Behavioural Surveillance Surveys - The Wisdom of Whores
Behavioural Surveillance Surveys - The Wisdom of Whores Behavioural Surveillance Surveys - The Wisdom of Whores
certain age will be six months older than that age. (For example those who say they are 15 will range from those who turned 15 on the day of the survey to those who will turn 16 the following day. Assuming an even age distribution, they will be on average 15.5). Half a year should therefore be added to the exact ages used in the calculation of the median age at first sex. Strengths and limitations Because this indicator is constructed from a question about current virginity status, it is sensitive to recent changes in the age at first sex. The indicator itself does not, however, give any idea of the full distribution of ages at sexual initiation. In some circumstances, such as when a significant proportion of girls are exposed to sex at very young ages, it may be the tails rather than the middle of the age curve which interest those designing prevention programs. Most questionnaires also include questions such as “How old were you when you first had sex?”. These data are NOT used in the construction of this indicator. This is because they exclude people who have not yet had sex, and therefore tend to bias the median age downwards. Retrospective data can be used from age cohorts at which virtually everyone is already sexually active. However an indicator constructed in this way is not sensitive to recent changes in the age at first sex, and it is these recent trends that are of interest in monitoring the success of HIV prevention programs. The indicator is most useful where the median is rather young — between 15 and 19 years. Where the median age at first sex is over 19 for both men and women, promoting abstinence among adolescents may be replaced by other priority interventions within the program and this indicator will diminish in importance and may not even be measured. To allow for the construction of a robust indicator using this “current status” methodology, reasonable sample sizes are needed at each single year of age (preferably at least 100 respondents of each sex in single years, especially the single years at which the median age is expected). 120 Chapter H A PTER 9 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S
Youth Indicator 4 Youth sexually active Definition Numerator : Number of respondents reporting having had sex in the last 12 months. Denominator : Total number of respondents surveyed. Measurement instrument Youth questionnaire Q205 What it measures This indicator is a measure of sexual activity among young people. Because the youth questionnaire is designed for young people who are not married, it amounts to an indicator of premarital sex. A high score on this indicator reflects a failure of prevention messages stressing abstinence until marriage. How to measure it In a survey among unmarried people aged 15-24, respondents are asked about sexual activity. Those that report any sex partners in the last 12 months enter the numerator. The denominator is all respondents. Like all indicators of sexual behavior, this should be reported separately for men and women. It may also be constructed separately for those aged 15-19 and 20-24, as appropriate. In some settings, the proportion of 20-24 years olds who are single will be very low, at least among women, and it may not be appropriate to construct the indicator for this age group in these cases. Strengths and limitations This indicator has a critical role in advocacy. Resistance to improved sexual education and service provision for young people frequently comes from parents or other authorities who believe that abstinence until marriage is the only acceptable message for youth. An indicator that tracks premarital sex tracks the success or failure of this message and may point to gaps in the current approach. B EHAV I OR A L S U R V EI L L A NC E SURVS U R V EY S CHAPTER Chapter 9 121
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Youth Indicator 4<br />
Youth sexually active<br />
Definition<br />
Numerator :<br />
Number <strong>of</strong> respondents<br />
reporting having had sex<br />
in the last 12 months.<br />
Denominator : Total number <strong>of</strong> respondents<br />
surveyed.<br />
Measurement instrument<br />
Youth questionnaire<br />
Q205<br />
What it measures<br />
This indicator is a measure <strong>of</strong> sexual<br />
activity among young people. Because the<br />
youth questionnaire is designed for young<br />
people who are not married, it amounts to an<br />
indicator <strong>of</strong> premarital sex. A high score on<br />
this indicator reflects a failure <strong>of</strong> prevention<br />
messages stressing abstinence until marriage.<br />
How to measure it<br />
In a survey among unmarried people aged<br />
15-24, respondents are asked about sexual<br />
activity. Those that report any sex partners<br />
in the last 12 months enter the numerator.<br />
<strong>The</strong> denominator is all respondents.<br />
Like all indicators <strong>of</strong> sexual behavior, this<br />
should be reported separately for men and<br />
women. It may also be constructed separately<br />
for those aged 15-19 and 20-24, as appropriate.<br />
In some settings, the proportion <strong>of</strong> 20-24 years<br />
olds who are single will be very low, at least<br />
among women, and it may not be appropriate<br />
to construct the indicator for this age group<br />
in these cases.<br />
Strengths and limitations<br />
This indicator has a critical role in advocacy.<br />
Resistance to improved sexual education and<br />
service provision for young people frequently<br />
comes from parents or other authorities<br />
who believe that abstinence until marriage<br />
is the only acceptable message for youth.<br />
An indicator that tracks premarital sex tracks<br />
the success or failure <strong>of</strong> this message and may<br />
point to gaps in the current approach.<br />
B EHAV I OR A L S U R V EI L L A NC E SURVS U R V EY S CHAPTER Chapter 9<br />
121