Assessing Quality of Population Size Estimates of People Who Inject DrugsScientific Development WorkshopAIDS 2014, Melbourne, 22 July 2014

• Riku Lehtovuori, United Nations Office on Drugs and Crime (UNODC)

• David Wilson, The World Bank

• Eliot Ross Albers, International Network of People Who Use Drugs (INPUD)

• Waimar Tun, Population Council

Workshop Objective

To strengthen participants’ capacity to assess the quality of population size estimates of people who inject drugs (PWID) and take action for improving them

QUALITY OF POPULATION SIZE ESTIMATES OF PEOPLE WHO INJECT DRUGS:GLOBAL OVERVIEWRIKU LEHTOVUORI HIV/AIDS SECTIONUNODC

GLOBAL PREVALENCE OF PEOPLE WHO INJECT DRUGS 12.7 MILLION (0.27%)

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

GLOBAL PREVALENCE OF HIV AMONG PEOPLE WHO INJECT DRUGS: 1.7 MILLION (13.1%)

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Assessing global data set on PWID and HIV

1) By methodology of the estimates;

2) By year of the estimates

Pop Size of People Who Inject Drugs Global classification of country estimatesGRADE METHODA Indirect prevalence estimation methods

(capture-recapture, multiplier methods, etc)B General population surveyC Treatment and other national registersD1 Experts’ judgment with known method of estimation (e.g. obtained

through a rapid assessment);Delphi method or other consensus estimate;Official government estimate with no methodology reported

D2* Estimate with methodology unknown

* Data graded D2 excluded from the UN dataset

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank(based on Mathers et al, 2008)

Size estimates of people who inject drugs; By Methodology Grade (n=89 countries)

63%(n=56)

8% (n=7)

11% (n=10)

18% (n=16)

ABC

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Size estimates of people who inject drugs; By Methodology Grade (n=89 countries)

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Size estimates of people who inject drugs; By Year (n=89 countries)

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Size estimates of people who inject drugs; By Year + Method (n=89 countries)

49% (n=44)

51%(n=45)

2008 or later + Best Graded Method

Before 2008 + Lower Graded Method

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

HIV among People Who Inject Drugs Global classification of country estimatesGRADE METHODA Multi-site seroprevalence study with at least two sample types

(e.g. treatment or outreach sample); Seroprevalence study from a single sample type

B Registration or notification of cases of HIV infection (e.g. from treatment services)

C Prevalence study using self-reported HIV D1 Official government estimate with no methodology reported;

Modelling studies (e.g. mode of transmission models)

D2* Estimate with methodology unknown

* Data graded D2 excluded from the joint UN dataset

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank(based on Mathers et. al, 2008)

Estimates of HIV among PWID; By Methodology Grade (n=111 countries)

57%35%

4%4%

ABC

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Estimates of HIV among PWID; By Methodology Grade (n=111 countries)

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Estimates of HIV among PWID;By Year (n=111 countries)

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Estimates of HIV among PWID; By Year + Method (n=111 countries)

41%(n=46)

59% (n=65)

2010 or later + Best Graded Method

Before 2010 + Lower Graded Method

World Drug Report 2014/UNODC, WHO, UNAIDS, World Bank

Still, many countries1) Currently have PWID

estimates, which are critically outdated and/or

2) Currently have PWID estimates which are methodologically very weak

or3) Do not have PWID and/or

PWID/HIV estimates at all

Thank you