Weak signal detection: A discrete window of opportunity for achieving ‘Vision 90:90:90’?

Abstract

Introduction: UNAIDS’ Vision 90:90:90 is a call to ‘end AIDS’. Developing predictive foresight of the unpredictable changes that this journey will entail could contribute to the ambition of ‘ending AIDS’. There are few opportunities for managing unpredictable changes. We introduce ‘weak signal detection’ as a potential opportunity to fill this void. Method: Combining futures and complexity theory, we reflect on two pilot case studies that involved the Archetype Extraction technique and the SenseMaker® Collector™ tool. Results: Both the piloted techniques have the potentials to surface weak signals – but there is room for improvement. Discussion: A management response to a complex weak signal requires pattern management, rather than an exclusive focus on behaviour management. Conclusion: Weak signal detection is a window of opportunity to improve resilience to unpredictable changes in the HIV/AIDS landscape that can both reduce the risk that emerges from the changes and increase the visibility of opportunities to exploit the unpredictable changes that could contribute to ‘ending AIDS’.

The Application of Systems Thinking to the Prevention and Control of Sexually Transmissible Infections among Adolescents and Adults: A Scoping Review

“…Of the HIV-focused studies, 33 were concerned with treatment [5,35-38,40,43-53, 56-60,67,69-71,74,84,87,91-93,98]. Of these, 17 examined aspects of the treatment cascade (e.g., commencement and/or adherence) [5,35,37,[43][44][45][48][49][50][51][52][53]57,67,69,74,87], 12 investigated the concept of treatment as prevention including in the context of vertical transmission [36,38,52,56-60,70,71,84,91,98], four focused on factors contributing to HIV drug resistance [40,46,92,93], and one concerned the provision of care to terminally ill patients [47].…”

“…Twenty-one studies had an HIV testing focus [5,37,42,43,[49][50][51]56,64,65,[69][70][71]74,85,87,[94][95][96][97][98], of which one was focused on home-or self-testing [85]. Twenty-five studies focused on issues related to HIV harm reduction, including intentional transmission [9], stigma [41], sexual behaviours and 'high risk' behaviours [38,39,58,59,61,[76][77][78][79]89,90], female condom use [11], PrEP [39,42,62,[81][82][83]98], injecting drug use [54,56,58], and general preventative measures [63,66].…”

“…The processes mapped were patient pathways through a clinic/service [10,64,65,71,95], and a sexuality education enhancement intervention [73]. One study incorporated a systemigram [35], and four related papers incorporated the Cynefin framework [76,[87][88][89]. No studies used the root cause analysis technique.…”

Contemporary HIV/AIDS research: Insights from knowledge management theory

“…Literature stresses the importance of social factors in HIV/AIDS epidemics, and the potential impact of emerging biomedicine ‘and its attendant opportunities and (perhaps unintended) social consequences’ (Friedman, Kippax, Phaswana-Mafuya, Rossi, & Newman, 2006 , p. 959). Although an extensive literature exists on progress toward visions of ultimate eradication (see Burman, Aphane, & Delobelle, 2016 ), challenges such as ongoing societal stigma (Gilbert, 2016 ), poor infrastructure and treatment delivery issues (Koto & Maharaj, 2016 ) and continued risk-taking behaviours (Ngidi, Moyo, Zulu, Adam, & Krishna, 2016 ) persist. This article makes the argument that certain recent developments in knowledge management enabled by technological advances offer hope for the ultimate eradication of HIV/AIDS, and offers insights into how these novel developments might contribute to this end.…”

Complex adaptive HIV/AIDS risk reduction: Plausible implications from findings in Limpopo Province, South Africa

“…Despite the limitations of the pilot study in Limpopo, there has been sufficient international growth in management tools and techniques designed to work with complexity, including electronic monitoring and evaluation tools that could be aligned to SA's eHealth strategy, [15] to warrant further investigation. This would require further pilots to empirically determine if this style of intervention could contribute to developing one of the biosocial responses that UNAIDS calls for.…”