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Condom use at last commercial sex: client report

Export Indicator

Proportion of men reporting condom use the last time they had sex with a sex worker, of those who report having had sex with a sex worker in the last 12 months
What it measures

This indicator gives an indication of success or failures of campaigns to increase condom use among clients of sex workers.  It measures condom use by men with partners they consider to be commercial partners.
 

Rationale
Numerator

Number of men who report they used a condom at last sex with a sex worker

Denominator

Number of men who say they have had sex with a sex worker in the last 12 months

Calculation
Method of measurement

As with Sexual Behaviour Indicator 3, Commercial sex in the last year, this indicator is only relevant to settings where commercial sex or prostitution is well defined. In general population surveys or in specialised surveys among groups of men who fit the profile of clients of sex workers (the military, truck drivers, etc.), men are asked if they had sex with a sex worker in the previous 12 months. If they reply yes, they are further asked whether they used a condom the last time they had sex with a sex worker. The indicator is the number of men who report that they used a condom at last sex with a sex worker, divided by all those say they have had sex with a sex worker in the last 12 months.

Measurement frequency

Every 2-3 years

Disaggregation

Condom type: N/A

Education: N/A

Gender: N/A

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: N/A

Service Type: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Type/Timing of testing: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

Most AIDS programmes aim to increase consistent use of condoms with sex workers. Surveys of clients of sex workers will almost certainly want to ask whether they use a condom always, sometimes or never in sex with sex workers over the last 12 months. However the pressure to say "always" is strong. Asking about a particular, and recent, act of sex may give a more robust measure of levels of condom use in commercial sex. This measure should therefore be used as the core indicator. However it is strongly recommended that programmes focusing prevention resources on increasing condom use in commercial sex also construct an indicator of consistent use of condoms in commercial sex. If both questions are asked, the "last time you had sex with a sex worker" question should precede the "always, sometimes, never" question. Where there are several distinct populations of sex workers with different levels of perceived risk-for example, brothel-based prostitutes may be thought of as having riskier behaviour than girls in night-clubs-data may be collected separately for separate categories of sex worker. This can provide important information for programming. For example, men may report very high levels of consistent condom use in brothels, but much lower levels with women working out of night-clubs. This may be a warning signal for a shift of the high prevalence from one group to another. In constructing the indicator, however, only the last commercial sex partner of any sort should be considered.

Further information