Table 1 Outcome definitions for the Indian National Collaboration on AIDS (NCA) study
Outcome | Data inputs | Population (denominator) | Definition | |
|---|---|---|---|---|
Primary Outcome | ||||
HIV testing | ||||
1 | HIV testing in the prior 12 moths | Survey | All participants, excluding those that report being HIV-positive AND report being tested more than 12 months ago. | Either 1 OR 2: 1. Reports HIV test within the prior 12 months OR 2. Was told he/she had HIV within the last 12 months |
Secondary Outcomes | ||||
Awareness of HIV status, access to care, and HIV treatment | ||||
2 | Awareness of HIV status among HIV-seropositive persons | 1. Survey 2. Serologic HIV test | HIV seropositive participants | Reports having a positive HIV test OR being told by a doctor that he/she had HIV. |
3 | Accessing HIV medical care in prior 6 months | 1. Survey 2. Serologic HIV test | HIV seropositive participants | Reports seeing a doctor about HIV AND reports visit with the indicated doctor in the prior 6 months. |
4 | Use of ART among ART-eligible | 1. Survey 2. Serologic HIV test | HIV seropositive participants who meet either criteria 1 or 2 1. Reports taking ART at any time in the past OR 2. CD4 < 350 cells/μL | Reports ART use in prior 30 days. |
5 | Use of trimethoprim-sulfamethoxazole (TMP-SMX) when indicated | 1. Survey 2. Serologic HIV test 3. CD4 | HIV seropositive AND CD4 count < 200 cells/μL | Reports taking TMP-SMX in past 30 days |
6 | Viral suppression among ART-eligible | 1. Survey 2.Serologic HIV test 3. CD4 4. HIV RNA | HIV seropositive participants who meet either criteria 1 or 2 1. Reports taking ART at any time in the past OR 2. CD4 < 350 cells/μL | HIV RNA <150 c/mL |
7 | Viral suppression among HIV-positive | 1. Serologic HIV test 2. HIV RNA | HIV seropositive participants | HIV RNA <150 c/mL |
8 | Average CD4 cell count among HIV-positive | 1. Serologic HIV test 2. CD4 cell count | HIV seropositive participants | CD4 cell count |
Risk behaviors, substance use, and depression | ||||
9 | Unprotected anal intercourse with non-main male partner in prior 6 months [MSM] | Survey | Participants at MSM sites | Does not report “always” using a condom during insertive or receptive anal sex with non-main (e.g., casual, one-time partner, sex worker) male partners in the prior 6 months |
10 | Number of non-main male sexual partners in prior 6 months [MSM] | Survey | Participants at MSM sites | Number of non-main male (e.g., casual, one-time partner, sex worker) male partners with whom the participant reports having insertive or receptive anal sex in the prior 6 months |
11 | Symptoms of sexually transmitted infection [MSM] | Survey | Participants at MSM sites | Reports genital/anal discharge, pain, or ulcer in prior 6 months |
12 | Syphilis infection | 1. RPR test 2. TPHA test | Participants at MSM sites | Positive for syphilis infection by both RPR and TPHA tests |
13 | Shared injection equipment in prior 6 months [PWID] | Survey | Participants at PWID sites | Reports sharing (passing or receiving) a needle and/or syringe with another individual in the prior 6 months |
14 | Shared injection equipment at last use among active injectors [PWID] | Survey | Participants at PWID sites that report injection of one or more drugs in prior 6 months | Reports sharing (passing or receiving) a needle and/or syringe with another individual at last injection |
15 | Reported injection abstinence in prior 6 months [PWID] | Survey | Participants at PWID sites | Denies injecting any drug in prior 6 months |
16 | Hazardous alcohol use or dependence | Survey | All participants | Score ≥8 (hazardous) or ≥15 on Alcohol Use Disorder Identification Test (AUDIT) [61] |
17 | Depression | Survey | All participants | Score ≥ 10 on Patient Health Questionnaire (PHQ)-9 [62] |
Services and stigma | ||||
18 | Spouse HIV testing among married participants | Survey | Participants who report being married | Reports spouse has ever been tested for HIV |
19 | Symptoms of sexually transmitted infection for which participant sought care in prior 6 months [MSM] | Survey | Participants at MSM sites | Reports genital/anal discharge, pain, or ulcer in prior 6 months AND reports seeking medical care for symptom(s) |
20 | Used needle/syringe exchange program (NSEP) in prior 6 months [PWID] | Survey | Participants at PWID sites | Reports NSEP use in prior 6 months |
21 | Used needle/syringe exchange program (NSEP) in prior 6 months among active injectors [PWID] | Survey | Participants at PWID sites that report injection of one or more drugs in prior 6 months | Reports NSEP use in prior 6 months |
22 | Used opioid agonist therapy (OAT) in prior 6 months [PWID] | Survey | Participants at PWID sites | Reports OAT in prior 6 months |
23 | Stigma subtypes | Survey | All participants | Summed score from each of four 6-item stigma scales (enacted, vicarious, felt normative, and internalized stigma) [63] |
Community viral load and HIV incidence | ||||
24 | Prevalence of viremic individuals in population | 1. Serologic HIV test 2. HIV RNA | All participants | Prevalence of HIV-positive subjects with HIV RNA >150c/mL [64] |
25 | Average viral load in HIV-positive participants | 1. Serologic HIV test 2. HIV RNA | HIV seropositive participants | Average (log10) HIV RNA |
26 | HIV incidence | 1. Serologic HIV test 2. HIV RNA 3. CD4 cell count 4. BED assay 5. Avidity index | Participants who meet criteria 1 or 2 1) HIV-seronegative OR 2) HIV-seropositive participants who meet criteria for recent infection by HIV RNA, CD4, BED assay, and avidity assay | Cross-sectional HIV incidence estimated as described previously [6, 7, 64] |