**4.2 UNGASS indicators**

In this section, the main data referring to the UNGASS indicators are provided. As mentioned in section 2, a specific Declaration of Commitment on HIV/AIDS and a Political Declaration on HIV/AIDS were proposed and adopted by the UN General Assembly in 2001. In these documents, a specific set of epidemiological and surveillance activities are proposed, as well as the adoption of the so-called UNGASS indicators. UNGASS indicators are a set of measures to be used among different countries in order to effectively monitor the HIV epidemic (UNAIDS & WHO, 2009). The idea which is behind the UNGASS indicators is that all data provided by the different countries can represent a reliable picture of the status of the epidemic and on the different prevention activities implemented against the spread of HIV in specific and general population.

The national-level UNGASS indicators are basically divided into three categories. The first one refers to the National commitment and action, taking into account topics as policy decisions, financial plan and activities for the HIV prevention, testing and treatment, drugs and care as well. The second category refers to knowledge and behaviour in different population, while the third category refers to the national level programme impact. For all these three areas, specific guidelines and procedures on how these indicators have to be calculated are provided (for instance, they provide specific numerators and denominators to calculate the different percentages and levels of the indicators).

Despite the relevance and importance of the UNGASS Declaration and the number of countries involved in this process, it should be mentioned that to date, a number of limitations in the UNGASS reporting have emerged. For instance, in 2008 less than half of those countries that stated the indicators and procedures referring to the most-at-risk populations (MSM included) were able to provide data based on these very indicators.

The SIALON Project: Report on HIV Prevalence

older people (61.4% and 72.0% respectively).

with a male partner in the last six months (Fig. 6).

Barcelona (64.3%) and lowest in Bratislava (39.7%).

**4.2.3 UNGASS indicator N°19** 

%

and Risk Behaviour Among MSM in Six European Cities 217

the number of respondents who replied that they have been given condoms for free in the last 12 months and knew where to go if they wished to be given an HIV test. The

59.5 38.3 83.5 71.1 84.7 71.3

Prague Bratislava Barcelona Bucharest Ljubljana Verona Country

The highest percentages of participants reached by prevention programmes are reported in Ljubljana (84.7%) and Barcelona (83.5%), while the lowest are in Prague (59.5%) and Bratislava (38.3%). In Verona, the percentage is 71.3%, while in Bucharest it is 71.1%. According to the UNGASS request of disaggregating the data according to the age group (<25/25+), young people (< 25 years old) were less reached by prevention programmes than

This indicator describes the percentage of men reporting the use of a condom during their last anal sex intercourse with a male partner. The goal is to monitor the condom use among MSM, as it represents the main means for risk reduction. In this case, the numerator is the number of respondents who reported that a condom was used the last time they had anal sex, while the denominator is the number of respondents who reported having had anal sex

UNGASS 19 with steady and casual partner was calculated. As shown in Fig. 6, the percentage of participants who reported the use of a condom the last time they had anal sex with a male partner in the last 6 months with their steady partner was highest in Barcelona (35.1%) and lowest in Prague (19.1%). The percentage with occasional partner was highest in

denominator is the number of MSM involved in the survey (Fig. 5).

Fig. 5. UNGASS indicator N. 9: MSM reached by prevention programmes

In this regard, one of the added values of the SIALON project is to provide reliable data on behaviours and HIV infection levels based on the UNGASS procedures and indicators. In some of the participating countries, the results of the SIALON project represent the first time in which UNGASS indicators were put into practice at the National level through a crosssectional survey. In designing the SIALON questionnaire, four indicators were taken into account, focusing on high risk population, namely MSM. UNGASS indicators have proven to be effective measures to be considered in surveillance systems and in a comprehensive national monitoring and in an evidence-based evaluation approach.

### **4.2.1 UNGASS indicator N°8**

In order to measure the HIV testing level, a specific UNGASS indicator was set, namely the UNGASS 8. This indicator refers to the percentage of MSM tested for HIV in the last 12 months and who know/collected the result, with the purpose of monitoring advancement in promoting HIV VCT among most-at-risk populations, in this case MSM. The indicator foresees as a numerator the number of most-at-risk population respondents who have been tested for HIV during the last 12 months and who know the results and as denominators the number of most-at-risk population included in the sample (Fig. 4).

Fig. 4. UNGASS indicator N. 8: MSM who were tested in the last 12 month and knew the result

The Southern European cities had a high percentage of tested people who collected the test result (56.3% in Barcelona and 53.0% in Verona). In the other cities, low percentages are reported: 31.6% in Bratislava, 42.6% in Bucharest, 38.0% in Ljubljana and 40.2% in Prague.

#### **4.2.2 UNGASS indicator N°9**

This indicator refers to the percentage of most-at-risk populations reached with HIV prevention programmes. With regard to the construction of the indicator, the numerator is

In this regard, one of the added values of the SIALON project is to provide reliable data on behaviours and HIV infection levels based on the UNGASS procedures and indicators. In some of the participating countries, the results of the SIALON project represent the first time in which UNGASS indicators were put into practice at the National level through a crosssectional survey. In designing the SIALON questionnaire, four indicators were taken into account, focusing on high risk population, namely MSM. UNGASS indicators have proven to be effective measures to be considered in surveillance systems and in a comprehensive

In order to measure the HIV testing level, a specific UNGASS indicator was set, namely the UNGASS 8. This indicator refers to the percentage of MSM tested for HIV in the last 12 months and who know/collected the result, with the purpose of monitoring advancement in promoting HIV VCT among most-at-risk populations, in this case MSM. The indicator foresees as a numerator the number of most-at-risk population respondents who have been tested for HIV during the last 12 months and who know the results and as denominators the

40.2 31.6 56.3 42.6 38.0 53.0

Prague Bratislava Barcelona Bucharest Ljubljana Verona Country

Fig. 4. UNGASS indicator N. 8: MSM who were tested in the last 12 month and knew the

The Southern European cities had a high percentage of tested people who collected the test result (56.3% in Barcelona and 53.0% in Verona). In the other cities, low percentages are reported: 31.6% in Bratislava, 42.6% in Bucharest, 38.0% in Ljubljana and 40.2% in Prague.

This indicator refers to the percentage of most-at-risk populations reached with HIV prevention programmes. With regard to the construction of the indicator, the numerator is

national monitoring and in an evidence-based evaluation approach.

number of most-at-risk population included in the sample (Fig. 4).

**4.2.1 UNGASS indicator N°8** 

**4.2.2 UNGASS indicator N°9** 

%

result

the number of respondents who replied that they have been given condoms for free in the last 12 months and knew where to go if they wished to be given an HIV test. The denominator is the number of MSM involved in the survey (Fig. 5).

Fig. 5. UNGASS indicator N. 9: MSM reached by prevention programmes

The highest percentages of participants reached by prevention programmes are reported in Ljubljana (84.7%) and Barcelona (83.5%), while the lowest are in Prague (59.5%) and Bratislava (38.3%). In Verona, the percentage is 71.3%, while in Bucharest it is 71.1%. According to the UNGASS request of disaggregating the data according to the age group (<25/25+), young people (< 25 years old) were less reached by prevention programmes than older people (61.4% and 72.0% respectively).
