Behavioural Surveillance Surveys - The Wisdom of Whores

Men Who Have Sex With Men
Indicator 7
Men paying for sex with
commercial partners
Definition
Numerator :
Number of respondents who
have paid for anal sex with
another man at least once
over the past 6 months.
Denominator : Total number of respondents
Measurement tools
Men who have sex
with men questionnaire
Q307
What it measures
In homosexual as in heterosexual relations,
unprotected sex with a commercial partner
carries a higher risk of HIV transmission
than with a non-commercial partner. This is
because male sex workers tend to have a
high turnover of partners, so unless they
consistently use condoms they are repeatedly
exposed to the risk of infection. The indicator
gives an estimate of the proportion of men
in the sub-population of interest who are
exposed to particularly high risk partners.
It is similar to Adult Indicator 6, but refers
only to male commercial partners.
This indicator is intended to measure the
proportion of men sampled who are buying
anal sex with other men (whether insertive
or receptive). Where there is an identifiable
population of men selling sex, a separate
questionnaire and sample can be developed
for this sub-population.
Strengths and limitations
This indicator gives an idea of the overall
proportion of men exposed to any commercial
partner. Like Adult Indicator 6, it is not sensitive
to changes that involve the reduction rather
than the elimination of commercial partners.
This indicator includes only men who
have paid cash for sex with other men. It is
recognized that many other exchanges take
place in return for sex. However the spectrum
is wide, and exchange of non-cash items for
sex may not imply that those who accept a gift
or non-cash payment have a particularly high
turnover of partners. Men who accept cash
for sex tend to represent those with highest
partner turnover and highest risk for HIV.
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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