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Hivdr prevention and Assessment Annual Country Report Outline


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B. Progress towards integration of the surveys into routine public health activities


Please describe

C. Future plans for surveys to monitor HIVDR emerging during ART, and related ART site factors, in sentinel ART sites


In this section the report should describe the next year's plan for surveys at representative ART sites. List nest year’s sites and describe plans for site operating procedure development and potential solutions to anticipated challenges associated with operationalization of surveys in selected sites.

VII. Surveys to evaluate the prevalence of transmitted resistance in geographic areas where ART has been widely available for > 3 years


HIVDR "Threshold Surveys" (HIVDR-TS)

Countries should not report surveys that do not meet the criteria for an HIVDR threshold survey in this section.  Other HIVDR related activities and studies should be reported in Section XI. The following is an outline of the elements of the threshold survey:

1.  For each survey reported, specimens must come from the same site type in one geographic area (specimens may come from more than one site in the same area, but specimens from different site types cannot be combined -- for instance, from a voluntary counseling and testing site and an antenatal clinic cannot be used in the same survey-, and specimens from different geographic areas cannot be combined -- for instance, specimens from two different cities be used in one survey.

2.  Specimens must come from newly diagnosed individuals < 25 years of age who are not eligible to start ART; if female, they must have no previous pregnancies at the time of blood draw.  Additional criteria listed in the protocol may also be applied and should be listed in the report, but these criteria are mandatory.

3.  Between 34-47 eligible specimens must be available from each area (that is, for each survey).  If resistance mutations that are included in the WHO list for surveillance of transmitted resistance are seen among the first 34 specimens, then at least 44 specimens will be needed for the analysis.  If more than 1 specimen of the first 44 specimens has a resistance mutation from the WHO list, then 47 specimens are needed for the analysis.

4.  Specimens must be analyzed in order of blood draw date and time using the chart in Appendix 5 (Classification for HIVDR-TS).


5.  Perform a separate analysis (that is, fill in a new chart) for each drug class.


6.  The WHO list of mutations for surveillance of transmitted HIV drug resistance must be used for the analysis. [WHO mutation list for HIVDR-TS is provided in Appendix 6]. No other mutations should be used to define transmitted resistance.

7.  Prevalence results for each drug class may only be categorized as <5%, 5-15%, or > 15%.  Do not report a prevalence estimate (that is, do not report "8%" or "2%" or "12%); report only whether the result is below or above the two prevalence thresholds, or between them.

A. HIVDR-TS Activities and Results


    • Introduction: purpose of HIVDT-TS

    • Geographic area(s) in which the survey(s) was/were performed

    • Site type; number of sites in each area; specify risk group being assessed

    • Populations or groups represented in each survey: Specify eligibility criteria for surveillance [WHO suggested eligibility criteria for HIVDR Threshold surveillance are provided in Appendix 7

    • Specimen type (if separate specimen types were used for different surveys, specify the type used in each survey)

    • Describe the enrolment and data collection process

    • Specimen handling processing and tracking

    • Transport of and storage of specimens

    • Which WHO-accredited laboratory(ies) performed genotyping?  Describe methods briefly.

    • Quality assurance for TS

    • Results for each survey in each area (or in each site type in the area in which a survey was performed, or each subgroup in the area for whom a survey was performed)

In an appendix, show the analysis for each HIVDR drug class separately using the HIVDR threshold survey classification chart. If prevalence to any class is > 5%, perform a separate analysis for each drug in that class routinely used in the country.

B. Progress towards integration of HIVDR-TS into routine public health activities

Please describe




C. Future Plans

Please describe


VIII. Designation of a WHO-accredited genotyping laboratory or laboratories for HIVDR surveillance and monitoring

For HIVDR surveillance and monitoring, WHO priority countries should select laboratories accredited by WHO Global HIVDR Laboratory Network

Sections VI and VII of the report above should include the accredited laboratory and methods used for genotyping in each respective survey.


  • Describe plans for use of WHO-accredited laboratories for genotyping for HIVDR surveillance and monitoring

    • If currently a regional or specialist lab within the network has been designated as the country's genotyping lab for surveillance and monitoring, describe

    • If plans for one or more in-country labs has been designated by the Ministry of Health to be assessed for accreditation

      • Describe results of assessment if already performed

      • If assessment not yet performed or accreditation not yet achieved, describe interim plan for use of a WHO-accredited lab at regional or specialist level until national accreditation is achieved

  • Please describe current in-country laboratory capacity as it relates to HIV viral load and HIVDR genotyping (if relevant).

  • Describe plans (if relevant) for development of genotyping capacity (for the purposes of surveillance and monitoring) within the country



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