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Background: In the Enhanced Comprehensive HIV Prevention Planning (ECHPP) project (2010-2013), health departments in 12 U.S. cities with high AIDS burden were funded to implement a high-impact prevention approach. Grantees enhanced local efforts to affect the epidemic, including improved STD screening for HIV-positive persons. The ECHPP evaluation team analyzes process, outcome, and impact indicators for these cities from existing data sources, using a data triangulation approach to obtain a comprehensive picture of the epidemic and the public health response in these areas. Lessons learned from this evaluation approach may inform STD program monitoring/evaluation activities.
Methods: During the development of the ECHPP evaluation, several STD-related process, outcome, and impact indicators were created. Additionally, challenges regarding data availability gaps were encountered (e.g., data sources not available in all 12 areas, survey questions not asked in the desired way and survey questions not consistent across evaluation years).
Results: Process indicator-data related to STD screenings can be used to monitor implementation of STD screening guidelines. Outcomes reported for priority populations living in these cities can be used to assess trends in risk behaviors and service uptake. Surveillance data can be used to monitor changes in disease burden, assess program impact, and identify areas with large numbers of co-infected individuals to help prioritize areas for prevention efforts. Data gaps can be addressed using an analytic strategy that uses extrapolation methods and proxy data, and triangulates quantitative and qualitative data.
Conclusions: When new data collection is not feasible for program evaluation, existing data sources may be available, that when integrated, can provide a comprehensive picture of the HIV/STD epidemic in specific geographic areas while reducing data burden on grantees. Lessons learned through the ECHPP evaluation may contribute to the monitoring/evaluation of STD prevention activities and improve efforts to link local STD programs to community impact.