Behavioural Surveillance Surveys - The Wisdom of Whores

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Youth Indicator 9 Youth using condoms at first sex Definition Numerator : Number of male/female respondents who used a condom the first time they ever had sex Denominator : Total number of male/female respondents who have ever had sexual intercourse. Measurement tools Youth questionnaire Q202A What it measures It is generally believed that it is easier to maintain safe behaviors established from the onset of sexual activity than to change risky behaviors once they have become habitual. In addition, data from a number of serosurveys suggest that in high HIV prevalence areas, very high proportions of young women become infected with HIV during their first few acts of sex. The physical trauma caused by the rupture of the hymen may contribute to a high likelihood of infection during first sex. Life skills programs for young people have therefore concentrated on promoting safe behavior right from the beginning of young people’s sex lives. This indicator measures progress towards establishing safe behavior from the outset of people’s sexually active lives. The indicator should of course be disaggregated by gender. Disaggregation by age and concentration on 15-19 year-olds will increase the sensitivity of the indicator to recent changes in condom use at first sex. Strengths and limitations One limitation of this measure is that where it is high, it may create a false sense of complacency. HIV and STIs are far from being the only concern for young people. Many adolescents are more concerned about the immediate threat of pregnancy than they are about HIV and STIs. Integrated life skills and reproductive health programs for young people stress avoiding unwanted pregnancies as much as they stress avoiding STIs, including HIV. High levels of condom use at first sex may in fact reflect growing use of condoms as a use of contraceptives. When sexual activity becomes more regular, young women may adopt longer-term forms of contraception, and abandon condom use. Because of this, it is important to present this indicator in conjunction with other indicators of condom use among young people. 126 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 10 Commercial sex among young men Definition Numerator : Number of unmarried male respondents who report at least one commercial partner in the last 12 months. Denominator : Total number of unmarried male respondents. Measurement tools Youth questionnaire Q206 What it measures This measure is identical to Adult Indicator 6., except that the denominator is restricted to unmarried men aged 15-24. Youth Indicator 11 Condom use at last commercial sex among young men) Definition Numerator : Number of unmarried male respondents who report condom use during their last act of commercial sex Denominator : Number of unmarried male respondents reporting at least one commercial partner in the last 12 months. Measurement tools Youth questionnaire Q303 What it measures This measure is identical to Adult Indicator 8, except that the denominator is restricted to unmarried men aged 15-24. B EHAV I OR A L S U R V EI L L A NC E SURVS U R V EY S CHAPTER Chapter 9 127
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BEHAVIORAL SURVEILLANCE SURVEYS GUI
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Family Health International (FHI) H
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Chapter 7 Analysis and interpretati
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3. Choosing populations for behavio
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G UIDELINES FOR REPEATED BEHAVIORAL
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Recognizing that HIV surveillance d
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Different approaches to collecting
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The principal rationale for focusin
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It is not possible to validate data
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GUIDELINES FOR REPEATED BEHAVIORAL
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The process of building partnership
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Funders of HIV prevention activitie
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What is to be measured ? Indicators
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Step 7 : Constructing a sampling fr
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Step 12 : Data collection and super
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choosing population groups GUIDELIN
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the spread of HIV. For this reason,
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In some circumstances, public healt
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The majority of sub-populations of
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In the end, the issue boils down to
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In looking at behaviors of hard-to-
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Maps derived from program planning
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Selecting primary sampling units (c
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...when measures of size are not av
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If there is no reason to believe th
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Figure 3 : Decision tree for first-
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Implications of alternative samplin
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Table 5 : Values of Z 1-α and Z 1-
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Table 6 : Sample size requirements
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equired. In this case, the pros and
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Should one- or two-tailed z-score v
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Other measurement issues for BSS Th
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A “low-tech” solution to the pr
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5 Weighting in multi-stage sampling
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Figure 6 : Procedures for calculati
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Calculating weights from sampling p
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Calculating standard errors with mu
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6 Adapting and using questionnaires
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Some attempts have in the past been
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Informed consent Confidentiality an
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Recommended Methods of Statistical
