Sexual Behaviour Indicator 2

Condom use at last higher risk sex

(Modified WHO/GPA Prevention Indicator 5)
Core indicator for all epidemics

Definition

The percent of respondents who say they used a condom the last time they had sex with a non-marital, non-cohabiting partner, of those who have had sex with such a partner in the last 12 months

Measurement tools

UNAIDS general population survey; DHS AIDS Module; FHI BSS (adult)

What it measures

If everyone used condoms every time they had sex with a non-marital or non-cohabiting partner, a heterosexually transmitted HIV epidemic would be almost impossible to sustain. While AIDS programmes may try to reduce casual partnerships, they must also, if they are to succeed in curbing the epidemic, promote condom use in the casual partnerships that remain. This indicator tracks changes in condom use in these partnerships.

How to measure it

For each partner listed in the last 12 months, respondents are asked whether they used a condom the last time the couple had sex. Other questions will allow for the classification of partnerships as cohabiting or non-cohabiting. All those who report at least one non-marital, non-cohabiting partner in the last 12 months (i.e., the numerator of Sexual Behaviour Indicator 1) form the denominator. The numerator is the number of those in the denominator who used a condom the last time they had sex with their most recent non-cohabiting partner.

Strengths and limitations

A rise in this indicator is an extremely powerful indication that condom promotion campaigns are having the desired effect among their principle target market.

Since condom promotion campaigns aim for consistent use of condoms with non-regular partners rather than simply occasional use, some surveys have tried to ask directly about consistent use, often using an always/sometimes/never question. While this may be useful in sub-population surveys (see below), it is subject to recall bias and other biases and is not sufficiently robust for use in a general population survey. Asking about the most recent act of non-cohabiting sex minimises recall bias and gives a good cross-sectional picture of levels of condom use. It is recognised that consistent use of condoms is an important goal. But inevitably, if consistent use rises, this indicator will also rise.

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