Guidelines for second generation HIV surveillance - World Health ...

1. Introduction
1.1. What is second generation surveillance
First generation surveillance relied solely on data on AIDS cases and some sentinel studies on HIV prevalence.
In 2000, a new strategy named second generation surveillance (SGS) was promoted to tailor surveillance
systems to the epidemic state of a country (1). More specifically, the strategy proposed the following:
• to concentrate strategic information resources where they would yield information that is useful in
reducing the spread of HIV and in providing care for those affected;
• to concentrate data collection in key populations at higher risk of HIV exposure, such as populations
with high levels of risk behaviour that places them at increased risk or young people at the start of their
sexual lives;
• to compare information on HIV prevalence and on the behaviours that spread the infection to build up
an informative picture of changes in the epidemic over time;
• to make the best use of other sources of information, such as communicable disease surveillance and
reproductive health surveys, to increase understanding of the HIV epidemic and the behaviours that
spread it.
Evaluating a National Surveillance System
The components of HIV second general surveillance remain similar as presented in figure 1.
Figure 1: Components of HIV second generation surveillance
HIV and AIDS case &
mortality reporting
STI Surveillance
Second Generation
Surveillance (SGS)
Size Estimation of Risk
Groups
Behavioural or Bio-
Behavioural Surveys
Sentinel Surveillance
3