Behavioural Surveillance Surveys - The Wisdom of Whores

Adult Indicator 7 (men only)
Number of commercial
partners in the last year
Definition
Option 1 :
Option 2 :
Numerator :
Median number of commercial sex
partners in the last 12 months
Number of male respondents
who have had sex with more
than x commercial partners in
the past 12 months
Denominator : Total number of male
respondents
Measurement tools
Adult questionnaire
Q304
What it measures
High partner turnover is a prime determinant
of the early sexual spread of HIV. Sex workers
and their regular clients often contribute
disproportionately to the early spread of the
virus, and clients also provide a “bridge”
though which HIV can pass into the general
population. Adult Indicator 5 measures the
proportion of men in the respondent groups of
interest that have any contact with commercial
sex workers, but it is not sensitive to reductions
in frequency of commercial sex, or overall
numbers of commercial partners. This indicator
attempts to give an idea of reductions (rather
than elimination) of risk behavior. It is intended
principally for use among men whose
occupations or social situation create the
conditions for the frequent purchase of sex.
How to measure it
Respondents are asked whether they have
had sex in the past 12 months, and if so,
whether they have had sex with a spouse or
regular partner, with a non-regular partner,
or with a commercial partner. They are
further asked how many partners they have
had of each type in the previous year. This
indictor is calculated using information about
the third category only. For this indicator the
“threshold” number of commercial partners
should be defined locally. Since the purpose
of an indicator is to measure changes in risk
behavior over time, it is suggested that this
threshold be derived from the first round of
surveillance There may be wide variance in
the number of commercial sex partners, so a
measure of the mean number of partners may
be hard to interpret. Reductions in the median
number of partners would be encouraging.
Because HIV prevalence in sex workers
has reached high levels in many countries,
and any unprotected sex with sex workers
carries a high degree of risk, it is suggested
that any threshold be set fairly low. One
suggestion would be to set the threshold at
the median number of commercial partners
measured in the first round of surveillance.
Strengths and limitations
This indicator shares the strengths and
limitations of Adult Indicator 3.
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