Sexual decision-making among young people
This indicator measures whether young people feel confident that they have some degree of control over their sexual lives and activities. Related to self-efficacy at the individual level, it reveals the extent to which young people feel capable of protecting themselves. If young people feel that sex is something that happens to them over which they have little control, they will probably be unable to avoid unwanted sex, or demand the use of condoms.
The number of young people who feel that they have the ability to refuse unwanted sex.
All young people.
For the numerator, culturally appropriate questions about young peoples perceived ability to refuse sex should be developed, e.g. If you did not want to have sexual intercourse, how confident are you that you would be able to refuse it? Possible responses and scores corresponding to this question would be:
definitely could not (0);
probably could not (1);
probably could (2);
definitely could (3).
In an interviewer-led survey these options would be read out to the respondent, who would be asked to choose one of them. In order to calculate the indicator as a percentage the probably could or definitely could answers can be classified as Yes and the others as No. Alternatively, the distribution of all the answers can be presented as percentages totalling 100% for each subgroup of interest, e.g. male and female, age groups.
This indicator should be presented separately for males and females, disaggregated by age in following groups: 15-19, 20-24 and 15-24 years (six categories).
Age group: 15 years - 19 years, 15 years - 24 years, 20 years - 24 years
Gender: Male, Female
Geographic location: N/A
Pregnancy status: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
This indicator is useful because it measures an essential attribute of the context in which young people live and their perceptions of it. If young people perceive that the context or cultural environment in which they live limits their power to refuse or negotiate sex, efforts in HIV prevention must be tailored accordingly and the evaluation of existing prevention efforts must take this limitation into account. If more in-depth information is desired concerning the types of sexual relationships and situations of young people, this question can be expanded, e.g. to cover the ability to refuse sex with a longterm partner, with someone who offers money or gifts, or with someone who holds power over the respondent, such as a teacher or employer. Additionally, respondents can be asked if they are confident of being able to negotiate condom use. This question could be expanded to cover the ability to use a condom after drinking or taking drugs, to insist on condom use even if a partner is reluctant, and to refuse sex if a condom is not used.
For further insight into how such questions are formulated, reference can be made to the FOCUS guide.