Injecting drug users: safe injecting and sexual practices

Export Indicator

Percentage of injecting drug users who have adopted behaviours that reduce transmission of HIV, i.e, who both avoided using non-sterile injecting equipment and used condoms in the last month  
What it measures

 To assess progress in preventing injecting drug use-associated HIV transmission

Rationale

Safer injecting and sexual practices among injecting drug users are essential, even in countries where other modes of HIV transmission predominate, because: (i) the risk of HIV transmission from contaminated injecting equipment is extremely high; and (ii) injecting drug users can spread HIV (e.g., through sexual transmission) to the wider population.
 

Numerator

Number of respondents who report having never used non-sterile injecting equipment during the last month and who also reported that a condom was used the last time they had sex

Denominator

Number of respondents who report injecting drugs and having had sexual intercourse in the last month

Calculation
Method of measurement

Respondents are asked the following sequence of questions: 1. Have you injected drugs at any time in the last month? 2. If the answer to question 1 is “yes:” Have you used non-sterile injecting equipment at any time in the last month? 3. Have you had sexual intercourse in the last month? 4. If the answers to questions 1 and 3 are both “yes:” Did you or your partner use a condom when you last had sex?
 
Indicator scores are required for all respondents and should be disaggregated by gender and age (<25/25+).
Whenever possible, data for injecting drug users should be collected through civil society organizations that have worked closely with this population in the fi eld.
Access to survey respondents as well as the data collected from them must remain confi dential.

Measurement frequency

Biennial

Disaggregation

Age group: < (less than) 25 years, > (greater than) 25 years

Condom type: N/A

Education: N/A

Gender: Male, Female

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

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

 • Surveying injecting drug users can be challenging. Consequently, data obtained may not be based on a representative sample of the national injecting drug user population being surveyed. If there are concerns that the data is not based on a representative sample, these concerns should be reflected in the interpretation of the survey data. Where different sources of data exist, the best available estimate should be use. Information on the sample size, the quality/reliability of the data and any related issues should be included in the report submitted with this indicator.
• The extent of injecting drug use-associated HIV transmission within a country depends on four factors: (i) the size, stage and pattern of dissemination of the national AIDS epidemic; (ii) the extent of injecting drug use; (iii) the degree to which injecting drug users use contaminated injecting equipment; and (iv) the patterns of sexual mixing and condom use among injecting drug users and between injecting drug users and the wider population. This indicator provides information on the third factor and partial information on the fourth factor.

Further information