From January 13th to 20th, 2026, the Government of Sierra Leone, through the National Public Health Agency (NPHA), convened a seven-day Training of Trainers (ToT) workshop at the New Brookfields Hotel in Freetown. This workshop marked the official launch of preparations for the Sierra Leone Population-Based HIV Impact Assessment (SILPHIA 2026), a landmark initiative aimed at strengthening the country’s HIV response. I had the privilege of attending this workshop, which brought together a diverse group of professionals committed to advancing public health in Sierra Leone.
SILPHIA 2026 is a cross-sectional, household-based, sub-nationally representative survey focused on the Western Area Urban and Western Area Rural Districts. Its mission is to generate high-quality, locally relevant data on HIV-related health indicators to inform policy and improve health outcomes. The NPHA serves as the principal investigator for SILPHIA 2026, with technical and operational support from ICAP at Columbia University. This collaboration was made possible through the leadership and vision of the Honorable Minister of Health and Sanitation, Dr. Austin Demby, whose advocacy and strategic engagement with global health partners helped secure the resources and partnerships necessary to launch this critical survey.
The survey will focus on several key areas, including HIV prevalence and viral load suppression (VLS), CD4 T-cell count distribution among people living with HIV (PLHIV), HIV-related risk behaviors and prevention practices, and the uptake of HIV care and treatment services. It will employ a two-stage cluster sampling design, selecting 4,445 households and targeting approximately 12,240 adults aged 15 years and older. Of these, an estimated 11,798 individuals will participate in interviews, and 10,166 are expected to provide blood samples for HIV testing and biomarker assessment.
Participants in the survey will provide information on a range of topics, including demographics and marital status, reproductive history (for women), antenatal care and prevention, male circumcision, sexual activity and HIV-related risk behaviors, and their HIV testing history, care, and treatment experiences. This comprehensive dataset will empower policymakers and health administrators to better understand the HIV epidemic and design more effective, evidence-based interventions.
Since 2015, Population-based HIV Impact Assessment (PHIA) surveys have been conducted in over a dozen countries across Southern, Eastern, and West Africa, as well as Haiti. These surveys have provided the first population-level estimates of HIV incidence, viral load suppression, pediatric HIV prevalence, and antiretroviral therapy (ART) coverage. By joining this global effort, Sierra Leone ensures its HIV response is guided by robust data and aligned with international best practices.
The primary objective of SILPHIA 2026 is to estimate the sub-national prevalence of HIV viral load suppression. Secondary objectives include estimating sub-national HIV prevalence, measuring CD4 T-cell counts among PLHIV, assessing HIV-related risk behaviors, knowledge, and attitudes, identifying behavioral and demographic determinants of HIV prevalence, examining exposure to, uptake of, and barriers to HIV-related services, and tracking progress toward achieving the UNAIDS 95-95-95 targets.
Countries such as Botswana, Cameroon, Côte d'Ivoire, the Democratic Republic of the Congo, eSwatini, Ethiopia, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe have all implemented PHIA surveys. Sierra Leone now proudly joins this collective effort, ensuring its HIV response is data-driven, evidence-based, and globally connected.
SILPHIA 2026 is more than a survey; it’s a turning point. By combining rigorous science with community engagement, and under the stewardship of national leadership, Sierra Leone is taking bold steps toward ending the HIV epidemic and achieving the UNAIDS 95-95-95 targets.
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