) was conducted among those HIV negative in the pre-cohort survey to estimate HIV incidence.

Epicentre’s responsibilities included:

  • Recruitment and training of survey teams. Trainings included modules on interviewer techniques, conducting informed consent for study participation, use of survey instruments, HIV testing and counselling, and human research ethics.
  • Survey teams approached sampled households to identify the head of household and to seek his/her permission to conduct a census of household members.
  • All household members who satisfied study inclusion criteria were asked about their interest in study participation, and if so, were asked to provide informed consent. If an eligible household member was not at home, at least three follow-up visits were conducted to obtain contact.
  • Standardized questionnaires were administered at T1 and at T2. The questionnaires included interviewer-administered questions about demographics, and clinical and behavioural factors, including sexual history and self-reported male circumcision status.
  • Blood draws were administered to conduct home-based, HIV counselling and rapid testing.
  • Pre-cohort survey participants who tested HIV-negative were asked about their interest to enrol in the cohort, and if so, study staff obtained informed consent.
  • To help ensure high study retention, cohort participants received an interim phone call three months after enrolment to confirm residence and other contact information. A second phone call was conducted six months after enrolment for appointment scheduling. Additionally, at least three visit attempts were made to complete cohort follow-up interviews.

The effort Epicentre put in resulted in a very high uptake rate of the survey: out of a total of 24 484 eligible pre-cohort participants, 18 169 (74.2%) participated and even 11 927 out of 12 025 (99.2%) of HIV negative pre cohort participants took part in the second survey.

The publication that resulted from this study can be downloaded here