Condom use among transgender people

Export Indicator

Percentage of transgender people reporting using a condom during their most recent sexual intercourse or anal sex
What it measures

Progress in preventing exposure to HIV among transgender people through unprotected sex with partners

Rationale

Condoms can substantially reduce the risk of sexually transmitting HIV. Consistently and correctly using condoms is therefore important for transgender people, particularly trans-women, because of the high risk of HIV transmission during unprotected anal sex. Condom use with the most recent penetrative sex partner is considered a reliable indicator of longer-term behaviour.

Note: countries with generalized epidemics may also have a concentrated subepidemic among transgender people. If so, calculating and reporting on this indicator for this population would be valuable.

 

Numerator

Number of transgender people who reported using a condom at last sexual intercourse or anal sex

Denominator

Number of transgender people surveyed who reported having sexual intercourse or anal sex in the past six months

Calculation

Numerator/denominator

Method of measurement

Behavioural surveillance or other special surveys

Respondents are asked the following question:

Did you use a condom with your most recent sexual intercourse or anal sex?

Whenever possible, data for transgender people should be collected with civil society organizations that have worked closely with this population in the field. Access to transgender people and the data collected from them must remain confidential and secure.

Measurement frequency

Every two years

Disaggregation
  • Gender (transman, transwoman, other) 
  • Age (<25 and 25+ years)
Additional information requested

If there are subnational data available, please provide the disaggregation by administrative area, city, or site in the space provided. Submit the digital version of any available survey reports using the upload tool.

Strengths and weaknesses

For transgender people, condom use at last sexual intercourse or anal sex with any partner indicates well the overall levels of and trends in protected and unprotected sex in this population. In countries in which transgender people in the subpopulation surveyed are likely to have cis-and trans-gendered partners, condom use with female, male and transgender partners should be investigated. In these cases, data on condom use should always be presented separately for female, male and transgender partners.

This indicator asks about sexual intercourse or anal sex in the past six months. If you have data available on another time period, such as the last three or 12 months, please include this additional data in the comments section of the reporting tool.

Surveying transgender people can be challenging. Consequently, the data obtained may not be based on a representative national sample of the key populations at higher risk being surveyed. If there are concerns that the data are not based on a representative sample, the interpretation of the survey data should reflect these concerns. If there are different sources of data, the best available estimate should be used. The report submitted with this indicator should include information on the sample size, the quality and reliability of the data and any related issues.

To maximize the utility of these data, it is recommended that the same sample used for calculating this indicator be used for calculating the other indicators related to these populations.

 

Further information

United Nations Development Programme, IRGT: A Global Network of Transgender Women and HIV, United Nations Population Fund, UCSF Center of Excellence for Transgender Health, Johns Hopkins Bloomberg School of Public Health, World Health Organization et el. Implementing comprehensive HIV and STI programmes with transgender people: practical guidance for collaborative interventions. New York (NY): United Nations Development Programme; 2016 (https://www.undp.org/content/dam/undp/library/HIV-AIDS/Key%20populations...).

Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization, 2022 (https://www.who.int/publications/i/item/9789240055315).

Global HIV Strategic Information Working Group. Biobehavioral survey guidelines for populations at risk for HIV. Geneva: World Health Organization; 2017 (https://apps.who.int/iris/bitstream/handle/10665/258924/9789241513012-eng.pdf).

Related Indicators

PR.1 Condom use (KP), 2020, WHO Consolidated HIV strategic information guidelines: driving impact through programme monitoring and management (https://www.who.int/publications/i/item/consolidated-hiv-strategic-information-guidelines).