Measuring self-reported HIV status in bio-behavioural surveys

Currently, many epidemiological and surveillance surveys of general and key populations do not ask participants the results of their most recent test for human immunodeficiency virus (HIV) test. Not asking about HIV status precludes measuring the cascade of engagement in HIV-related care thus undermining the ability to track key indicators in the response to the epidemic. Common reasons cited why participants are not asked their current HIV status in surveys include: 1. doing so may violate respondents' human rights; 2. asking has the potential to exacerbate stigma and discrimination; and 3. self-reported status can be inaccurate. HIV surveys should routinely ask for self-reported HIV status to characterize the state of the HIV epidemic response. Normalizing reporting of HIV status is one step in a move from exceptional HIV surveillance to standard infectious disease surveillance. While stigma and discrimination remain important concerns and require appropriate safeguards, the researchers believe that asking about HIV status can lead to a more robust response to HIV control and prevention.