Evaluating HIV estimates from national population-based surveys for bias resulting from non-response

Antenatal clinic-based surveillance is commonly used to monitor trends in HIV in developing countries that have generalized epidemics. Recently, HIV seroprevalence data have been also collected in national population-based surveys, such as the Demographic and Health Surveys (DHS) and AIDS Indicators Surveys (AIS). Such surveys enable direct estimation of population HIV prevalence. A major challenge for population-based surveys is bias resulting from non-response, both from refusal and absence. In this study, we evaluate national HIV prevalence estimates from DHS and AIS surveys for bias resulting from non-response in the surveys. The study finds that non-response for HIV testing tends to have small, non-significant effects on national HIV seroprevalence estimates obtained from national household surveys. National population-based surveys are an important source of reliable data on HIV prevalence that can enhance surveillance-based estimates in generalized epidemics. (Author abstract)