Abstract

Estimates of the size of key populations at risk for HIV infection: Men who have sex with men and commercial sex workers in Lebanon

Ziad Mansour, M.D. ABOG, MHs/HE1, Racha Said, M.Sc.1, Lina Torossian, M.P.H.1, Joe Estephan, M.Sc.1 and Mostafa El Nakib, M.D., M.P.H.2
(1)Connecting Research to Development, Baouchrieh, Lebanon, (2)National AIDS Program, Beirut, Lebanon

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

Size estimates of populations at higher risk for HIV infection are needed to help policymakers comprehend the magnitude of the epidemic and allocate appropriate resources. Population size estimates of men who have sex with men (MSM) and commercial sex workers (CSWs) are few in Lebanon. In 2018, an integrated biological and behavioral surveillance (IBBS) survey included a mixture of methods to estimate the sizes of the MSM and CSW populations in Lebanon.

Population size estimates resulting from an IBBS are inaccurate and disposed to many potential biases due to the absence of a gold standard method. Four methods were suggested (literature review, enumeration, unique object multiplier and wisdom of crowds) to strengthen confidence in estimates and reduce the likelihood that biases of any single method markedly impact results. Data were presented and discussed at a national stakeholder meeting to highlight the strengths and limitations of each size estimation method as well as provide upper and lower acceptability bounds.

The median population sizes generated from all previously mentioned methods were estimated to be 16166 for MSM and 4338 for CSWs with plausible ranges of 12300-21765 and 3544-4855, respectively.

We employed multiple methods to estimate the size of two vulnerable populations in Lebanon. These estimates provide valuable information for the planning, implementation and evaluation of HIV prevention and care programs at the national level. Moreover, we believe that our results will narrow the gap in the availability of data on the estimates of MSM and CSW population sizes in the country.

Conduct evaluation related to programs, research, and other areas of practice