Behavioural Surveillance Surveys - The Wisdom of Whores

Adult Indicator 5
Consistent condom use with
non-regular, non-commercial
partners
Definition
Numerator :
Number of male/female
respondents who used a
condom every time they had
sex with any non-regular (i.e.
non-spousal, non-cohabiting
and non-commercial) partner
over the past 12 months
Denominator : Number of male/female
respondents who have had
sex with at least one nonspousal,
non-cohabiting and
non-commercial partner in the
past 12 months.
Measurement tools
Adult questionnaire
What it measures
This provides the measure of consistent
condom use in non-regular sex that is not
provided by Adult Indicator 4.
Q606
How to measure it
Respondents who report non-regular sex
partners are asked about condom use with
the most recent partner of this type, and are
further asked about consistency of condom
use with all non-regular partners in the past
year. Those who report always having used
a condom with every non-regular partner in
the last 12 months form the numerator for this
indicator. The denominator is all men/women
reporting sex with a non-regular partner
(excluding commercial partners) in the last
12 months.
Strengths and limitations
Depending on the respondent’s level of
sexual activity, this indicator may refer to
many different acts of sex with many different
partners. It is therefore likely to be subject to
recall bias. And because the question is asked
in general terms, respondents may be more
than likely to give an answer they believe is
socially desirable than they would be if the
question asked about a specific act of sex,
such as the most recent sex act.
By only including people who say they
always use condoms with every non-regular
partner, this indicator sets the standard for
consistent condom use very high. This may
result in the indicator being measured at low
levels for some years.
It has been suggested that respondents
who report that they use condoms “most of
the time” be included in the numerator.
However this is likely to overstate true levels
of consistent use. The “desirability” bias
mentioned above probably means that many
respondents who truly use condoms “most
of the time” are already included in the
numerator (by overlooking the rare occasions
when they do not use condoms and reporting
that they use them all of the time).
It is especially important to maintain a high
threshold for this indicator where background
HIV prevalence is high, since the protective
value of occasional condom use diminishes as
the likelihood of encountering an infected
partner rises.
B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 9
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