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Page 89 and 90: Table 2 : Reported number of non-re
Page 91 and 92: False conclusions: the danger of co
Page 93 and 94: Analysis of trends in behavior over
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Page 97 and 98: 8 Using the data collected to impro
Page 99 and 100: Improving prevention programs As a
Page 101 and 102: Finally, information about HIV and
Page 103 and 104: Figure 9 : HIV and STD prevalence,
Page 105 and 106: 9 Indicators This guide identifies
Page 107 and 108: The standard questionnaires are acc
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Page 111 and 112: INDICATORS Page INDICATORS FOR MEN
Page 113 and 114: KEY INDICATORS What follows is a fu
Page 115 and 116: The indicator uses promoted data. O
Page 117 and 118: To be counted the numerator for thi
Page 119 and 120: Strengths and limitations Some meas
Page 121 and 122: Adult Indicator 5 Consistent condom
Page 123 and 124: Adult Indicator 7 (men only) Number
Page 125 and 126: Adult Indicator 9 Consistent condom
Page 127 and 128: Adult Indicator 11 Population seeki
Page 129 and 130: Adult Indicator 12 Exposure to inte
Page 131 and 132: Youth Indicator 2 No incorrect beli
Page 133 and 134: Youth Indicator 4 Youth sexually ac
Page 135 and 136: Youth Indicator 6 Number of sexual
Page 137: Youth Indicator 8 Consistent condom
Page 141 and 142: Youth Indicator 14 Exposure to inte
Page 143 and 144: Female Sex Worker Indicator 2 No in
Page 145 and 146: Female Sex Worker Indicator 5 Sex w
Page 147 and 148: Indicators for men who have sex wit
Page 149 and 150: Men Who Have Sex With Men Indicator
Page 151 and 152: Men who have sex with men Indicator
Page 157 and 158: Indicators for injecting drug users
Page 159 and 160: Injecting Drug User Indicator 3 Inj
Page 165 and 166: Injecting Drug User Indicator 8 Dru
Page 167 and 168: Injecting Drug User Indicator 10 Dr
Page 169 and 170: Suggested Reading Brown T, Sittitra
Page 171 and 172: QUESTIONNAIRE For Adult Target Grou
Page 173 and 174: The ADULT questionnaire includes th
Page 175 and 176: FHI 1999 HIV/AIDS/STD BEHAVIORAL SU
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FHI 2000 HIV/AIDS/STD BEHAVIORAL SU
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POSSIBLE ADDITIONAL QUESTIONS Commu
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STD Treatment seeking behaviors No.
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STD Treatment seeking behaviors (co
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QUESTIONNAIRE For Unmarried Male An
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The YOUTH questionnaire includes th
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No. Questions and filters Coding ca
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Stigma and Discrimination No. Quest
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FAMILY HEALTH INTERNATIONAL (FHI) H
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STD Treatment seeking behaviors No.
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STD Treatment seeking behaviors (co
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QUESTIONNAIRE For Men Who Have Sex
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The MSM questionnaire includes the
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STD Treatment seeking behaviours No
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No. Questions and filters Coding ca
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QUESTIONNAIRE For Injecting Drug Us
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This questionnaire includes the fol
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EXAMPLE OF SUPERVISORS’ AND INTER
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A “take-all” approach is to be
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• To probe for additional informa
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Part B: How to use the Long Distanc
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An example of a question for which
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Part C: Section-by-section review o
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Q109. If the respondent says he/she
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it is asking if the respondent has
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Section 5 : Non-regular partners Q5
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Q706 : This question determines the
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Q910 - Q912 : Knowledge of maternal
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in riskier behavior (i.e., not usin
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Section 5 : Non-paying partners Que
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3 APPENDIX WORKING EXAMPLES OF SAMP
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For the purposes of the BSS, the ke
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The second stage sampling procedure
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Notes: 1. It may not always be poss
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The information from the mapping ex
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In Figure 3, clusters were chosen b
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Fieldwork assignments when the “t
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Figure 4 : Example of targeted snow
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In some settings it may not be acce
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Figure 6 : Steps in using the segme
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Figure 9 : Map of hypothetical samp
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In-class sampling of school youth T
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Alternative to “in-class” sampl
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found at the various locations at d
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What should be done if, even after
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FIELDWORK FORMS The following set o
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Form I Cluster Selection Sheet (Pro
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Form 2 Cluster Selection Sheet (Equ
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Form 3 Assignment Information Sheet
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Form 4 Cluster Information Sheet Su
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TABLE OF CHI-SQUARE STATISTICS AND
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Step 2 : Calculate the expected num
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Behavioural Surveillance Surveys - The Wisdom of Whores

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