Full form of IBBS

The full form of IBBS is Integrated Biological and Behavioural Surveillance .

The National IBBS aims to generate evidence on risk behaviours among risk groups in order to support programme planning and prioritisation at the district, state, and national levels. A strong surveillance system that tracks the HIV epidemic in nearly every district in the countryhas been central to the National AIDS Control Programme's evidence-based decision making (NACP). 

This surveillance system has evolved over time, tracking the progression of the epidemic and guiding responses at the national, state, and district levels.

The specific goals are as follows:

 • Analyze and comprehend HIV-related behaviours and HIV prevalence among key risk groups in various regions by linking behaviours to biological findings

• To assess and estimate the change in HIV-related risk behaviours and HIV prevalence among key risk groups between baseline and end point for NACP-IV.

Launch of IBBS

India has one of the most extensive and robust HIV surveillance systems in the world. Since 1998, this system has assisted the national government in better monitoring the trends, levels, and burden of HIV among various population groups, as well as in delivering an effective response to the country's epidemic.

The world's largest bio-behavioural surveillance, with a total sample size of 1,38,400, has used cutting-edge information technology to efficiently implement the survey. National IBBS bio-behavioural data collection was implemented from October 2014 to November 2015. 

Computer Assistant Personnel Interviewing (CAPI) devices with Android-based applications were used for behavioural interviews, which were immediately transferred to a central server in real time. 

To ensure quality sample collection in the most remote locations, blood specimens were collected using the Dried Blood Spot (DBS) method. The entire project was closely managed and supervised at the state, regional, and national levels using the Integrated IBBS Management System.

Modules & Components of IBBS

This national report provides a descriptive analysis of behaviour and biological data collected for the FSW, MSM, and IDU populations as part of the National IBBS. The indicators presented in this report are comprehensive, including, but not limited to, risk behaviours, HIV-related knowledge and practises, experiences of violence, stigma and discrimination, programme exposure, and HIV prevalence.

It was discovered that biological surveillance via HIV Sentinel Surveillance and behavioural surveillance via BSS were carried out separately. The frequency with which they were carried out, the geographical unit of study, and the population covered did not match, leaving no room for linking behaviours with HIV outcomes and gaining a better understanding of vulnerabilities and risk profiles.

The review specifically recommended a new strategy known as second generation surveillance, which includes collecting information on risk behaviours as well as HIV prevalence among risk groups. Such Integrated Biological and Behavioural Surveillance (IBBS) would allow researchers to investigate the factors driving the HIV epidemic, including data comparisons on prevalence and risk behaviours.

Purpose of IBBS

The outputs of the national IBBS can be used for a variety of purposes, including: better characterization of epidemics and vulnerabilities at the district and state levels; evidence-based programme planning; HIV estimation, epidemic modelling, and programme evaluation.

The National IBBS is the world's largest bio-behavioural study of its kind, and it was carried out with the technical assistance of eight of the country's leading government public health institutes. Because of the concentrated nature of the Indian HIV epidemic, strong surveillance among key populations/high risk groups (HRG) is required to facilitate an effective national response.

 NACO implemented Integrated Biological and Behavioural Surveillance (IBBS) to generate evidence on risk behaviours among HRGs to support planning and prioritisation of programme efforts at the district, state, and national levels in order to strengthen surveillance activities among HRGs.

Occupation and Maintenance

NACO organised a review of the country's HIV surveillance system in 2009 in order to strengthen high risk group (HRG) surveillance activities. Given the low prevalence of HIV in the general population and the concentrated nature of the Indian HIV epidemic, HRG surveillance is critical to an effective national response to HIV/AIDS control.

The national IBBS in India is a significant milestone for the national programme and is uniquely positioned as one of the world's largest bio-behavioural surveys among HRGs. 

The learning from IBBS is twofold: data from IBBS will contribute to an increased knowledge base / understanding of HIV epidemiology among HRGs in the context of concentrated epidemics, resulting in more informed decision making; and successful implementation of IBBS at such a large scale offers tremendous opportunity to learn lessons on a wide range of issues, including technical/methodological, planning, executing, monitoring, and on the utmost importance.

It was implemented in high outmigration districts for six population groups: Female Sex Workers (FSW), Men who have Sex with Men (MSM), Injecting Drug Users (IDU), Transgender (TG), Migrants, and Currently Married Women (CMW). The findings of the IBBS among FSWs, MSMs, and IDUs are presented in this report.

The National IBBS methodology was a community-based cross-sectional survey design with probability-based sampling.

Blood specimens were collected using the Dried Blood Spot (DBS) method as part of the national IBBS.