Behavioural Surveillance Surveys - The Wisdom of Whores
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Behavioural Surveillance Surveys - The Wisdom of Whores

Behavioural Surveillance Surveys - The Wisdom of Whores Behavioural Surveillance Surveys - The Wisdom of Whores

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Men Who Have Sex With Men Indicator 8 Condom use at last anal sex with a commercial partner Definition Numerator : Number of respondents who report condom use at last anal sex with a male commercial partner whom they are paying cash for sex. Denominator : Number of respondents who report anal sex with at least one male commercial partner in the last 6 months Men Who Have Sex With Men Indicator 9 Consistent condom use in anal sex with commercial male partners Definition Numerator : Number of respondents who used a condom every time they paid for sex with any man over the past 6 months. Denominator : Number of respondents who have paid for anal sex with a man at least once in the past 6 months. Measurement tools Men who have sex with men questionnaire Q403 Measurement tools Men who have sex with men questionnaire Q405 What it measures This measure is the same as Men Who Have Sex With Men Indicator 5 except that it is restricted to condom use at last sex with commercial partners, and includes in the denominator anyone who has paid for anal sex at any time in the last 6 months. What it measures This measure is the same as Men Who Have Sex With Men Indicator 6, except that it is restricted to consistent condom in anal sex with all commercial partners, and includes in the denominator anyone who has paid for anal sex at any time in the last 6 months. 142 C 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

Men Who Have Sex With Men Indicator 10 Men who have risky sex with men and women Definition Numerator : Number of respondents who have had unprotected sex with a woman at least once in the last 6 months, and who have had unprotected anal sex with at least one other man in the last 6 months Denominator : All respondents. Measurement tools Men who have sex with men questionnaire Q405, Q505, Q604, Q605 What it measures Anal sex between men carries a relatively high risk of HIV transmission, especially if partner turnover is high. But many men who engage in this relatively risky sexual behavior also have sex with women. Unless all their sexual acts are protected by condom use, they may therefore be putting their female partners at elevated risk of contracting HIV. This behavior may be especially likely in societies where there is no clearly defined “gay” community, whose members self-identify as homosexual. How to measure it In a survey of men who have sex with men, respondents are asked about their male sexual partners over the last 6 months, and about consistent condom use with those partners. They are then asked about female partners in the last 6 months, and about condom use with those female partners. The numerator is men who report any anal sex with at least one man in the last 6 months and do not report always using condoms with every male partner, and who report sex with at least one woman in the last 6 months and do not report always using condoms with every female partner. The denominator is all respondents. Strengths and limitations This indicator is rather complicated to construct, since it requires several different pieces of data : sex with men in the last six months, consistent condom use with men in the last six months, sex with women in the last six months, and consistent condom use with women in the last six months. It is not, however, difficult to understand. It gives a fairly accurate measure of the proportion of men who have sex with men who put female sex partners at risk because of their male-male sexual practices. This indicator does not qualify as a key indicator because few if any prevention programs work to reduce the proportion of men who have sex with both men and women. However it is of immense value as part of an “early warning system”, one of the prime functions of BSS. The indicator can help to provide warning of the possibility of spread from a sub-population in which HIV may already by concentrated to a wider population of women and their other male partners. B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 9 143

Men Who Have Sex With Men<br />

Indicator 8<br />

Condom use at last anal sex<br />

with a commercial partner<br />

Definition<br />

Numerator :<br />

Number <strong>of</strong> respondents who<br />

report condom use at last anal<br />

sex with a male commercial<br />

partner whom they are paying<br />

cash for sex.<br />

Denominator : Number <strong>of</strong> respondents who<br />

report anal sex with at least<br />

one male commercial partner<br />

in the last 6 months<br />

Men Who Have Sex With Men<br />

Indicator 9<br />

Consistent condom use<br />

in anal sex with commercial<br />

male partners<br />

Definition<br />

Numerator :<br />

Number <strong>of</strong> respondents who<br />

used a condom every time<br />

they paid for sex with any<br />

man over the past 6 months.<br />

Denominator : Number <strong>of</strong> respondents who<br />

have paid for anal sex with a<br />

man at least once in the past<br />

6 months.<br />

Measurement tools<br />

Men who have sex<br />

with men questionnaire<br />

Q403<br />

Measurement tools<br />

Men who have sex<br />

with men questionnaire<br />

Q405<br />

What it measures<br />

This measure is the same as Men Who<br />

Have Sex With Men Indicator 5 except that<br />

it is restricted to condom use at last sex with<br />

commercial partners, and includes in the<br />

denominator anyone who has paid for anal<br />

sex at any time in the last 6 months.<br />

What it measures<br />

This measure is the same as Men Who<br />

Have Sex With Men Indicator 6, except that<br />

it is restricted to consistent condom in anal sex<br />

with all commercial partners, and includes in<br />

the denominator anyone who has paid for<br />

anal sex at any time in the last 6 months.<br />

142<br />

C 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

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